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Wednesday, October 27, 2021

Last of Covid not over yet, goal to ensure zero deaths: Dr Shashank Joshi

Much to look forward to on the treatment front with the promise of first oral pill against the disease, says member of Maharashtra Covid task force

Written by Anuradha Mascarenhas | Pune |
Updated: October 12, 2021 12:38:33 pm
Covid has been relentless and while the last of Covid is not over yet, there is much to look forward to on the treatment front with the promise of a first oral pill against the disease,” says Dr Joshi (Express photo)

Even as the number of Covid-19 infections in the state — and the country — has stabilised, the last of Covid is still not over although there is a lot to look forward to in terms of treatment against the disease, said Dr Shashank Joshi, member of Maharashtra Covid task force and renowned Mumbai-based endocrinologist.

Twenty months into the pandemic, Dr Joshi said the current goal of the task force is very clear – to ensure zero Covid deaths.

“Covid has been relentless and while the last of Covid is not over yet, there is much to look forward to on the treatment front with the promise of a first oral pill against the disease,” Dr Joshi, who was recently felicitated at a function by Maharashtra Governor Bhagat Singh Koshyari for his exemplary services during the pandemic, said.

Dr Joshi said the last 20 months have been challenging. “We were suddenly embraced by an unknown virus and did not know its behaviour. It allowed me the opportunity to study the virus and its interaction with humans – what were the risk factors, how it was different across Maharashtra and how the virus is now getting into an endemic-like state,” he added.

The experts in the task force have been meeting every week, framing Covid protocols and gathering key learnings. “We soon understood that Covid has a timetable of two to three weeks and that post-Covid syndrome can last for 100 days. The second week was most crucial. Many people who were asymptomatic in the first week suddenly deteriorated in the second week and died. In the second wave, early detection was possible. However, the virus was spreading faster and science soon showed us that air ventilation was key to the spread,” Dr Joshi said.

Dr Joshi’s experience in public health in the HIV pandemic back in 1989 allowed him to crystallise a thought process that helped during the management of the present Covid pandemic. “We were reading what was published, seeing what was happening and correlating to a scientific direction and then developing clinical protocol and guidelines,” he said.

Emphasising that the last of Covid was still not over, Dr Joshi said, “We have observed that after a wave comes in the United States, India follows three months later. While disruption-free Covid will only happen when total vaccination is achieved, there is a possibility of one more disruption between April and July 2022. The entire public health approach has been on stepping up preparedness,” Dr Joshi, who is also the Chairperson of International Diabetes Federation – South East Asia, told The Indian Express.
Maharashtra has reported more than 65.8 lakh Covid infections and 1.39 lakh deaths. While the state has gradually lifted Covid restrictions, Dr Joshi said rise in infections has not been exponential. “Of course, there should be micro containment in geographies where the virus is in circulation but our current goal is very clear – we want zero Covid deaths. Apart from the cocktail of antibodies that can be given in the first 72 hours, one promising drug is now Merck’s molnupiravir that can cut the risk of severe disease and death by half. Five Indian companies have done trials and Merck has tied up with them so that the drug is easily available in the country,” Dr Joshi said. “We hope that soon the drug will be (available) along the lines of oseltamivir that was used to treat H1N1 virus,” he added.
Dr Joshi said there is no major new variant of concern, adding a third wave will come in a small way in December-January and will be a mutated one. “Vaccination coupled with exposure to the virus means there is some level of herd immunity,” he said.

“There are still several unknown areas as we do not know the nature of immunity generated by vaccines versus those generated by natural infection – currently, it is hypothesised that the best immunity is among people who have had the infection and have also been vaccinated,” Dr Joshi said. He said there is a lot of unpublished data on long Covid. “At times, I feel like taking a sabbatical, collating data and getting into research so that we get a better scientific understanding,” the expert added.

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