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Saturday, August 13, 2022

Explained: Making sense of the Covid-19 spike in India

Active cases in Maharashtra have risen 15 times in a month, with even previously infected people catching the virus. What explains the spike, how different are the symptoms, and what precautions should you take?

Written by Dr Rahul Pandit | New Delhi |
Updated: June 21, 2022 8:37:12 am
Vaccination at a Navi Mumbai Hospital last week. (File photo)

Covid-19 has spiralled in Maharashtra once again, with the positivity rate hovering around 10%. As of June 19, active cases stood at 23,746, a 15-fold spike from May 16, when the count was just 1,526. Cases have also been jumping in most metros. Dr Pandit spoke to Rupsa Chakraborty.

A number of previously infected people are again contracting Covid-19. Is there any evidence that antibodies from previous infections are waning?

It is well-known that viruses always try to mutate and produce new lineages or sub-lineages to escape acquired immunity. There is no precise data available about the sub-lineages of Omicron, but the immunity conferred by Omicron is lower than that provided other variants like Delta. Therefore, reinfection has become common. It is a well-established fact that antibodies do not mean that a person will not get infected, but they will experience milder symptoms. So, it is quite evident that having a higher number of antibodies does not necessarily mean one can quickly overcome any new infection.

People who have taken two vaccines doses too are getting infected. Is the efficiency of vaccine reducing?

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Vaccines will confer sterilising immunity on everyone. They provide us immunity against severe diseases and mortality. These are generation one vaccines made from the ancestral strain. Besides, it has never been claimed that vaccinated people will never get infected. Also, if one gets infected, the chances are that they will be asymptomatic or have minor symptoms.

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Some patients are complaining of high fever, touching almost 105°F. Are there any symptomatic differences between the new bout and earlier ones?

I don’t think many patients have reported 105° fever, and it might have been a rare aberration. We haven’t observed such a high fever in patients although some of them had high-grade fever of 101-102°F with some throat pain. Most patients get better within four to five days and do not require hospitalisation.

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Some other symptoms that patients are currently experiencing include tiredness, body ache, runny nose and mild cough. Apart from that, some gastro-intestinal symptoms are also being observed, like diarrhoea and a tender stomach.

Why are some patients are experiencing gastro-intestinal issues after recovery?

Most patients in their post-recovery phase are experiencing significant symptoms like fatigue, sleep disturbance and inability to concentrate. They also have specific body aches and pain, especially joint pains. Some of them even have resting tachycardia, or Inappropriate sinus tachycardia (IST).

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While gastro-intestinal (GI) symptoms are not a part of the post-viral condition itself, they could be part of viral illness. This may be because the virus can cause GI disease that could last longer even after the person has recovered from other symptoms. Further, loss of appetite and change in bowel habits are some of the symptoms that have been associated with Covid-19.

What are the reasons behind the surge in Maharashtra?

The main reason behind the surge is that the virus follows a pattern of resurgence and retreat. Also, for the last several months, people are not following the necessary precautions to avoid transmission. It is due to this Covid-inappropriate behaviour that the virus is still in circulation. Hence, we are seeing a rise in the number of cases in a few districts and cities across Maharashtra.

Are we heading towards a fourth wave? If yes, will this be more infectious?

The fact is that the cases are rising rapidly and there is no evidence to suggest that the situation is different in terms of infectivity and severity as compared to the third wave. However, there is a similar pattern that has been observed currently.

Should the Maharashtra government and the Brihanmumbai Municipal Corporation focus more on testing?

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Testing has been one of the main strategies to control the disease, and we need to evolve and develop an intelligent strategy. Smart testing means that we should study more symptomatic patients and all their high-risk contacts. We ought to increase the capacity of testing so that we can isolate the infected and avoid any further spread of the infection.

Maharashtra is behind other states in vaccine coverage. What steps should the state take?

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Maharashtra is one of the largest states in India with a population of over 12 crore. Also, the population density is very high. When the number of cases goes down, many people stop following Covid-19 protocols. So, they are equally lax about not taking their booster shots. That’s why we need to go back to information, education and communication and get the message across that vaccines can save lives. There is enough data to prove that vaccines are one of the most important strategies to prevent severe illness and mortality. We need to understand their importance and convince people to take their precautionary doses so that the virus can be controlled.

Are we heading towards an endemic situation?

Eventually, we will head towards an endemic situation. Whether we have reached that stage or not right now, it is too early to say as Covid-19 is here to stay with us for some time. That is why we must learn to live with the virus and not let it disrupt our daily lives. We need to work towards keeping ourselves and our loved ones safe by following Covid-appropriate behaviour. Masking up should become a regular healthy habit that we must practise every day.

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First published on: 20-06-2022 at 04:00:16 am
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