‘Immunity conferred by Omicron is lower than Delta’

Once again, Covid-19 has spiralled in Maharashtra with the positivity rate hovering around 10 per cent. As of June 16, active cases stood at 20,634, a 13-fold spike from May 16, when the total number was just 1,526. Not only that, cases are jumping with alarming speed in most metros.

Q) A lot of previously infected patients are again contracting Covid-19. There are claims that the protection acquired against other variants is ineffective against the new ones. Is there any initial 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 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 mild symptoms. So, it is quite evident that having a higher number of antibodies does not necessarily mean one can quickly overcome any new infection.

Q) People with two doses of vaccines are also getting infected. Is it because the efficiency of the vaccine is reducing with time?

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Vaccines will confer sterilizing 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.

Q) Some patients are complaining of high fever, almost touching 105 degree Fahrenheit. Are there any symptomatic differences being observed in the recent bout compared to the past? What are the key symptoms to watch out for?

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

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.

Q) Some doctors have observed that patients are experiencing gastro-intestinal issues post-recovery. How do you explain this?

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, which is called Inappropriate Sinus Tachycardia (IST). 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.

Q) Over the last 15 days, the number of Covid-19 cases has surged drastically in Maharashtra, especially in cities like Mumbai, Thane and Pune. What are the main reasons behind the surge?

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 precaution to avoid transmission. It is due to this Covid-inappropriate behavior 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.

Q) Are we heading towards a fourth wave? If yes, will this be more infectious than the previous ones?

The fact is that the cases are rising rapidly and there is no 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.

Q) Last December — before the third wave commenced — the Brihanmumbai Municipal Corporation conducted over 35,000 daily tests, which has now dropped to below 10,000. Should the state and the civic body focus more on testing?

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.

Q) Maharashtra is lagging far behind in vaccine coverage compared to other states. The response to booster doses is also lukewarm. What steps should the state take to close the gap?

Maharashtra is one of the biggest 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.

Q) Are we heading towards an endemic? What does the future hold for us?

Eventually, we will head towards an endemic situation. Whether we have reached that stage or not right now 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 habit that we must practice every day.


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