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3 top doctors weigh on the second wave of the virus, limited lockdowns and what next

Medical experts remain divided on when the Second Wave is going to peak and how long it could take to subside

April 27, 2021 / 12:40 PM IST
Representational image

Representational image

As the Second Wave of the coronavirus ravages lives and businesses, India is wiser with the benefit of hindsight. Doctors are agreed on a few aspects of this new, seemingly unstoppable Second Wave.

One, the country started to celebrate too early the end of the first wave of the coronavirus, whereas nothing of the sort was visible on ground.

Two, experts sent out enough warning signals to the government to double and treble up vaccination, which was overlooked.

Three, there is a very high probability that there is going to be a third, and possibly a fourth wave as well.

Four, this second calamitous wave could peak around the first week of May, though some say it could last out until the end of May.


COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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Five, the limited lockdown is fetching dividends; while Maharashtra has seen a turnaround, the other affected areas like the National Capital Region (NCR) could benefit in the days ahead.

The Association of Healthcare Providers (AHPI) shot off repeated communications to the government. On March 8, 2021, AHPI suggested that the government open up the vaccination for the rest of the population.

“`While current provision for 60 plus and 45 plus with co-morbidity, can continue to be provided at a subsidised rate of Rs. 250, the government may open up the vaccination through open market to hospitals at a rate as deemed appropriate by the government. To begin with, such a facility may be set up at hospitals with 100+ beds,” said the APHI note.

Then again on April 16 this month, the APHI pleaded with the government to “strictly enforce proper usage of masks, which needs renewed promotion through education as well as through strict administrative measures. It is simple, yet far more effective in preventing transmission; Making available and ensuring that vaccination coverage is adequately and effectively carried out involving private setups across the country to all adults as early as possible and ensuring uninterrupted supply of oxygen and vital drugs.” But there was no response, per doctors.

Moneycontrol spoke to three senior doctors, battling the pandemic in the field, to see how they read the situation.

Dr MC Mishra, Former Director, AIIMS:

Is a lockdown the answer to flatten coronavirus’ curve?

While it is true that no one wins in a lockdown, people are now realising that this short lockdown of two to three weeks has helped. Maharashtra has affected a turnaround and Delhi, too, could be coming under control.

When will this deadly Second Wave peak, in your estimate?

The peak of the second wave should come in the first week of May. It is important to remember that the first wave never went away – we thought it had gone, but that was never the case. Likewise, the second wave will not go away. It will taper down.

What next?

Most certainly there would be a Third and even a Fourth wave. The virus does not go away so soon. It always finds a home. My estimate is that India will get a handle on coronavirus by the end of the year when about 70-80 percent of the population is vaccinated. It is certainly a tall order. Now about 15 percent of the population is vaccinated. Once the private sector gets involved and the government boosts its efforts, I believe we can cover 70-80 percent of the population by the end of the year.

What is your take on the vaccine pricing controversy?

Look let’s face it. A vast majority of people in India do not pay for their health, unlike the West. Even if the people pay Re 1 per day, it works out to Rs 130 crore and many health initiatives can be planned. I also feel that insurance companies need to reimburse people, who are paying for their vaccines.

Dr Alex Thomas, National President, Association of Healthcare Providers (AHPI)

How would you describe the pandemic situation today?

The situation is precarious. The reports that we have from our state units suggest that while Assam and North East are better off than the rest of the country, they too are slowly catching up and their numbers are going to go up.

What are the main problems that you foresee in the days ahead?

Distributing oxygen is a huge problem and will continue to remain so for some time to come. There is a shortage of beds and doctors. There are serious infrastructure woes. We have been advising the government for a long time to open up vaccination. Yet, no one took any notice. So many deaths could have been avoided, only if we had been more careful.

When will the second phase peak and when will the curve flatten?

Our hunch is that the second phase of the pandemic will peak in the first week of May. It will take a couple of weeks, at least, before it plateaus. There is a lot of hard work that lies ahead of us and we need to be very careful.

What next?

There is a strong probability of a Third Wave. We cannot afford to be complacent like we did during the First Wave. There are huge lessons to learn from the First Wave disaster. If we are not careful, I believe that the worst is yet to come.

Dr Giridhara R Babu, Epidemiologist   

When will the Second Wave peak, in your estimate, and when do you see a decline?

Some projections indicate that around May 17, India will have 33 million total cases compared to 14.8 million cases, adding over 18 million in the intervening period. Guess this will be the peak of the Second Wave, as per this model that I am quoting. The INDSCI-SIM epidemiological compartmental model for COVID-19 in India predicts that India-wide peak is more likely to be slower sometime between mid-May and early-June. INDSCI-SIM is the first detailed, state-specific, epidemiological compartmental model for COVID-19 in India.

What did India get wrong after the first wave?

India started celebrating too early. But now, hopefully, we have learnt our lessons. The strictest possible curbs need to be in place. All current cases must be handled with care. Resources mobilisation must be of the highest order. The supply chain mechanism must be in place, functioning smoothly. The typical Indian system of chronic mismanagement and mishandling must go.

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Ranjit Bhushan is an independent journalist and former Nehru Fellow at Jamia Millia University. In a career spanning more than three decades, he has worked with Outlook, The Times of India, The Indian Express, the Press Trust of India, Associated Press, Financial Chronicle, and DNA.
first published: Apr 27, 2021 12:40 pm
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