The first 14 days of January will be crucial on how COVID-19 progresses in India: Dr Randeep Guleria

The first fortnight of January will be crucial in the way COVID-19 takes hold in India, said Dr Randeep Guleria, pulmonologist and former director of the All India Institute of Medical Sciences (AIIMS).

Speaking on the growing concern of a possible new wave of coronavirus in India, following the recent spike in the BF.7 Omicron variant in China, Dr Guleria said, “The first 14 days of January will be crucial for us to watch out for COVID-19, as people travel and come back.”

In an exclusive interview to Moneycontrol, Dr Guleria said, “As people travel and come back, and then you have an incubation period, which may be five to seven days, you will come to know if there is a surge in the number of cases as far as travel-related transmission of infection is concerned.”

Emphasising the need to closely monitor COVID-19 cases during the next month, he recalled the events of 2019 that resulted in global pandemonium. “It started with the Chinese New Year and a lot of people from Wuhan travelling to Italy and Europe and carrying with them the infection there. And then we had this huge surge of cases in Europe, especially in Italy. So, that had a ripple effect for many weeks and months,” he said.

Last time, the surge in cases happened right after the holiday season as many people travelled and airports witnessed heavy crowding. According to Dr Guleria, people can continue to travel as long as they are vaccinated and follow COVID-appropriate behaviour.

“Those who have not taken the third shot, that is the booster dose, should come forward and take it,” recommended Dr Guleria. He added that the US and Europe are administrating bivalent vaccines (covering SARS-CoV and Omicron), although its use in India is to be watched as the data surrounding its efficacy is still not “strong”.

The symptoms of the latest variant remain largely the same as of the other variants. “We also find that some people have hyperactive airways. The airways become more sensitive, and slight exposure to dust/change of temperature brings on a spasm of cough.”

However, according to Dr Guleria, “The virus, in some cases, causes individuals who may be genetically predisposed to more irritation of the airways and the throat, to (suffer from) persistent spasmodic cough for many weeks. And in some of these patients, we've actually had to give inhalers for it to settle down. But it does improve over the next two, three months.”

Dr Guleria insisted that everyone who experiences fever, sore throat, running/blocked nose, head ache, body aches, or persistent cough, which is usually dry but may contain a little bit of sputum, should get tested for COVID-19.

Underlining the need for getting the RT-PCR test done, Dr Gulleria said that data collected through tests could help in formulating policies. “The sample can also be evaluated for genome sequencing and we will know what is the variant which caused the infection. Is it the older variant? Is it a different lineage? Is it BF.7 or something else?”

Cautioning against hoarding medicines, Dr Gulleria said that the number of patients who are being admitted requiring antiviral drugs like Remdesivir, steroids or drugs like Tocilizumab is almost zero right now.

“We are seeing predominantly most of our patients who turn out to be COVID positive being given symptomatic treatment – paracetamol, some treatment for cold and cough like anti-allergic and anti-stimulant treatment, and supportive treatment like multivitamins, maintaining their hydration, and they recovered within about five to seven days.”

“Because if you are vaccinated, if you are having some degree of immunity, then the current strain that we've seen, although more infectious, having a higher chance of causing infection, is not causing severe infection, not causing hospitalisations, and not causing deaths as far as our population is concerned,” he said.

Dr Guleria said that China’s Zero COVID policy had become “counterproductive” as a large part of their population which had never been exposed to the virus in its milder form, and could not build immunity against it, is now getting easily infected.

Secondly, the vaccination uptake in China has been low, he said, adding that the efficacy of the Sinovac vaccine is debatable. “There is really no data as to how effective they are against the new variants and it seems that they are not working effectively as far as the new variant is concerned,” he said.

According to Dr Guleria, the Zero COVID policy, low vaccination uptake, and no data on Chinese vaccination efficacy combined with the BF.7 strain have led to the mass infection and hospitalisations in China.

Explaining the trend of BF.7 in India, Dr Guleria said that India has been lucky with the new variant. “If you have immunity against the Omicron variant, you may still get the infection, but your immune system, which has geared up and has antibodies against this virus, will not allow it to cause severe illness, will not (need) hospitalisation, and will protect you against death. And that is what we are seeing.”

Advising those above the age of 80 to be extra careful, Dr Guleria said since morbidity and mortality increase with rising age, people have to be extra careful in terms of wearing their masks properly, and avoiding overcrowded areas.

People who are immunocompromised, on chemotherapy or with low immunity need to be careful as well. Dr Guleria advised all to take booster doses, saying, “If these individuals have not taken their booster shots, then they should come forward and take it because many individuals now feel that COVID-19 is more or less over in India and they don't need to take the booster shot.”

Dr Guleria advised parents to get their kids immunised for COVID-19. “Parents get their children immunised against various diseases, including diphtheria, pertussis, and tetanus. Similarly, they should get them vaccinated against COVID-19 too.”