Of waves and variants
Posted 10 Jan 2022 | Source: bangaloremirror.indiatimes.com/

Delta is easily the most dangerous variant while Omicron s the most transmissible; experts say it’s time we stop taking Covid for granted

When Covid hit the country for the first time in March, many believed that the virus may not survive in the harsh summers of the Indian sub-continent. In spite of lockdowns, the first wave peaked in September-October 2020 before subsiding. During early 2021, everyone assumed that Covid was over until Delta wreaked havoc.

The second wave which started in mid-March 2021 became the worst health pandemic killing thousands of people. Since then, many experts said that the pandemic had turned endemic as Indians had achieved herd immunity. Then, Covid once again proved all of us wrong as the third wave hit the country post-Christmas.

While the second wave was much bigger than the first wave, the third wave seems to be like a tsunami as far as cases are concerned. Minister for Health and Family Welfare Dr K Sudhakar said, “During the first wave, Covid cases used to double in 15 days. It was eight to 10 days for doubling of cases in the second wave and now just two to three days in the third. This clearly shows the vertical growth of the third wave.
Dr Subramanian, Director, Department of Infectious Diseases and Infection Control, BGS Gleneagles Global Hospital, said that the current wave was very different from the previous ones. “We had a first wave which was the Wuhan wave and then the so-called second wave which was actually two waves in one. It started off with Alpha and was quickly taken over by Delta, and that was much more aggressive.
“The Alpha/ Delta wave has been pretty bad all over the world. While the rest of the world got two separate waves to contend with, we got done with one wave. But obviously, this wave is going to be completely different in that terms. Transmissibility in this is exceedingly very fast.”
Subramanian said that as more people were transmitting the virus simultaneously and therefore, there’s going to be a lot of people getting infected in a very short period of time. Also, previous infection or vaccination doesn’t protect against infection which basically means all of us are equally vulnerable to developing an infection. “I am projecting the peak to be before the end of the month and a quick drop by the end of February.
Vivek Anand Padegal, Director, Pulmonology, Fortis Hospitals, Bannerghatta Road, added, “The first wave began slowly and gradually worsened, with approximately five - 10 per cent of total patients experiencing low oxygen levels, leading in a major increase in hospitalisation rates and then a decline. The second wave, on the other hand, began more quickly, peaked, and then receded over the course of 2.5 months. With the advancement of the illness, more patients looked to become sicker, with lower oxygen levels and a greater requirement to be brought to the ICU.
“The third wave has just begun, and the patients appear to be in better health for the time being. Although ICU admissions appear to be down, the symptoms are varied, with more nasal symptoms like sneezing, runny nose, and headaches. However, it is too soon to say whether the changes in this peak are significant until the next few weeks.”

Effects on children

Dr Supraja Chandrasekhar, Consultant Paediatric Intensivist at Manipal Hospital, Yeswanthpur, said that in the first wave, the majority of the patients who were affected were from the vulnerable group, the elders and the ones who had severe co-morbidities. Children were admitted only for isolation purposes and the rule of 10-day admission was followed. They were usually admitted with co- infections like dengue. In the second wave definitely, we had a surge in children getting admitted for two common reasons: Multi-System Inflammatory Syndrome in children which was a post-Covid development.

I am projecting the peak to be before the end of the month and a quick drop in cases by end of February ­–Dr Subramanian, BGS Gleneagles Global Hospital

Symptoms

Dr Swati Rajagopal, Consultant - Infectious Disease and Travel Medicine, Aster CMI Hospital, said that the symptoms cannot differ from Delta to Omicron variants. The delay in getting sequencing reports does make treatment strategies difficult as certain treatments work for Delta, certain treatments for Omicron. “We need quick results on genome sequencing to identify the variant as patients are just isolated in hospitals due to non-availability of the variant report. If we do not adhere to Covid-appropriate behaviour, we would be facing a situation of increased numbers and a huge burden on the already-exhausted healthcare system.”
Subramanian added that medical facilities will remain busy during the Omicron wave. “The issue is going to be a lack of medical personnel. Many places are becoming shorthanded in the west as well because their healthcare providers are falling ill due to Omicron because of which, patient care has been seriously disrupted and it is only a matter of time before it happens in India. So, it is very important to give booster doses to the frontline health care workers,” he added.