Are we entering a new phase of Covid?
INDIA MAY HAVE REACHED SOME SORT OF ENDEMICITY. THIS COULD HAVE HAPPENED DUE TO SECOND WAVE-INDUCED SEROPOSITIVITY (68%), AND THE FACT OVER 600 MILLION PEOPLE HAVE RECEIVED A SINGLE DOSE OF A COVID-19 VACCINE
With news from Afghanistan dominating the headlines, it’s no surprise that it’s completely captured our attention. A tragedy of this horrific dimension can be riveting. What’s less explicable is that our 18-month-old concern about Covid-19 has been almost forgotten. No doubt, for many, that’s a relief. But the news on this front is good and needs recognition. It’s something to cheer about.
The facts are convincing. After weeks, when daily cases seemed to plateau at 40,000 levels, the latest seven-day average shows they’ve fallen below 34,000. The R Number, which crossed 1.2, has reduced to 0.9. Even in Kerala, where the daily tally of cases is half the national total, and the positivity rate in all 14 districts has crossed 10%, the seven-day average has stabilised. Onam, no doubt, has set that back, and though cases have increased, hospitalisation has not.
So, is India, at last, exiting the second wave? And are we entering a new phase of Covid-19? Dr Soumya Swaminathan, the World Health Organization’s chief scientist, clearly thinks so. “India could have reached some sort of stage of endemicity”, she says. That sounds carefully worded and measured until you hear the rest of her comment. “It’s very feasible we may continue like this with a few local but not severe ups and downs…that’s what seems to be happening.” That could explain Kerala.
Now, the endemic stage is when a population learns to live with a virus. It’s very different to the epidemic stage when a virus overwhelms a population. In our case, what could have propelled us to endemicity is the massive second wave of April-May, which left behind seropositivity levels of 68%, and the fact that over 600 million people have received a single dose of a vaccine.
So how does Swaminathan view the fear — it’s much more that than a probability — of a third wave? “No one has a crystal ball and it’s impossible to predict a third wave”, she says. Politely but firmly, she contradicts the voices forecasting when it will happen, who it will affect and how severe the impact will be. “One cannot say with certainty when, where and how bad it will be.” Actually, before all of that is the question: Will there be one? Swaminathan’s viewpoint suggests India could experience local or regional ups and downs, but it’s unlikely to see a nationwide third wave similar to the second wave.
Swaminathan is also clear about the possible danger lurking in the future for unvaccinated children. It’s quite possible they could be infected in larger numbers than earlier, but they are unlikely to fall seriously ill. Of course, we must prepare for this, but there is no cause for panic. Some of the ill-informed forecasts, both now and earlier, have created unwarranted alarm.
Meanwhile, when, not if, India reaches United Kingdom (UK) levels of vaccination, ie 75% of the adult population — which is, of course, way short of the government’s seemingly unachievable target of fully vaccinating every adult before the end of 2021 — India will also be “reasonably secure” as the UK seems to be today. Infections won’t stop, but instances of serious disease will be far fewer, and hospitalisations limited.
Finally, what Swaminathan believes could be happening in India could also be the future that lies ahead for the rest of the world. I’m putting it simply, but not, I hope, simplistically. She believes — actually, the verb she used was hopes — Covid-19 will convert from its present epidemic status to an endemic one, as vaccinations spread across the world and people continue to observe Covid-19-appropriate behaviour.
“We cannot reasonably hope to eliminate or eradicate the virus”, she says, “but in a year or so, perhaps by the end of 2022” we could see the virus take on a form we can more easily — that doesn’t necessarily mean happily or, even, willingly — live with. However, at that point, it’s also possible it may not be much more threatening than influenza.