New Delhi: Indians must strictly follow the time tested public health measures like wearing masks, hand washing and social distancing and stop super spreader events like weddings and other large gatherings to start the next year without the fear of the Covid-19 virus as vaccines alone will not be effective against it, said a noted public health expert.
In an exclusive interaction with ETV Bharat, Dr K Srinath Reddy, a noted public health expert and President of Public Health Foundation of India, said the success in the country’s fight against the deadly second Covid wave largely depends on following the time tested public health measures, which are effective against any new variants as well.
"Don't depend only on vaccination. If you depend on vaccination but allow super spreader events and people go around without a mask then you are not going to get out of the trouble for a year," Dr Reddy told ETV Bharat.
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“We should start 2022, the year of the 75th anniversary of our independence without the fear of the virus. That is only possible when we are disciplined in 2021 with both our public health measures and our vaccination drive,” explained Dr Reddy.
“Let us keep that discipline while we are increasing our pace of vaccination. How many people we vaccinate depends upon the availability of vaccines. I believe that everybody above 35 will be preferably vaccinated by August 15,” he said.
What led to the second wave!
Talking about the onset of the second Covid wave, which gripped the nation in recent weeks and overwhelmed the medical infrastructure, Dr Reddy said it was a mistake to believe that the country had won the war against Covid at the start of this year when case count was low.
“We became too relaxed from early January when the numbers came down markedly, both in terms of daily case count and death count as well as the test positivity rate. We sort of assumed that we have seen the end of the pandemic,” said Dr Reddy.
He said this belief gained currency as some people talked about achieving heard immunity believing that Indians had some inherent genetic protection against the deadly virus.
Lockdown contained first wave
Dr Reddy says in the first wave, the cases had come down due to several steps, which included a long lockdown, several stages of unlocking with travel restrictions.
“Even during Diwali, large crowds were not there. That discipline disappeared the moment we declared the victory prematurely,” he told ETV Bharat.
“People thought they could celebrate large wedding gatherings, birthday parties, assembly and local body elections. Both domestic and international travel became frequent. And then came the new variants.”
UK delayed disclosure of new variant
Dr Reddy blamed the UK government for delaying the disclosure of a new variant to the rest of the world by several months.
"UK variant was known to them in September but it was declared to the world in December. Thereafter we set up the India consortium for genome sequencing in January and started looking for it. It was found in substantial numbers so it will not be proper to blame the travel policy," he said.
Faster transmission
Dr Reddy explained that the UK variant of Covid-19 virus is 60% faster in terms of infectivity rate as it has spike protein mutations.
“These proteins are the tools through which a virus opens the door to a human cell. There is a receptor called S2 receptor, the spike protein attaches itself to the receptor and then it twists the handle like a door and opens the door to the cell. Then it goes inside the cell, takes over the genetic machinery of the cell and starts multiplying and creating its own forms,” Dr Reddy explained.
“This particular mutant, and other mutants are using new spike protein mutations to more effectively stick to the receptor binding sites so that they cannot be easily dislodged or it can more easily open the cell so that it can get in. Their infectivity rate is much more because of that characteristic, not so much because they can travel faster,” he explained.
Lack of proper sampling
Talking about the importance of taking proper samples, Dr Reddy explained that even the RT-PCR test has only 60-70% test positivity rate in terms of sensitivity in identifying the virus when it is done in very good laboratory conditions.
“The swab collection is very important. What you are really looking for in a test is how the virus is replicating in the lab. If the swab is not transported properly or stored properly in the lab, a lot of mistakes can be made there and then you get a false negative result. That's why you need to repeat RT-PCR twice or thrice,” Dr Reddy explained.
Surface transmission!
Dr Reddy says we may be able to detect the virus on surfaces, particularly in frozen foods where the virus survives for longer but it may not be a replicating virus and the chances of surface transmission of virus is very low.
He says that droplets and transmission through aerosols are the dominant methods of transmission of the virus but the surface transmission doesn't appear to be a significant mode of infection in light of the real-life tests.
Pace of Vaccination
Dr Reddy says despite the hiccups, the country must do its best to vaccinate everybody above the age of 35 years to contain the second wave but refused to predict as to what part of the population must be vaccinated to contain the second wave.
He says most of the earlier predictions done by Indian and international experts were off the mark in some or some other way as they failed to take into account the varied conditions that exist in India.
Time tested method will contain second wave
The public health expert says the country can contain the virus by the old method of following the social distancing protocols such as use of masks, hand washing and avoiding super spreader events like weddings and other such gatherings.
"You have to give the virus an opportunity to transmit. If you provide a smooth highway it will travel fast, if you give a bumpy road, it will come down," he told ETV Bharat.
"It doesn't matter whether it is the original virus, UK or some other mutants or double mutants."
He also advises people to use goggles as now the virus is also entering through the eyes.
Unless we are disciplined, right from the political leadership to the common man, the virus is going to spread and all talks that it will be covered in 2-4 or 6 months are meaningless if we don't follow discipline.
How effective single dose is?
Commenting on the reports about a significant number of people contracting the virus even after receiving the first dose of a Covid vaccine, Dr Reddy said it was difficult to predict the level of immunity that one will get with just one dose of vaccine as it depends on multiple factors.
He clarifies that 14 days after the second shot, a recipient is supposed to have strong immunity against the virus.
Vaccine will prevent severity of disease
"The immunity will protect you against severe disease and death. It may not be able to protect you against the infection per se. These vaccines induce systemic immunity which fights the virus after it has entered the body, it does not prevent the virus from entering the body," he explained," said the noted public health expert.
“It may cause some illness but not a serious illness and it will also bring down the rate of infection."
How long will the immunity last?
Dr Reddy clarified that it was difficult to say at this stage as to how long the immunity will last after receiving both the doses of a Covid vaccine.
“Some people say it will last six months, whereas Pfizer says that it will last for one year and after that, a recipient will need another shot. We will have to wait and see," he noted, adding that we will have to see how the virus mutates in future.
Faster adoption of foreign vaccines
Dr Reddy says that Johnson and Johnson’s vaccine would have been a very good option for the country as a large number of people could have been covered with the single-dose vaccine but it has run into some trouble in that country.
Talking about the Russian Sputnik-V vaccine, which has been cleared by India's drug regulator for emergency use, Dr Reddy says according to Russian scientists their vaccine is much more stable and doesn't lead to blood clotting seen in some other vaccines.
"As for US vaccines like Pfizer and Moderna are considered, the government will have to negotiate their price and see how we can produce them in the country," he said.
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