Dr N prabhu dev

Last year it was Corona first and corona next and corona last! This year on we may have to live with a touch of subdued corona!

Corona virus will be the new flu virus we have to live with!

The coronavirus will no longer be novel — to our immune systems or our society.

Vaccines are a Triumph of hope and life over fear. Its triumph of science over pathology! Science reigns again.

Patriotism has always been associated with armed forces! Now it is also associated with doctors, nurses, Paramedics — many of whom were suddenly saddled with unfathomable tasks, compounded by an increased risk of contamination and death they never signed up for.

India will administer 1billion vaccine doses by October end- including first and both jabs. 73% of the total population has been given at least a single dose of the vaccine; close to 30% has received both doses India is yet to start vaccinations of those under the age of 18. Vaccine for those in the 12–18 age group, ZyCoV-D was approved on August 20 along with Bharath Biotech vaccine for the same age group!

Booster shot has been the hot topic recently, but there is confusion as to who is eligible to get the third shot of the vaccines. WHO has rightly supported the use of COVID booster shot for immune compromised people! Israel and some other countries have started the booster dose to their population!

First priority is two jabs for all. Next comes the booster dose! But put preparations underway for the booster!

India has seen two Covid-19 waves in the past and a third wave is presumed to occur. There may not be one!

Corona has become Endemic!

Failure to eradicate the virus means some viral load is still in circulation but with low virulence. The incidence, hospitalisation, and deaths will not be as grave as in the previous days- Endemicity. Outcomes are predictable.

We still need to be cautious and cannot go back to normalcy yet. We need to vaccinate as many people as possible, which will reduce the emergence of variants and reduce the virulence. We have to scale up genome sequencing to understand if there are new variants emerging, so that the infections are contained. We should be vigilant and still follow the safety protocols.

The pandemic with its ferocity will end — not that it will be eradicated. The virus gets Endemic! The virulence of the leftover virus will be at lower scale.

2020 was unfamiliar and unsettling.

The future was uncertain. Nations stayed closed! Even a Touch become a taboo? Masks masked the faces! Staying indoors was the norm! Everyone was vulnerable! Religious worship will be different. There has been more cooking and less dining!

It could be difficult to shake hands again or even touching our own faces without the flashing across of the dark memories. We may all find we can’t stop washing our hands.

How quickly that depressing awareness recedes will be different for different people, but it can never vanish completely for anyone who lived through the nightmares of the last year.

There was comfort in isolation. Distance made us feel safe!

The online communication — it creates more distance but it connects! Government hospitals have regained some of their lost glory. Private hospitals have made name for minting money the wrong way and irregularities! The inequality gap has widened.

A touch of subdued Corona

When enough people have gained some immunity through either vaccination or infection — preferably vaccination — the coronavirus will transit to what epidemiologists call “endemic.” Phase. It won’t be eliminated, but it won’t upend our lives anymore.

There will be fewer hospitalizations and fewer deaths from COVID-19. Cases may continue to rise and fall perhaps seasonally, but the bad outcomes will be rare. If immunity to the new coronavirus wanes then it will keep causing reinfections over time, but still mild enough. We’ll have to adjust our thinking about COVID-19.

The path to endemic COVID-19 will also depend on how much the virus itself continues to mutate. Delta has had its share of human misery and deaths! There is so much of the world still vulnerable to infection, the virus has many opportunities that may yet enhance its ability to spread and re-infect.

But our immunity is not at Zero setting! “Our immune responses are so complex, it’s basically impossible for the new variants of the virus to escape them all! Levels of antibodies that neutralize the virus do indeed drop over time. But the body has enough reserves of B and T cells that carries the blueprint of the virus to attack the virus as soon as it recognises them. The Immunity against infection may wane first, but the protection against severe illness is lasting and is durable.

The new variants, like Beta, Gamma, and now Delta, do erode some protection from vaccines over time! The virus will continue to circulate, but fewer people will get sick enough to be hospitalized or die. This pattern is playing out in many countries seeing spikes with only a fraction of their virulence and deaths.

Reinfections!

People are having a hard time understanding one another’s risk tolerance.

Severity of reinfections of COVID-19 depend on how quickly the protective effects of immunity against the virus wanes. It depends on how quickly our immune systems get rusty and the how quickly the virus disguises itself.

Reinfections do reinvigorate our immune response. It acts like booster dose of the vaccine! Recent infections are more protective than old infections and old vaccinations! The virus itself will also change with time. The flu also mutates every year in response to existing immunity.

When everyone has some immunity, a COVID-19 diagnosis becomes as routine as diagnosis of streptococcus throat infection or flu but not a reason for particular fear or worry or embarrassment either.

Booster only after all receive the vaccine!

The need for annual boosters isn’t clear, and key biology and policy questions remain to be answered. On the biology side, how much antigenic evolution will we see in corona and to what extent will it evolve to evade our immune system need answers.

A vaccine that is 90% effective at blocking transmission will need to reach at least 55% of the population to achieve temporary herd immunity as long as some COVID protocol measures remain in place according to a model developed by Imperial College London.

A vaccine would need to reach almost 67% of people to provide herd immunity if all social distancing measures were lifted.

Vaccinating even 55% of the population is challenging in many countries. India has vaccinated 97 crores of its population- A single Jab in almost eight months.

Considering that the efficacy of the available vaccines in India is 80 percent, we would have to vaccinate at least 80 percent of our population including children to achieve herd immunity

The coronavirus is here to stay, but it won’t be as deadly in the future.

Way forward with Corona Virus

We, Physicians and scientists have cured polio and most childhood cancers and infections. We have reduced deaths from heart disease and stroke and developed better treatments for diabetes and kidney failure. We routinely transplant organs and use robots for surgery, remove brain tumors with minimally invasive procedures, and perform surgery on babies while they are still in the womb. We are up to these challenges, and we can fix the virus as well! •

Prioritize distribution of the Corona vaccine.

Establish national criteria for reopening of schools, theaters, malls, religious places and mass gatherings

Address and resolve health care inequities.

standardized data collection system

Inform, educate, and engage the public.

Broaden health insurance.

Public health at all levels should be better funded.

Former Director Jayadeva institute of cardiology and research institute

Former VC Bangalore University- undivided

Former chairman Karnataka state health commission

Mobile: 94480 67890

E mail ID nprabhudev@gmail.com

Former director of Sri Jayadeva Institute of Cardiology, Former VC of Bangalore University and former chairman of the Karnataka State Health Commission

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Dr Prabhu Dev

Dr Prabhu Dev

Former director of Sri Jayadeva Institute of Cardiology, Former VC of Bangalore University and former chairman of the Karnataka State Health Commission

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