Afraid of the fourth wave?

India has seen a 100 per cent surge in new Covid infections so far this month, with the test positivity rate (TPR) – a key marker for assessing the spread of an outbreak – recently hit 2.26. This has prompted fears of a fourth Covid wave sweeping the nation. Doctors say there’s no need to panic as no new worrisome variant has been found. But it’s time to mask and embrace Covid-19 appropriate behavior (CAB) and work to improve immunity, they warn. The HEALTH PIONIER reports

After a drop in Covid cases through mid-May, the coronavirus has gradually moved north less than a month after the country opened up after the third wave. This has raised fears of a fourth wave in the country, with some states like Maharashtra and Karnataka bringing back the mask mandate in public.

On June 11, India reported its highest number of daily cases in months, with 8,329 new Covid-19 cases and 10 deaths in the past 24 hours. While the total number of active cases stands at 40,370, the country recorded 4,216 recoveries. As of Friday, the country had reported 7,584 cases and 24 deaths.

Analysis of the data shows that cases have doubled in just 10 days, while the test positivity rate (TPR) – the number of positive cases from all tests conducted – has risen to 2.3 percent, the highest since February.

WHO Director-General Tedros Adhanom Ghebreyesus warned that the pandemic is not over yet. Tedros noted that 18 months after the first mass coronavirus vaccination programs began in rich countries, 68 countries still have 40% of their populations to protect.

While enough vaccines are now available, demand has fallen, he said. “The perception that the pandemic is over is understandable but misguided,” said the WHO chief. “A new and even more dangerous variant could emerge at any time, leaving large numbers of people unprotected.”

However, doctors in India are blaming Omicron subvariants for being behind the surge in Covid case numbers in the country. And since it’s naturally mild, don’t panic, they assured.

India has reported a gradual increase in coronavirus infections since mid-May, as BA.4 and BA.5 subvariants of the Omicron strain of SARS-CoV-2 entered the country.

The doctors explained that the ongoing rise in Covid-19 cases in some parts of the country should not be seen as the beginning of the fourth wave of the pandemic. Most people are protected by a previous infection and a high vaccination rate, they argue.

“It is wrong to say that the 4th wave is coming, we have to examine the data at the district level. A high number of cases in a few districts cannot be viewed as an even increase in cases across the country,” said Samiran Panda, ADG, Indian Council of Medical Research (ICMR).

“There is no reason to believe that the current surge in Covid-19 cases heralds the beginning of the fourth wave of the pandemic in the country,” said Dr. Sujeet Kumar Singh, director of the National Center for Disease Control, which leads India’s SARS-CoV-2 Genomic Surveillance (INSACOG) project, told a media outlet.

According to Singh, while the rise in cases may be due to the spread of subvariants BA.4 and BA.5 in several states, given India’s hybrid immunity after previous infection with other Omicron subs, it doesn’t mean much variant and high vaccination coverage.

dr NK Arora, head of the National Technical Advisory Group on Immunization’s Covid-19 working group, expressed similar views. “The rise in cases was the result of unbridled domestic and international travel by Indians after a long hiatus.” He dismissed fears that the country would be engulfed by the fourth wave. Mumbai has reported a sharp rise in cases in recent days. About 4,000 cases were recorded in the first five days of June – more than those reported for all of March and April and almost the same number as May.

“That’s because business and travel are getting back to normal and many people are being exposed to the virus,” Arora said.

He added that INSACOG’s monitoring so far has shown that there is no new variant in play, except for Omicron subvariants.

dr Rahul Bhargava of Fortis Hospital in Gurugram, Haryana called for a cautious approach. “These wave patterns will continue to affect humanity. We need a strategy by rapidly changing our daily lives, quickly reintroducing masks and social distancing into our lifestyles as cases increase.

“At the same time, we need robust genome monitoring to keep tabs on the emergence of new variants. Research must give us clear guidance on the frequency of Covid vaccination in the frontline and high-risk group,” he suggested.

As immunity became a buzzword during the Covid-19 pandemic, Dr. Tanuja Nesari, Director of the All India Institute of Ayurveda (AIIA), on the importance of holistic wellness in containing the virus and other infections. She emphasized the use of proven home remedies and Ayurvedic immunity herbs like Chyavanprasha, AYUSH Kwath and herbs like Tulsi leaf, crushed ginger and turmeric could be beneficial in developing overall immunity.

In this context, she cited the recovery of over 400 patients from Covid-19 at her institute through Ayurveda. Only 4% required integration with oxygen, she said.

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