With the low number of cases in India, can we say that Covid is now endemic?
In the last two years, we have seen three distinct Covid waves with cases going up and down. But now, we are seeing around 2,000-2,500 cases daily. So, people think that it is endemic, but in the case of COVID virus, endemicity is mythical.
The COVID-19 virus varies and evolves over time in terms of its size, characteristics, nature of spread, transmission, disease severity, etc. The way this disease has behaved so far has no meaning. Neither herd immunity has worked nor the concept of endemism has worked. So, unless it settles at a time when we feel that nothing more serious is likely to happen or nothing is likely to happen, then only we can say that it is a part of our life. Covid is very much around us; It’s spinning. During the past two weeks, we have seen two new sub-lineages of Omicron BA.4 and BA.5. There is a possibility that more sub-species or variants of this may emerge in the next few weeks or months. So, we have to be more vigilant to understand how this virus is behaving in the community.
Is the rise of BA.4 and BA.5 sub-lineages a matter of concern for India?
About two weeks ago, BA.4 and BA.5 cases were reported in the country. Now we are studying how fast this virus is spreading and whether it is causing severe symptoms and hospitalizing the infected person. We have started contact tracing from where these cases have come to the fore. We are also seeing if they are vaccinated or not. Overall how is this virus behaving? So far these are the people who have been vaccinated against BA.4 and BA.5. His symptoms were mild, such as cough and cold. He did not require hospitalization. They have been fine so far. We have not detected any cluster or outbreak in these cases so far. We have enlisted around 15-50 immediate contacts for tracing. Their samples have been sent for testing, and the report is likely to come in the next 10 days.
What should be the strategy to maintain this low trajectory of COVID cases?
Firstly, there should not be a large number of deaths. Second, health facilities should not be hampered and third, our daily economic activities should not be affected either. Each eligible person should receive their respective dose of COVID vaccine. Omicron is mild in our country today because vaccination has played a part. In addition, more than 90% of the population is naturally exposed to the virus. In Western countries, more than 100,000 cases are being reported each day, with hospitalizations and mortality rates increasing compared to Indian figures. So the most important thing is vaccination, and people should follow COVID-appropriate behaviour. Hand hygiene should become a part of our life. In addition, the monitoring strategy should be robust to track any new versions. We have over 50 laboratories across the country doing genome sequencing. We have also done Sewage Water Sampling Surveillance to monitor the cases so that any jump in COVID cases can be seen.
Have we seen any cases of adverse events due to COVID vaccination, and how do you analyze them?
Adverse events are a very important matter for us to ensure public confidence about the COVID vaccine and vaccination programme. Reporting of AEFI is done through CoWIN and SAFE-VAC portal only. India’s AEFI surveillance follows a robust mechanism of investigation and evaluation at all levels. For example, if a serious case or hospitalization or death is reported post-vaccination, a detailed investigation is carried out, followed by causality assessment at the state and national levels respectively.
Both the COVID vaccines, namely Covishield and Covaxin, are safe. However, occasionally, we have seen some serious events in both vaccines, and we immediately did a detailed evaluation. Even though we have used Covishield extensively in India, we have reported a small number of AEFI cases specifically with this vaccine.
Most of the AEFIs in the case of Covshield Vaccine have been reported in Western countries. This is because the response to the vaccine varies from person to person due to ethnicity. Overall, over the past year and a half, we have reported approximately 80,000 cases of adverse events, of which only 2.7% fall into the ‘severe and severe’ categories.
Does India need to speed up vaccination?
In the past few weeks, India has seen a slight drop in vaccination coverage. Few weeks back, we saw around 25-30 lakh vaccinations per day, but now we are seeing 8-10 lakh vaccinations per day. It is a matter of concern that there has been a sudden drop in vaccination. I urge every eligible citizen to come forward to get their vaccine dose. We have two types of population for vaccination; First, the population above 18 years of age and second, the population below 18 years of age.
We also observed that about 4% of the population groups over 18 years of age and the elderly over 60 years of age have a lower dose of precaution. Therefore, the Union Health Ministry is going to launch the door-to-door vaccination campaign 2.0 from Wednesday to identify survivors for vaccination and encourage them to get vaccinated. The reason the number of vaccinations is low is because people think that Omicron is mild and won’t cause any problems. I appeal to everyone to get the vaccine dose.
Similarly immunization of people below 18 years of age i.e. 12-15 years and adolescents of 15-18 years of age is very less. While 75% of vaccination coverage is accomplished at 15–18 years of age, in the 12–15 year age group, 60% of adolescents have received the first dose, with only 40% receiving a second dose. Vaccination. There is a need to increase awareness among parents to come forward to vaccinate children. To encourage and educate parents, Union Health Ministry is creating guidelines for parents, making them aware about vaccinating their children, with new messages on the safety and efficacy of vaccines And it’s also explained why vaccines are important for their children. The guidelines will come in the public domain in the next two weeks.