What India learned from last years 2nd Covid Wave. How it is used?

What India learned from last years 2nd Covid Wave. How it is used?

On May 7, 2021, India reported a Covid-19 case of Rs 414,000. This is the maximum number of cases recorded in the second wave of the day. The overwhelming health infrastructure suffered from oxygen supply, labor shortages, narcotics and beds. The vicious second wave caused by the delta variant of SARS-CoV-2 has hurt India.

Seven months later, India celebrated the New Year with a more mild variant of Omicron, which heralds a third Covid-19 wave, but with a highly contagious threat. The ET will consider how the government should use the time between the two waves to strengthen its medical infrastructure and policy interventions to deal with the expected flood in 2022. ..


Ramp up

The center and the state government used the time between the two waves to strengthen their health infrastructure and train personnel to operate ventilators and oxygen production plants. The center has put together a management mechanism to coordinate with the state. Apart from the group of secretaries appointed to investigate a particular area, there was an officer on behalf of the state as an officer of the node. These officials were responsible for the state’s Covid-19 response in the second wave. Even if an incident happened, this setup was never dismantled.


The center continued to closely monitor through the Node Officer how the state trained its personnel and maintained its stockpile of essential medicines. A senior officer involved in the coordination between the center and the state told ET, “The coordination has continued. WhatsApp groups have been formed, overseeing them through these groups and ensuring that the interventions required by the state are addressed. I was asked. “


Prime Minister Modi deals with the availability of oxygen. “> Oxygen deficiency was the largest area of ​​intervention. Following the second wave in which India, especially the northern states, faced a serious oxygen deficiency, Empowered Group 4 addresses the availability of oxygen from Prime Minister Modi. Given the mission.


Another subgroup was formed in May under the then secretary (Housing and Urban Issues) Durga Shankar Mishra to oversee the installation and commissioning of 1,222 plants. The government faced great embarrassment when it discovered that none of the 162 plants licensed in October 2020 after the first wave were in operation when the second wave struck India. rice field. The government has created a portal to monitor the physical progress of the plant. The project monitoring unit tracks the daily progress of the plant under test, the performance of the plant in operation, and the assembled plant in transit.


With regard to hospital infrastructure, medical professionals feel that India can use its experience from the second wave to quickly launch the Covid infrastructure. Dr. Harsh Mahajan, President of NATHEALTH, said: Local hospitals and large private hospital chains are now investing in oxygen plants. The plant is not large enough to handle the surge, but it is a supplementary oxygen supply and is useful in the event of increased demand. “


What to expect

Daily cases are increasing rapidly. On January 9, 2022, India reported 1.59 Rakı cases and increased to 2.64 Rakı on January 14. This is an increase of over 66% in 5 days. Health professionals feel that India, like the rest of the world, will see more infections in this wave compared to the delta wave.


Dr. Sandeep Budhiraja, Group Medical Director of Max Healthcare, said, “This disease is mild. It has a significant effect on the upper respiratory tract. It shows high fever up to 103 degrees, cold and cough, headache, and severe body pain. It does not last for more than 5 days. ”Doctors feel that the majority of patients recover from home isolation because of the mild illness.


“There are two different experiences from South Africa and the United States. South Africa reported mild illness, low mortality and low hospitalizations, but the number was higher than the peak of the second wave. Increasing in the United States. Hospitalization trends. We have to wait for how the virus behaves in South Africa, “says Budiraja. It will taper. This will be a shorter wave than a delta wave. The upward graph is steep and the downward slope is also steep. “


Medical professionals feel that hospitalizations in India will increase, but not at US levels. “The United States has a predominantly elderly population, which is why it has more hospitalizations than South Africa. Due to the young population of India, Omicron-driven waves are expected to recreate South Africa’s trajectory,” Mahajan said. say.


Doctors feel that there is no need to worry as the number of cases increases and the second wave peaks on May 7th, as the majority of India’s population is vaccinated. “Currently, there is an argument that the infection rate of the virus is quadrupled. Therefore, even if the hospitalization is a quarter, the number is large and overwhelms our health infrastructure. This argument is overwhelming. From March to April 2021, less than 10% of our population received a single dose. Currently, almost 95% of our population is 1 It has been administered once, “says Mahajan.


The main concern for doctors is the vulnerability of children. Budhiraja says that experience in the United States has increased pediatric infections and hospitalizations with Omicron waves. “This is mainly because children are not vaccinated and are not vaccinated. This is the biggest trend. It is true that pediatric infections are less severe, but hospitalization is possible in the United States. It is increasing. The increase in pediatric hospitalization is reported to be four-fold, but it should be taken into account that the denominator of the previous wave was small. “


Policy issues

With the increasing number of cases, medical organizations are calling on the government for two major policy initiatives. It is the expansion of vaccination rates and treatment protocols that do not spread confusion. Dr. Bishnu Panigrahi, Head of Health Strategy and Operations Group at Fortis Healthcare, said: -60 years. They are what drives our economic engine. We are in a better position when it comes to vaccine supply. So why do we need to rob a group of booster doses? This (18-60 years) is an outgoing segment and they should not be ignored. “


Treatment protocols change frequently. India recommended remdesivir and plasma therapy, but only withdrew them. Monoclonal antibody therapy was recommended at the end of the delta wave, but it has no effect on Omicron. Two monoclonal antibody cocktails that are effective against Omicron are not available in India. “This happens with rapidly changing viruses, which require changes in treatment protocols,” says Budhiraja. Medical fraternity feels that conflicting signals from the government can be avoided. Molnupiravir, a recently approved drug for the early treatment of Covid-19, was called unsafe by Barram Bhargava, Secretary of the Indian Medical Research Council. “The government’s right hand didn’t seem to know what the left hand was doing. The government approved it, and Dr. Bargaba said it was teratogenic and mutagenic,” said one senior medical expert. All drugs have contraindications. You can’t put it down in a public forum. This should have been done in a closed environment to teach doctors how to use it wisely. ” ET HealthWorld