Double mutant variant may trigger intense second Covid wave: Expert

BENGALURU: With an exponential rise in the number of Covid-19 cases in the state, Dr Vishal Rao U S, Head and Neck Oncologist and member of the state Covid Task Force, talks on how bad the second wave will be and the possible reasons for the surge

What is the difference between the first and second wave?
One of the most important differences is that the first wave initially spread slowly due to early stringent government measures coupled with strong citizens’ vigilance. People mostly did follow stringent measures like using masks, ensuring well-ventilated environments, minimising social activities, leading to lower number of Covid cases. 

However, the second wave has a new signature to it. Overall, citizens have lowered their guard due to a deep sense of Covid fatigue. The hallmark of the second wave is the recuperation of the socio-economic setback of the first wave. The earlier experience has forced all stakeholders to increase socio-economic activities for maintaining economic sustenance, as also social connect which is indirectly influenced by the Covid fatigue. Beyond these factors, the double mutant strain is further contributing to the virus spread.
 
It was earlier said that this wave or new mutant is not lethal. But we are seeing more people dying. Why?
The double mutant variant is considered more virulent and it is a “variant of concern” (VOC). This strain is considered for the morbidity in the second wave. Mutations in the virus, per se, are not surprising. But specific mutations that either help the virus evolve to thwart vaccines or the immune system or are linked to a spike in cases or disease severity, are definitely a cause for concern. While the two mutations have been individually identified in other variants of SARS-CoV-2 globally, and associated with a reduction in vaccine efficacy and infectivity, their combined effect and biological implication has not yet been fully comprehended.  It is important to note that the ‘double mutant’ variant is likely to trigger an “intense second wave”. It is estimated that the virus is over 50 pc more transmissible and 60 pc more lethal.
  
We are seeing more asymptomatic patients testing positive. Why?
Around 32 pc of the population is aged between 22-45 years. This age group is most active socially as well as economically and hence, acts as common carriers with asymptomatic presentation, but may transfer infection to the vulnerable population. 

There is shortage of drugs/treatment considered vital for recovery. When we had the time, where do you think the government went wrong?
In the current situation, unfortunately, we know that there is no one single appropriate treatment available and accepted for Covid-19. While there could be opportunity to set up plasma therapy by government in every district to save the lives of critically ill patients and arrange for oxygen, the need for the hour is to strengthen the dose of Remdesivir and make it available in all the centres to save lives. 

When will the second wave peak and how long will this last?
Compared to the previous year’s data, India is still not in the midst of a second wave of the Covid-19 pandemic. Considering the duration from the present level of daily new cases to the peak India saw last year, the country is expected to reach the high in the last week of May. The second wave will last until the end of June and may also extend to July if proper precautions are not taken.

What should be done now to tackle this situation?
In the current regimen, vaccination is going to provide protection against the third wave. However, the second wave seems to be catapulting faster than our vaccination regime, and at this juncture, it would be more prudent for us to look at strengthening awareness and enforcement to slow down the virus, without moving towards a lockdown.