Covid-19: The Second Wave
Fidhat Fayaz Drangay
As of now 16.3 million people in India have been reported positive for the novel Corona Virus. Among these infected people 13.6 million recovered and 187 thousand people lost the battle with the novel Corona Virus.
In Jammu And Kashmir 1 lakh 54 thousand people have been reported positive for the novel Corona Virus. Among these 1 lakh 36 thousand people recovered and 2 thousand 92 people lost the battle with the novel Corona Virus.
In the last quarter of 2019, cases of novel Corona virus were reported in Wuhan, China. By the beginning of New Year 2020, two to three hundred of cases were reported in China. Slowly the virus began to transmit to other countries and first case outside China was reported in Thailand.
Virus took a deadly shape in most of the countries and consumed thousands of lives worldwide and Italy was hit worst by the virus. Lockdown was imposed over the whole world and transmission of virus was curbed to many extents.
On January 27, 2020 India reported the first case of novel Corona virus in Kerala. Kashmir reported first case on 16 March 2020. Proper measures were taken in India and virus was contained to many extents. In September 2020 India reported highest number of CoVid 19 cases in a single day.
By the end November 2020 India had total control on novel Corona Virus. By the start of 2021, vaccines in India were made available for the general public prioritized on some criteria’s. More than 109 million people have received one dose, and over 17 million people have been fully vaccinated after receiving two doses. But experts say India is unlikely to meet its target of covering 250 million people by July, especially as cases continue to surge.
New mutant strains of novel Corona Virus were reported this year from United Kingdom, South Africa and many more countries. Second wave of novel Corona Virus with this new mutant strains has began affecting many countries again.
On 4 April, 2021 first time in India more than 1 lakh cases in a single day were reported. These cases began to rise enormously due to lack of commitment from the Government and proper immediate measures were not taken. Within time of 18 days cases of novel Corona Virus has rose to 3 lakhs per day.
On 22 April, 2021 India reported 3 lakh 32 cases in a single day which is highest till date in any part of the world. Two thousand deaths daily are reported daily in India. In Jammu And Kashmir, On 22 April, 2021 two thousand cases of novel Corona Virus and 8 deaths were reported. In Srinagar alone more than 500 cases are reported daily.
Presently, the new mutant strains of novel Corona Virus is creating havoc and knowledge and understanding of these mutant strains is necessary for taking proper measures at individual level.
As per CME India, Guidelines on CoVid 19 management framed and reviewed by experts , published on 6 April , 2021 current COVID 19 cases may be a mixture of various strains. Apart from the previously known strains, a new double mutant strain of the SARS COV2 virus has been detected in India.
This is in addition to other UK, South African, and Brazilian variants of the virus already circulating in 18 states of the country. The new virus strain having two mutations is highly infectious and has the potential to skip the immunity developed either by natural infection or vaccines.
That’s why it is not uncommon to see re-infection cases and cases among vaccinated people. Newer strains are not only more transmissible, affect the younger population, and can lead to more severe illness. Younger age groups getting affected by the new mutant strains of novel Corona Virus is a challenge for doctors itself. Younger patients are not only getting adversely affected but they require admission in Intensive Care Units. More thrombotic complications as compared to the cases in 2020.
Patients are getting admitted with symptoms to the hospital even after two doses of vaccines. But disease in most cases is asymptomatic, mild, or moderate with a high CT value on RT PCR suggesting Low viral load and have a low potential for transmission. Understanding the behaviour and symptoms of CoVid 19 with the time is of utmost importance for better precautions and treatment.
Disease is most transmissible one day prior and 3 to 4 days after the first symptoms. For the initial 2-3 days the patient is likely to have high fever because of high replication of the Virus but at this time innate immunity by Macrophages, Neutrophils, etc. starts mounting defense against the attack of the virus.
The beginning of the second week heralds the worsening of symptoms which is mainly immune-mediated inflammatory process and characterized by high-grade fever and increasing oxygen demand, hypoxia, etc. Unchecked hyper inflammation may lead to CoVid cytokine storm syndrome and multi-organ damage.
So, it is of utmost importance to act swiftly on 7 to 10 days by use of anti-inflammatory medications. And most of the current-day medications like corticosteroids, Tocilizumab, convalescent plasma work best when given in time during this phase.
According to BBC, triple Mutation Strain has been detected in four Indian States. Two of these triple-mutant varieties have been found in samples collected from Maharashtra, Delhi, West Bengal and Chhattisgarh, and this might aggravate India’s CoVid crisis further and the new triple mutant could make the virus even more capable of evading human immune response.
Last year we mostly saw fever with sore throat, cough, breathlessness, occasional diarrhea. This year there’re many who have nothing but weakness, loss of taste/smell and many with very high fever early in the course, severe headache, bodyache,a proper cold etc.
If you have any symptoms, test immediately. Do not start over the counter medications or follow someone else’s prescription. Do not panic. Get a thermometer and a good pulse-oxymeter. Monitor your vitals. Keep your body hydrated. Check oxygen levels 2-3 times a day. In case of dropping oxygen levels, worsening blood parameters, moderate-severe lung involvement, comorbidities, do not delay admission. This can be dangerous. Don’t try home remedies at this stage. Hospitalisation on time and judicious treatment can prevent critical infection.
RT PCR is considered Gold standard test as of now for the detection of SARSnCOV-2 virus. However, new CoVid cases may not be detected by routine RT PCR Tests. Ideally, RT PCR should detect COVID 19 caused by all strains, but still, some newer variants may be missed.
According to WHO, some mutations like HV 69/70 have the capability to affect the RT-PCR testing as well and may go undetected in the tests. But the impact of the new mutation on the RT-PCR testing being deployed worldwide is expected to be minimal. Rapid antigen testing , results are available in less than an hour, Rapid tests…their chances of the false-negative rate can be as high as 50% and chances of the false positive rate are quite low.
So, if a patient tests positive from a rapid test it is more likely that he actually has the disease. In symptomatic patients If RAT is negative RT PCR test must be done for confirmation.
India lacks proper health infrastructure to deal with such a high number of daily cases. Lack of beds, ventilators, Intensive Care Units, medical oxygen is creating havoc among masses and consuming lives. With more than 22 lakh active cases, several states have reported shortages in oxygen and have been appealing to the Central government to cater to their needs. People are dying at homes, hospitals due to lack of oxygen.
On 21 April, 2021, 24 COVID-19 patients died due to low oxygen supply after an oxygen tanker leaked outside Dr Zakir Hussain Hospital in Nashik, Maharashtra. The incident caused the oxygen supply to be disrupted for 30 crucial minutes and led to the death of 24 patients on ventilators. As of 21 April, 1.75% of the patients were in ICU beds, 0.40% were on ventilators, and 4.03% were occupying oxygen beds and with current situation importing medical oxygen is the need of hour. As of now 23 April , 2021 a tender to import 50,000 tonnes of medical oxygen has been floated by the Ministry of Health and Family Welfare, and ‘Oxygen Express’ trains have been started to help hard-hit states.
Considering all these huge challenges currently faced by the health department, people of Kashmir must follow all the precautionary steps. Prevention is better than cure. Kashmir is lacking a proper health infrastructure to deal with such challenges. We don’t have such medical oxygen plants sufficient for the patients.
Follow CoVid 19 standard operative measures (SOP’s) properly , always wear masks, avoid gatherings, keep social distancing in markets, don’t board crowded vehicles, stay inside homes as maximum as possible ,restrict your children from playing outdoor games, eat healthy foods and sleep properly to boost your immunity.
Make sanitization as a habit in you daily life, sanitize periodically, sanitize everything you bring home from markets. For God’s sake, follow precautionary steps. Get yourself registered at nearby health care centre or hospital and get yourself vaccinated as early as possible. Your carelessness and non serious behaviour towards CoVid 19 can prove costly and perhaps deadly for you, your family members, your neighbours and other human beings.
For this you might be accountable on the day of Judgement. Be a responsible human being and act a force against the transmission of novel Corona Virus to save yourself and your loved ones. If you have previously recovered from the CoVid 19, consider yourself for donating plasma to save life of others. Please take all precautionary measures more properly and seriously. Save yourself from infection of the CoVid 19 and break the chain…..May Almighty Allah have mercy upon us all and protect us all from this deadly pandemic……!!!
(The author is pursuing MBBS at Community Based Medical College , Bangladesh)