The pandemic brings devastation, deaths and derails the health systems. Not only it leaves trails of sorrow, pain and agony for the families but it badly impacts the economy by way of financial crunch and job losses.
The Influenza pandemic of the year 1918-19 affected one-third of worldâ€™s population and accounted for 20-50 million (some estimates over 100 million) deaths. It killed more people in absolute numbers than any other pandemic in history. It began subtly in 1918 with physicians in Italy and Britain arguing that the epidemic was not influenza as it had very short duration without any relapses or complications. So the first wave of Influenza pandemic was of short duration and didnâ€™t have a visible impact. But within a few weeks, a second pandemic wave swept around the globe because it was virulent and spread fast. It was followed by a third wave in 1919-20.
Literature says that the persons affected in the first wave were resistant to the impacts of the second and third waves, even though the third wave was the most lethal one.
In 2019, a new disease emerged from Wuhan, Hubei province of China which was initially termed as Novel CoronaVirus Disease, and World Health Organization later coined it as COVID-19, an infectious disease caused by a newly discovered coronavirus, called SARS CoV-2. The virus transmitted trans-continentally and affected all countries in a few months of its emergence. As the biggest pandemic of the twenty-first century, COVID-19 traversed at different waves in different regions of the world. While the USA is experiencing the fourth wave, India is witnessing the down slope of the second wave.
The first wave of COVID-19 in India extended over many months while the second wave started with a sharp rise in cases, achieving new high case load with passing days till it reached a plateau and started declining. However, the second wave was severe due to mutation of the original virus with successive emergence of new variants; mutations will continue to happen as long as the coronavirus spreads through the population and this may ensue emergence of more waves. Moreover, the more people will get infected, the more chances there are to have new variants. Thatâ€™s why we are witnessing newer variants emerging every now and then.
Genomic sequencing has facilitated finding new variants across the world with some variants of concern (VOC) proving more lethal than other variants including variants of interest (VOI). Recently the World Health Organization (WHO) classified VOCs and VOIs in Greek nomenclature rather than associating them with nations or communities where they were initially isolated.
As long as more and more people get infected, the circulation of different variants in the community would continue. However following COVID appropriate behaviour (CAB), would limit the virus transmission which would further reduce the chances of emergence of new variants.
Thereâ€™s an urgent need to reiterate that following SOPs laid down by the government emphasising COVID appropriate behaviour (wearing mask, physical/ social distancing and practicing hand hygiene) augmented with universalisation of vaccination against COVID would thwart emergence of a more severe form of third wave in coming months.
Vaccination against COVID-19 is now a cornerstone against transmission of infection among unaffected populations, especially high risk and vulnerable groups of people. The global data highlights that in countries where the vaccination drive has covered the majority of population, the transmission of SARS CoV-2 virus as well as severity and duration of illness has considerably dropped to the level that it no longer remains a major public health concern.
In Indian set-up where around 30% population of under eighteen years age group and pregnant women are still unvaccinated as thereâ€™s no government guidelines as of now, itâ€™s imperative that all other age -groups over 18 years of age shall be vaccinated so that it would prevent transmission of infection to these unimmunized groups.
As parents and guardians, we have the responsibilities to protect our children by getting all other family members vaccinated against COVID infection. Vaccines are panaceas that weren't present during the Influenza Pandemic of 1918-19 which led to a severe third wave during that time. During current times, we need to decide whether we want to protect ourselves, families and communities against COVID through vaccination or allow people to get infected and evolve into the third wave, which may be more severe than the first two waves.
Meanwhile, we need our collective efforts to continue through COVID appropriate behaviour, testing, tracking and treatment to prevent further transmission of SARS CoV-2 infection and to vaccinate as much population as possible in the shortest period of time.
Dr S. Muhammad Salim Khan
Professor & HOD, Community Medicine
Government Medical College, Srinagar