India recorded 25,072 new COVID-19 situations in the 24 hours ending August 23rd morning. It is the lowest in more than 150 days so far, and the recovery price is rising to more than 97 per cent. This is excellent news even though there are pockets of main concern such as Kerala and a couple of other regions from the North East. There are many hot spots in smaller sized pockets across the nation with a greater share of vulnerable population exactly where care and more targeted techniques will have to play a essential part now.
Questions Galore
So, exactly where are we on the pandemic, and what is the way ahead? As firms get to reopen and men and women attempt to emerge from self-isolation, how critical is it for you to get a booster shot? How actual are the fears of a achievable third wave? How protected are the children, the valuable and most vulnerable section of the population?
As schools commence to reopen and parents are fearful of letting their unvaccinated children mingle, India nonetheless does not have a vaccine totally authorized for children. The nation only lately saw its 1st emergency-use authorized COVID-19 vaccine for children from Zydus Cadila, but then it is a DNA vaccine. It is the 1st such vaccine in the world and, as with each new item, there are many concerns becoming raised and issues expressed – some arguably genuine on the extended-term effects?
TheSpuzz Online reached out to Dr Gagandeep Kang, one of India’s most respected virologist and the professor at the Christian Medical College, Vellore. Here is what she has to say on some of these prickly concerns:
On The Determinants Beyond Delta
On what is taking place with the pandemic, Dr Kang who has looked closely at the pandemic considering the fact that it started unfolding 18 months ago, says, “in the rest of the world, the Delta variant is causing the kind of spread of infections that we saw in April and May in India. However, within India, because delta is so transmissible, we are continuing to see a fair amount of delta variant.”
“As soon as you lift the restrictions, delta begins to appear in pockets that were previously protected,” says Dr Kang. Any resolution and preparedness strategy now is thus linked to granular information. She apparently does not see a one-size-fits-all resolution for these regions that have a higher seroprevalence that is exactly where a bigger proportion of the population has currently been exposed to the virus, the resolution is diverse when compared to regions exactly where the vulnerability is more. Unfortunately, there is not significantly clarity on this granular information. Also, in regions exactly where there are more situations, micro-containment techniques might be necessary and with far better district-level grip on seroprevalence will aid focus sources and containment techniques far better. Also, if sufficient care is not taken, several professionals have been arguing that India offered its size and numbers, there can usually be a further variant that could take us all by surprise thus the focus has to be on vaccination, masking, and social distancing.
On What Data Matters Now
“For me the stage that we are in now, we really need data that is broken down” and significantly of it is now readily out there and even if has been collected is apparently not becoming shared, says Dr Kang.
So, what is the type of information we want now? “If the government does 1.5 million tests a day, how many are for asymptomatic individuals, how many are for contacts, how many are tested because somebody known to them is sick, how many tests are for people who are in hospital? We need that breakdown now to try and understand what is happening in the country in the context of 67 per cent seropositivity.” Previously, she says, “even without detailed data, because everybody was susceptible, we managed. Now, we are in a situation where there are many places that are 80 per cent seropositive. So, as long as the virus that is circulating there is an alpha or a delta variant, it does not really matter because there are only 20 per cent of people left to be infected in that area.”
It might thus aid if entities like the Indian Council of Medical Research (ICMR), which apparently have access to a wealth of information could share it. This could be information about testing, vaccination details, vaccination history of men and women who have had breakthrough infections.
Dr Rajib Dasgupta from the Centre of Social Medicine and Community Health at the Jawaharlal Nehru University (JNU), who has been studying this for a extended time, says, in the aftermath of the second wave – April to June last – the ICMR had carried out the fourth round of a national sero-survey to see how several had been exposed to the virus and located a sero-prevalence of 67.6 per cent general. But then, there is large variation across regions and inside regions.
There is a low 44.4 per cent in Kerala, which became more vulnerable than say 79 per cent in Madhya Pradesh. But then, once again inside Madhya Pradesh, there might be regions with reduced sero-prevalence that might want more targeted method to ramp up vaccination or to include the spread of the virus.
On the Booster shot
With arguments undertaking the rounds, even amongst the physicians, about the length of time antibodies stay in the body just after vaccination – six months or thereabouts – and that with time, the immunity tends to wane, there are some currently asking yourself if there is want for booster shot, at least for the healthcare and frontline experts handling COVID-19 situations. A booster shot is however a further jab just after the two initial vaccination shots and it is taken to remind the body’s immune method about how it responded to an infection and thereby provide an added layer of protection.
Here, Dr Kang is in favour of a more nuanced method rather of a universal resolution for the reason that she sees a clear hyperlink to the findings on the antibodies and could differ from one particular person to a further. But, at the moment, in the Indian context when a massive set of population is nonetheless not vaccinated, feels it is not morally proper to take a third dose when several have not had access to even one dose. “With two shots of the vaccine, there is reasonable level of protection against severe disease and death. So, there is no reason why someone who has had two doses of the vaccine should take a booster shot when the rest of the world has not been vaccinated.” To her, it boils down to a query of morality.
The six months that antibodies stay argument? “If you go out and test all adults for antibodies for polio virus, you will find that 40 to 50 per cent of them will not have measurable antibodies to polio. Do we think that they are protected against Polio? Yes, we do but they don’t have measurable antibodies. You don’t expect antibodies to remain at a high level forever. What you need to know is that did the people make an immune response? If they made an immune response and it fades with time then that is the natural course for every vaccine and every infection.”
Here, she points to a method exactly where there could be sampling of men and women completed for antibodies. If the antibody count is located to be unfavorable then one could get a booster shot. We could come to this in future but then, she feels, “the time for it is not now.”
On the danger is a prospective third wave, she says, “keep vaccinating and keep wearing masks and maintain social distancing for that alone will help.”
On the DNA vaccine
On the newly authorized DNA vaccine from Zydus Cadila and how secure can it be for use in children, Dr Kang says: “In general, any vaccine that is safe and efficacious in adults will also be safe and efficacious in adolescents and that is the data from the DNA vaccine, which we have not yet seen, seems to indicate that they had a large number of children in the study and the vaccine seems to be working. Obviously, we would like to see a breakdown of the data and that has not yet been shared and we will have to wait for the company to release that data.”
On the concerns becoming raised in some quarters and by some professionals on the extended-term effects of a DNA vaccine, Dr Kang says, “DNA vaccines are typically engineered to not be able to integrate with the chromosome of human cells but the way to rule is to do bio-distribution studies, which is to take samples from various locations and see if there is any evidence of integration of DNA vaccine into the genome. This can easily be done in animal studies. This will provide additional reassurance to people,” she says.