Third Wave "Inevitable, Could Hit India In 6 To 8 Weeks": AIIMS Chief

 Third Wave "Inevitable, Could Hit India In 6 To 8 Weeks": AIIMS Chief

A new frontier will have to be developed in India's fight against Covid to further study the mutation of the virus, AIIMS chief Dr Randeep Guleria said.

All IndiaReported by Rishika Baruah, Edited by Swati BhasinUpdated: June 19, 2021 3:41 pm IST

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Covid-19 Third Wave: India has logged 2.97 crore cases of coronavirus so far.

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New Delhi: A third Covid wave in India is "inevitable", and it could hit the country in the next six to eight weeks, AIIMS chief Dr Randeep Guleria told NDTV this morning amid unlocking in parts of the country after weeks of strict restrictions. The country's main challenge is vaccinating a huge population and the increase in dose gaps for Covishield "may not be a bad" approach to provide protection to cover more people, he explained.

A new frontier will have to be developed in India's fight against Covid to further study the mutation of the virus, Dr Guleria stressed, as he talked about the new Delta-plus variant, which has evolved from the Delta variant of COVID-19, triggering fresh concerns about monoclonal antibody treatment.

"As we have started unlocking, there is again a lack of Covid-appropriate behaviour. We don't seem to have learnt from what happened between the first and the second wave. Again crowds are building up... people are gathering. It will take some time for the number of cases to start rising at the national level. Third wave is inevitable and it could hit the country within the next six to eight weeks... may be a little longer," Dr Guleria said. "It all depends on how we go ahead in terms of Covid-appropriate behaviour and preventing crowds," he added.

Nearly 5 per cent of the country's population has so far been vaccinated with two doses. The government aims to vaccinate 108 crore of over 130 crore people in the country by the end of this year.

"That (vaccination) is the main challenge. A new wave can usually take up to three months but it can also take much lesser time, depending on various factors. Apart from Covid-appropriate behaviour, we need to ensure strict surveillance. Last time, we saw a new variant - which came from outside and developed here - and led to the huge surge in the number of cases. We know the virus will continue to mutate. Aggressive surveillance in hotspots is required," the AIIMS chief said.

"Mini-lockdown in any part of the country, which witnesses a surge and a rise in positivity rate beyond 5 per cent, will be required. Unless we're vaccinated, we're vulnerable in the coming months," he underlined, stressing that "testing, tracking, and treating" should be the focus in hotspots.

"We have to factor in human behaviour while unlocking, which needs to be done in a graded manner," Dr Guleria stressed.

On the spread of the Delta variant in the United Kingdom, which is now facing a third wave, he said, "Virus is still mutating, we need to be careful".

The highly transmissible variant first identified in India is now making up 99 per cent of fresh COVID-19 cases in the UK, news agency PTI reported.

The gap between the new waves is shortening and it's "worrying", Dr Guleria said.

"During the first wave (in India), the virus was not spreading that rapidly... all that changed during the second wave, and the virus became much more infectious. Now the Delta variant that's spreading is much more infectious. Faster spread is likely," said the AIIMS chief.

A debilitating second wave had led to the shortage of hospital beds and medical supplies in various parts of India. SOS messages on social media had caught the world's attention with many nations coming forward to help. Several states have now eased the restrictions after weeks of strict curbs; however, preparations are on against the third wave.

In Maharashtra, experts have now warned that at its peak, the third wave of the virus could cause 8 lakh active cases in the state, which currently has around 1.4 lakh patients.

"When there is a huge increase in the number of cases, shortage of (hospital) beds follows. The strategy should be multi-pronged - we have to make sure fresh cases don't rise. Any healthcare system globally will tend to collapse with the unprecedented rise in the infections," Dr Guleria said today.

Does India need to rethink its 12-16 week gap decision between two doses of Covishied, a vaccine the country is largely dependent on? "Nothing is written in stone. We will have to look at new strategies. But we need to have strong data to take that decision," the AIIMS chief said.

The decision should be driven by science and not the shortage of doses, he suggested.

The United Kingdom adopted the one-shot strategy not only for AstraZeneca (which is being used as Covishield in India), but also for Pfizer, Dr Guleria pointed out.

"One-shot strategy may not be a bad strategy as it can give protection to larger number of people," Dr Guleria said.

Third COVID-19 wave inveitable, says AIIMS chief: What Centre, states and experts have predicted so far

Citing a lack of COVID-appropriate behaviour across India, AIIMS chief Dr Randeep Guleria said that the 'inevitable' third COVID-19 wave could hit the country in the next six to eight weeks

FP Staff

June 19, 2021 20:48:18 IST

Third COVID-19 wave inveitable, says AIIMS chief: What Centre, states and experts have predicted so far

Representational image. AP

Albeit India's COVID-19 caseload has witnessed a declining trend following a disastrous 'second wave' between April and mid-June, with states unlocking activities after weeks of strict lockdown restrictions, a possible 'third wave of infections has entered the scientific and public discourse.

The "inevitable" third COVID-19 wave could hit the country in the next six to eight weeks, said Dr Randeep Guleria, Director of All India Institute of Medical Sciences Director (AIIMS), to NDTV on Saturday.

Why is this relevant?

There is a lack of COVID-appropriate behaviour after the easing of restrictions across India, Guleria said, adding the country's main challenge is vaccinating a huge population.

"As we have started unlocking, there is again a lack of COVID-appropriate behaviour. We don't seem to have learnt from what happened between the first and the second wave. Again crowds are building up, people are gathering. It will take some time for the number of cases to start rising at the national level. The 'third wave' is inevitable and it could hit the country within the next six to eight weeks, maybe a little longer," the report quoted him as saying.

Guleria's remarks have come amidst a debate within the public as well as scientific space on the possible third wave, and how it may impact India. Several state governments have already started preparing for the possible next wave of COVID-19 infections, and are regularly warning the public to follow COVID-19 precautions and the authorities to implement them.

What did the Maharashtra COVID task force say?

Guleria's remarks have come just two days after the Maharashtra government's COVID task force warned that the third wave could hit Mumbai within the next two to four weeks.

The predictions were part of the meeting chaired by Maharashtra chief minister Uddhav Thackeray on Wednesday to review preparedness for the projected third wave. It included task force members, the state health minister and senior bureaucrats. During the meeting, the Maharashtra COVID-19 task force presented the following projections:

Cases likely to double: According to data presented in the meeting, the total number of cases in the third wave is projected to double over those in the second wave, with active cases set to reach 8 lakh, News18 reported.

Children likely to be 10% of total cases: Unlike the claims from a section of experts — that children will be hit worst in the third wave — 10 percent of the total cases will come from children and young adults, the task force said.

Experts predict 100 days gap between peaks of two waves: Epidemiologists expect up to 100 days between the peaks of two waves or eight weeks from the decline of one wave to the next peak. Stressing on the need to practice COVID-appropriate behaviour, Dr Shashank Joshi, a member of the task force told The Times of India, "The UK is facing a third wave within four weeks of ebbing of the second wave. We could be in the same situation."

Groups that skipped the first, second wave most vulnerable: The task force has also warned that the population that managed to skip the dreaded virus in the first two phases are the most vulnerable in the third phase. "It is likely to affect the paediatric category, but it's difficult to predict. The population segment that escaped COVID-19 in the first two waves seems more vulnerable. But can't say when the third wave will come. We need to be prepared," said Dr Om Srivastava, Director of Infectious Diseases Department, Jaslok Hospital, and member of Maharashtra COVID task force.

Children and third wave: Who said what

Over the last few weeks, several theories and reports have emerged on how a possible 'third wave' may affect the children disproportionately or severely. However, there remains a significant difference in opinion between authorities and medical experts. Even doctors seem to disagree among themselves. Here's what's been said so far.

Centre, experts cite lack of scientific evidence

The government officials have dismissed reports claiming that the COVID third wave will impact children more as "misinformation" and lacking any scientific evidence.

During a media briefing on COVID-19 on 9 June, Guleria had said, “It is a piece of misinformation that subsequent waves of the COVID-19 pandemic are going to cause severe illness in children."

He also said that 60 percent to 70 percent of children who got infected and needed hospitalisation in the second wave were children with either comorbidities or low immunity. Healthy children recovered with only a mild illness and they did not need to be hospitalized.

Firstpost had spoken to Dr Tushar Parikh, consultant neonatologist and paediatrician at Motherhood Hospital in Pune's Kharadi Parikh to find out what they have to say on the subject.

"There is no evidence to say that children will be affected more or badly in the third wave but there is an assumption that since they will not have been vaccinated, they will be the vulnerable population by the time of the third wave," he had said.

Possible third wave unlikely to affect children more, concludes serosurvey

According to a seroprevalence study conducted by the World Health Organisation (WHO) and the All India Institute of Medical Sciences (AIIMS), a possible third wave is unlikely to disproportionately affect children than adults

The study, which compared the COVID-19 sero-positivity rate between children and adults from five locations in four states found a seroprevalence of  55.7 percent in those aged less than 18 (two to 17 years) age group and 63.5 percent in the 18 years and above age group.

The SARS-CoV-2 sero-positivity rate among children was high and was comparable to the adult population, the study said.

Among the 700 children aged 2-17 years who were part of the serosurvey, 362 (51.7 percent) were male. The number of participants in the aged 2-4 years were 33 (4.8 percent), 5-9 years 153 (21.8 percent), and 10-17 years 512 (73.1 percent).

"The higher seropositivity rate in children aged 10-17 years may be reflective of their higher mobility and independence compared to the younger children," it said.

How states are preparing for third wave

While the jury is still out on the third wave and its impact on children, state health departments don't want to get caught unprepared and have already started preparing to augment existing healthcare facilities for children, especially ICU and High Dependency Units (HDU) that provide specialised healthcare services.

Standalone paediatric hospitals in Telangana like Niloufer Hospital and Gandhi Hospital already have dedicated paediatric COVID-19 care facilities. In the coming days, HDUs and ICU will be strengthened within all the paediatric hospitals to handle Multisystem inflammatory syndrome in children (MIS-C) cases.

Kerala chief minister Pinarayi Vijayan advised people to exercise utmost caution due to the possibility of a third wave of COVID-19 . The third wave could be marked by a genetically mutated virus that could spread faster than the delta virus, the chief minister warned, and added that the government was fully prepared to face any eventuality.

Paediatric intensive care facilities are being strengthened to ensure expert treatment for children in the event of a third wave. An additional 10-bed paediatric ICU will be established in medical college hospitals, he said.

The Jharkhand government is on high alert to contain any possible third wave of the COVID-19 pandemic, following suggestions of experts that any laxity may lead to serious consequences, officials said on Friday.

The state government issued a detailed document to deal with the possibility of the third wave, which may lead to an increased number of infections among children.

"Experts suggest that the coronavirus is mutating at a fast pace and any kind of lethargy may lead to serious complications. With the inputs received from the experts, the state government of Jharkhand is on high alert regarding this matter. Efforts are being undertaken to enhance and upgrade the existing medical infrastructure," an official statement said.

With inputs from agencies