Dr. Jacob Eapen-
Dr. Jacob Eapen, a Medical Director at the Alameda Health System(AHS) and a member of the Board of Directors at the Washington Hospital in Fremont, California. He is also the Regional Vice President of the Federation of Kerela Association in North America(FOKANA). The views expressed are his own.
World has seen many different waves of pandemic. Americans and Europe have already faced about four waves and India is now in the middle of the second wave. The factors for the second wave to be so devastating are many folds. The first assumption is that the mutations have caused increase in numbers and hospitalizations.
The Indian variant designated as B1.617 with mutations at L452R, E484K, and P6814 making it a triple mutant has been designated by W.H.O as a variant of concern. The others are the British variant (B1.117), South African Variant (B1.351) and Brazil variant(P1). There are other 7 variants of interest that is also being monitored.
The W.H.O emphasized in its report that it was not yet clear how much the variant known as B1.617 has contributed to the devastating surge. It cautioned India, like many countries, that it is only sequencing a tiny portion of the positive samples with so little surveillance. India does only about 0.06% genomic studies and ideally, it should be between 2 to 5%. More genomic studies are needed to follow the mutation and monitoring its spread. They are not cheap but are a necessity. Britain does one of the highest genomic monitoring in the world.
W.H.O’s study comes amid growing condemnation of the Indian government’s response to the pandemic. It calls for a complete shutdown to try to limit the death toll, as hospitals are overrun, and crematories burn nonstop. They point to a perfect storm of public health blunders, such as permitting political rallies and religious festivals in recent months. Trying to please the Gods and political leaders has not worked well with the virus. Initial studies have shown that some of these variants have a tighter grip on the cells making it more infectious.
B1.617 first came to light in October of 2020. This variant has been detected in 49 countries now and is rapidly growing in Britain. Officials in India are trying to track how many of the vaccinated people have fallen ill, which might point to the variants’ ability to evade a vaccine.
Data submitted by GISAID from India indicate the variants’ distribution of 12% of B1.618, 28% of B1.617, and the rest B1.117. B618 was detected outside India in April of 2020. Now India accounts for 62% of B1.618 in the world.
Currently, there are several states and cities that are showing the worrying trend of increase. Karnataka, Kerala, Tamil Nadu, West Bengal, Punjab, Odisha, Assam Himachal Pradesh, Tripura, and Meghalaya are 16 states union territories showing a continuing increase in Covid 19 cases.24.44% of the total active cases are reported from 10 districts including Bangalore, Ernakulam, Thrissur and Kozhikode in Kerala. 26 states have positivity rate more than 15%.
India’s under preparation was exposed by this second wave. Hospitals were overrun with lack of beds, shortage of oxygen and PPE’s. Testing, isolating, and vaccinations were very slow to start with. Now India is conducting 18 to 29 lakh testing per day per ICMR but it all came too late.
Deaths have increased by touching 4,000 per day. Per international epidemiologists, the actual numbers may be about five times more. The death rate among the young have increased mainly waiting for hospital beds and oxygen. Most of these deaths could have been avoided. People who have blood in their hands will have to answer on judgment day.
After giving away Covid vaccine to 95 countries, India had to face vaccine shortage now. Vaccine rolls out has been very disruptive. There were mixed messages send out. Initially, it was all supposed to be centralized but it has become a free for all whereby now states can negotiate with manufacturers and place bid for procurement.
The supply chain was broken. Pfizer vaccine’s request for emergency use was denied and sputnik from Russia has been approved. Johnson and Johnson is still negotiating with India to start manufacturing in India. Less than 10% of the population has been vaccinated so far. Now to prioritize, the government has asked to allot 70% of the vaccines supplied for the second dose and the remaining 30% for the first dose. More than 90% have not received their second dose. The waiting continues.
The world is watching the smoke from the pyres and people might have to go back to the dark ages by taking black cumin and honey. Someone in the leadership in India must deliver some hope to its people before the situation becomes more hopeless. Time and Tide wait for no man…