The second wave of corona in India is weakening, but it is not over. The peak of the second wave was four times larger than the first peak in September last year. The death toll in the second wave has also doubled. More than 2.5 lakh people have died in 150 days. While the second wave is not over yet, many experts are saying that the third wave will come. And it can be very dangerous even for children.
But Dr. Chandrakant Lahariya, an expert on epidemics, has a different opinion. He says there is no scientific basis to prove it. Children are no more at risk than older people. 40% of the population in our country is under 18 years of age. Of these, 10 percent have been infected so far. "Under-reporting of deaths is happening in every country," he said. The actual death toll in India can be 2 to 6 times higher than the actual death toll.
Dr. Lahariya met Dr. Randeep Guleria, Director, Delhi AIIMS, and Dr. Gagandeep Kang, Top Vaccine Scientist, and wrote a book on coronavirus in India. Its name is "Till We Win". Dr. Lahariya Koro is also a member of several committees. We discussed with him various issues like Corona's current condition, its potential risk to children, future wave, speed of vaccination. Here are some excerpts from this:
Q: Where did we go wrong in estimating such a large corona wave?
Dr. Lahariya: When an epidemic strikes, long-term planning is necessary. There were three big mistakes in stopping Corona in our country..1. We lacked planning there. 2. Testing and treatment facilities did not reach the villages. 3. We learn from the mistakes of others and their best practices in epidemics. But we didn't learn that! The speed of vaccination could have been increased, but we did not.
Now a lot of attention needs to be paid to mental health and post-covid treatment. You have to understand that an epidemic has to be fought on three levels ... 1. Government 2. Health system 3. People. If one of the three does not do its job properly, the level of the epidemic will increase and it will spread.
Question: Is the third wave coming by September and will it affect the children?
Dr. Lahariya: There is no scientific basis for saying that the third wave or any other wave will be more dangerous for children. The first and second waves have had little effect on children. People up to the age of 18 have had Corona's Moderate to Severe Illness from 10 percent to 11 percent. 40% of the country's population is under 18 years of age. Corona affects 89 percent of the 60+ population of 18+.
There is also a scientific basis for low risk for children. The virus attaches to receptors called APE-1 in the lungs. In children those receptors are under-developed. It does not cause serious symptoms in children even after infection. Even in countries where a third or fourth wave has occurred, children are less affected. Even the new variants do not affect the children much. In other words, there is no risk in children.
Question: Where is the shortcoming in the government's vaccination planning?
Dr. Lahariya: For successful vaccination, it is possible to work on three levels ... 1. Policy. 2. Supply 3. Delivery at ground level, now it should be scrutinized
Policy: The country has formed a working group on vaccination, which has been setting priorities since September, 2020. But the supply of vaccines was not taken into consideration.
Supply: Vaccination was to start from January 16 and the first order was placed on January 11. I.e. only 5 days ago. There were also many misgivings about the vaccine. The vaccine was previously available but no one was vaccinated. As people increased demand, supply began to dwindle. Because no attention was paid to timely supply.
Delivery on the ground: We would have benefited better if we had learned from the polio eradication campaign. However, AEFI (Adverse Events Following Immunization) has been put to good use. The cold chain system that has developed over the last 15 years has also been put to good use. However, with proper care, our vaccination program would be much better today.
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Question: Reports say that people who have an infection do not need a vaccine, is this true?
Dr. Lahariya: As far as the study is concerned, a person who has been infected has protection for 6 to 9 months. Because of this the WHO also says that people who have been infected once can wait up to six months for the vaccine.
According to a May 24 study in the journal Nature, people who have had a mild infection begin to have a gradual decrease in antibodies, which disappear after about 11 months. However, due to the presence of long live plasma cells in its bone marrow, a person can be protected for a long time.
Question: Reports say that people who have an infection do not need a vaccine, is this true?
Dr. Lahariya: As far as the study is concerned, a person who has been infected has protection for 6 to 9 months. Because of this the WHO also says that people who have been infected once can wait up to six months for the vaccine.
According to a May 24 study in the journal Nature, people who have had a mild infection begin to have a gradual decrease in antibodies, which disappear after about 11 months. However, due to the presence of long live plasma cells in its bone marrow, a person can be protected for a long time.
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This is all an early understanding. Along with this new variants of Corona are also coming. The vaccine is the most effective option in these circumstances.
Question: Fear of variants is also being shown to speed up vaccination. Is there a risk of new variants or strains being delayed in vaccination?
Dr. Lahariya: According to a study conducted in the last few days, the need for neutralizing antibodies against the new variant is higher than the traditional variant. However, no one in Corona has a level of antibody. If a person has antibodies it is considered protected. Then even if not based on antibodies.
If a person has antibodies they are considered protected. Then no matter what the amount of antibody. This means that the vaccine will also be effective against newer variants.
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This is all an early understanding. Along with this new variants of Corona are also coming. The vaccine is the most effective option in these circumstances.
Question: Fear of variants is also being shown to speed up vaccination. Is there a risk of new variants or strains being delayed in vaccination?
Dr. Lahariya: According to a study conducted in the last few days, the need for neutralizing antibodies against the new variant is higher than the traditional variant. However, no one in Corona has a level of antibody. If a person has antibodies it is considered protected. Then even if not based on antibodies.
If a person has antibodies they are considered protected. Then no matter what the amount of antibody. This means that the vaccine will also be effective against newer variants.
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This can be understood from a study in the UK. It found that the efficacy against the Delta variant was 32 percent after a single dose of the vaccine. While against the alpha variant was 52 percent. This means that with the advent of new variants, the effectiveness of vaccines may be somewhat diminished. However, it cannot be said that it will be completely useless.
Question: Should children be vaccinated first or should they cover the elderly?
Dr. Lahariya: There is no unlimited amount of vaccine. In these circumstances vaccination should be done on a priority basis. This type of vaccination program should be run worldwide. India is the first country to have vaccinated so many people at once.
The dog was sitting on the sofa watching TV and all of a sudden it happened that you would be blown away by the video.
This can be understood from a study in the UK. It found that the efficacy against the Delta variant was 32 percent after a single dose of the vaccine. While against the alpha variant was 52 percent. This means that with the advent of new variants, the effectiveness of vaccines may be somewhat diminished. However, it cannot be said that it will be completely useless.
Question: Should children be vaccinated first or should they cover the elderly?
Dr. Lahariya: There is no unlimited amount of vaccine. In these circumstances vaccination should be done on a priority basis. This type of vaccination program should be run worldwide. India is the first country to have vaccinated so many people at once.
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As far as children are concerned, the risk to children is very low. These circumstances will be covered at the very end. My guess is that vaccination of children in India could start in September or later.
Question: Some countries have banned Kovishield, but we have all hopes on it there ... What do you think about the ban?
Dr. Lahariya: The restrictions that have been imposed are not a ban. Nor do such countries allow for a specific age group. The main reason behind this is suspected to be a rare blood clot from the cove shield. However, scientists believe that this risk is much lower than the benefits of vaccination.
The risk of blood clotting is reduced. This means that people over the age of 60 are the least likely to be in the age group of 50 to 60. It increases at a younger age. For this reason some countries have made it available to people of a certain age. In addition, most countries have a choice of vaccine.
Question: Even after being vaccinated with cove vaccine, it is not considered vaccinated abroad, what is the reason behind it and there is talk of fourth phase trials, is there any need for it?
Dr. Lahariya: Emergency use of Covexin was approved in India. The clinical trial of the vaccine was completed in March and the results came in May. The trial must be completed for approval from the WHO. All data should be available. The process is not complete. As a result, it has not been approved at the international level.
I think covexin will be approved as soon as the process is complete. Hope to see you soon from WHo then. Then this problem is considered to be over.
Question: Which of the mix and match vaccines is right, what does the research say so far?
Dr. Lahariya: This was the first research in Spain. There the first dose of Oxford Astragenica was given. Then another dose of mRNA based Pfizer Biotech was given. They found that the side effects of mixed vaccinations were slightly higher, although antibody levels were much higher in mixed doses than in both doses of a single vaccine.
That is, the vaccine protects both conditions. Similar studies are being conducted in the UK. There are similar results. There will be several vaccines in the near future. If further studies show that the longer the protection from mix and match, the greater the benefits.
Q: Bihar recently restructured the death toll from Corona, what do you think could be the reason behind this gap in statistics?
Dr. Lahariya: Death is under- reported in this type of epidemic all over the world. Under-reporting takes place at different levels in each country. According to a WHO report, the death toll worldwide is two to two and a half times higher. If we talk about India, the actual number of deaths in India could be two to six times.
However this fact of death cannot be suppressed. The matter will come up in the next census. Second, when the country's 2020-21 death toll rises one year later, the total death toll will rise. The figures released by Maharashtra and Bihar after the review show that some deaths have definitely been under-reported.
As far as children are concerned, the risk to children is very low. These circumstances will be covered at the very end. My guess is that vaccination of children in India could start in September or later.
Question: Some countries have banned Kovishield, but we have all hopes on it there ... What do you think about the ban?
Dr. Lahariya: The restrictions that have been imposed are not a ban. Nor do such countries allow for a specific age group. The main reason behind this is suspected to be a rare blood clot from the cove shield. However, scientists believe that this risk is much lower than the benefits of vaccination.
The risk of blood clotting is reduced. This means that people over the age of 60 are the least likely to be in the age group of 50 to 60. It increases at a younger age. For this reason some countries have made it available to people of a certain age. In addition, most countries have a choice of vaccine.
Question: Even after being vaccinated with cove vaccine, it is not considered vaccinated abroad, what is the reason behind it and there is talk of fourth phase trials, is there any need for it?
Dr. Lahariya: Emergency use of Covexin was approved in India. The clinical trial of the vaccine was completed in March and the results came in May. The trial must be completed for approval from the WHO. All data should be available. The process is not complete. As a result, it has not been approved at the international level.
I think covexin will be approved as soon as the process is complete. Hope to see you soon from WHo then. Then this problem is considered to be over.
Question: Which of the mix and match vaccines is right, what does the research say so far?
Dr. Lahariya: This was the first research in Spain. There the first dose of Oxford Astragenica was given. Then another dose of mRNA based Pfizer Biotech was given. They found that the side effects of mixed vaccinations were slightly higher, although antibody levels were much higher in mixed doses than in both doses of a single vaccine.
That is, the vaccine protects both conditions. Similar studies are being conducted in the UK. There are similar results. There will be several vaccines in the near future. If further studies show that the longer the protection from mix and match, the greater the benefits.
Q: Bihar recently restructured the death toll from Corona, what do you think could be the reason behind this gap in statistics?
Dr. Lahariya: Death is under- reported in this type of epidemic all over the world. Under-reporting takes place at different levels in each country. According to a WHO report, the death toll worldwide is two to two and a half times higher. If we talk about India, the actual number of deaths in India could be two to six times.
However this fact of death cannot be suppressed. The matter will come up in the next census. Second, when the country's 2020-21 death toll rises one year later, the total death toll will rise. The figures released by Maharashtra and Bihar after the review show that some deaths have definitely been under-reported.
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