The moment Omicron variant was detected in South Africa and a few countries, the Manipur Health Department announced that measures have been put into place to combat this new variant of concern. Except for testing of arrivals, especially arriving by air from identified countries; other measures have not been spelt out; leading people to think that no systematic measures have been put in place. Whether testing of arrival from other states where the variant have been detected is in place need to be made public as several states and Union Territories (UT) have reported the variant. The concern of the people of the state in this regard needs to be dispelled. This can only be done by transparency in the system.
Omicron cases have crossed 100 in India covering 11 states and UT and 91 countries have reported the case by December 17. It is spreading faster than any known variant, including the Delta variant and can soon become the dominant variant inching out the delta variant. Manipur cannot be inured from this variant and whatever methods are adopted to stop from reaching the state, due to various reasons, it will arrive unheralded and can cause havoc.
Nearly a month after its detection, certain aspect of the behaviour of the variant has been reported. It transmits faster and is more resistant to the existing vaccines though it causes less severe symptoms. One common symptom of this new variant is ‘scratchy throat’ which is followed by nasal congestion, dry cough, myalgia manifesting in lower back pain. Many cases are accompanied by loose motion.
By saying that the symptoms are less severe does not mean it is like a common cold; it can kill and if the number of infected is high, the death toll will also go up. Besides as the target of infection is reportedly on the nasopharyngeal region the incubation period is also shorter and the chance of it being airborne also increases.
The omicron variant has reportedly branched into two sub-lineages, BA.1 for the original variant and BA.2 for the new found variant. The key differences is that BA.1 has a key deletion which is 69-70del, while in the BA.2 this deletion does not occur, leading to a little bit more difficulty in identifying through RT-PCR test. The behaviour of the latter sub-lineage is not very clear. During this month, another sibling was also discovered which was temporarily assigned England/MILK-2D24AC9/2021. This indicates the complexity of meeting the challenges of the virus.
One good news for India is that the Indian version of Novavax manufactured by Serum Institute of India known by the name Covovax have received Emergency Use Authorisation from the WHO and can be an armour for vaccination for those between 12 to 17 years and for use as a booster dose. This vaccine has high efficacy and is a recombinant protein vaccine using spike proteins and assembled them into nanoparticles that mimicked the molecular structure of SARS-CoV-2 but does not replicate.
The measures the state needs to take is to ramp up the vaccination as though its efficacy is lower against the new variant it still provides protection to a fairly large percentage. This is despite the fact that breakthrough infection is much higher with this new variant, or in other words, those who have got COVID-19 or those who have been vaccinated can be infected by the variant much more easily. The Government must reiterate and make the people understand the likely danger of this new variant and ensure that the public must scrupulously follow the laid down protocol of maintaining physical distance of 2 metre, correctly wearing proper mask, following proper hand hygiene and respiratory etiquette, ventilating rooms by opening windows and interacting more outdoors, etc. Besides, people must be desisted from non-essential travel, mass gathering and observe low intensity festivity.
Easier said than done with Christmas and New Year knocking at the door and the election not far off! Failure to take precautions may lead to socially and economically crippling lockdowns and if precautions are not taken election may be postponed with the State coming under a spell of President Rule. State must bring pressure to the Centre for booster dose as there are scientific evidences that booster dose of a different vaccine elicit very strong immune response. Politics of favouring Indian vaccines like Covaxin and ZyCov-D need to stop. Covishield for propaganda purposes is treated as an Indian vaccine which is not, and only manufactured under licence like Covavax.
The hospitals and beds must be kept ready and all oxygen manufacturing units installed need to be kept functional. Medicines and consumables may be stocked as it is better to err on safety than on neglect. The newly constructed dedicated hospital is an advantage. The emphasis on testing should be on RT-PCR which at present constitute from 50-60% and the percentage need to be increased. All travellers from outside must be properly tested and they should be quarantined. Public awareness must be increased and experts must communicate with the public on the likely danger of this variant and the damage it can wrought on the state and its people. Experts opine that the third wave due to omicron may peak in India by February and Manipur can see peak by March, 2022. The lag period will be shortened due to higher infectivity. If preparation based on the experience of other countries is made, the state can be well prepared. Review may be held every week or fortnight and changes made with the latest information available so that it is not taken by surprise as in the second wave.
With the tapering of the second wave, people have let down their guard which is not unexpected as people want to become ‘normal’ and many are seen without masks and there are large gathering for marriages, saradhas, funerals, etc. The road are choc-a-bloc with people violating the laid down protocol, which need an urgent change if Manipur does not want to see more death in the likely third wave driven by the omicron variant. Manipur had lost nearly two thousand deaths during the first two waves. The old norm may never return and a new normal need to be set in response to COVID-19, failing which the state will see more mortality and morbidity.
In the vaccination front as per the target laid down by the Centre, Manipur has achieved only 55.58% 1st dose and 40.56% 2nd dose. Despite such poor achievement, the vaccination on 17th December is only 1st dose 1455 and 2nd dose 3421 which is miserably low. The progress of vaccination, especially 1st dose is too low and with this pace of progress the full coverage cannot be achieved even in two years. This need urgent ramp up as despite collaboration with an NGO, the progress is still poor and other methods need to be thought of and put in place. The focus should be on the first dose as once the first dose is administered, second dose can follow with limited intervention.
The aspiring candidates who swear to serve the people must realise that crowding can lead to outbreaks and thus they should ensure that in any gathering for election purposes the laid down protocols are strictly observed. Failure to observe this can only mean that despite public utterances, they think only about themselves and have no responsibility towards the public. The Government must also understand that the protocols are for all; be it government or private. The tendency to break the protocol by government agencies and leaders is a great disservice to the people as public tends to follow their leaders. The virus does not differentiate between ruling and opposition or between government and private or rich and poor. Any gathering of any colour can be a cause of major outbreaks.
As per a Supreme Court directive, every person who died of COVID-19 must be provided ex-gratia to their family members at the rate of Rs 50,000 each from the State Disaster Fund. Many states after calling applications have started distributing the money. Manipur last week issued orders for seeking application for providing monetary benefits to the families whose members passed away from COVID-19. Better be late than never and the orders was to avoid Supreme Court’s displeasure. The tragedy is that most deaths are yet to be issued with death certificate indicating Covid as the cause.
The state Government have as assured on the floor of the House during the monsoon session brought out a white paper on the fight against Covid. However, one fails to understand why it was not uploaded in the website of the state government especially Health Department and why copies are just not available. The whole purpose of a white paper is to communicate with the people and what better way for large reach than the web-sites of the government? Government talks of e-governance but upload seems selective.
(The views expressed are personal)