There are two theories-Lab leak and Animal Origin. Although several scientists stress upon the Lab Origin theory, it has been rather difficult to gather sufficient data to support this view. Of late, it's becoming increasingly likely that COVID-19 might have originated from bats and spread to humans via an intermittent host e.g. raccoon dog in a live animal market in China.
Several evidences point to Wuhan Seafood Market as the likely origin of the outbreak which later became a global pandemic. The first coronavirus patient who picked up the novel virus became sick on December 11, 2019 (New Scientist, Nov. 18, 2021).
Dr Michael Worobey, University of Arizona, has painstakingly put together a timeline of all known cases of SARS-CoV-2 before it became a global pandemic (CNN, Nov. 19, 2021). He found many coronavirus cases in people who lived or worked near the Huanan seafood market, even if they didn't have direct links to the market. From his detailed studies which have been published in the premier journal Science, Worobey concluded that the Huanan Market is the most likely place where the pandemic started.
New Variants: What is causing the current Covid surge across Europe?
The Delta Plus variant, AY.4.2. is still raging across UK and other parts of Europe. Several countries such as Germany, Austria and Netherlands are imposing lockdowns or considering imposing other forms of restrictions. Maybe the waning immunity after receiving the AstraZeneca vaccine may be what's causing the current surge in Europe. Vaccine-elicited immunity may dip significantly six months after the second dose. That's why there is the need for booster doses. Germany has declared a 'state of emergency' due to an alarming surge in cases recently. Similar restrictions have been imposed or about to be imposed in other European nations such as Austria, Netherlands, and Belgium. Germany is logging over 50,000 cases for the third day running.
A new sub-lineage named AY 104 (B.1.617.2.AY 104) derived from the Delta variant has been detected in Sri Lanka (NDTV, Nov. 19, 2021). This is the third coronavirus mutant that originated in this island nation. However, the transmissibility of AY 104 is yet to be determined.
A new variant called B.1.X or B.1.640 has recently been found in parts of Europe (Deseret News, Nov. 16, 2021). This variant infected 24 people in a French school in October. Subsequently, a limited number of cases have been detected in the UK, Scotland, Switzerland, and Italy. What's concerning is that this variant has some mutations that scientists haven't seen so far. For example, the spike protein has deletions that have never been found before. This may make it harder for vaccines to identify the spike protein before it infects people. The variant possibly came from Africa and it emerged possibly due to low vaccination rates there. This means that pockets of unvaccinated populations anywhere in the world may be the breeding grounds for new COVID variants.
According to Dr Mark Dybul, Georgetown University, US; a vaccine-resistant variant is likely to emerge by Spring 2022 (Deseret News November 18, 2021). This means that getting booster doses in the coming months may be better for all of us. Scientists in Germany have warned that an older variant called A.30 can evade the Pfizer and AstraZeneca vaccines. Dr Anthony Fauci had warned in September that a 'monster variant' could emerge that would make the delta variant look much weaker in comparison.
New Symptoms - Can Covid spread through tears?
It's now known that COVID can cause strange symptoms not described earlier. COVID can cause strange eye and ear symptoms, including red eyes, ringing ears and trouble in hearing etc. (Scientific American, Nov. 17, 2021). Red eye or conjunctivitis may be a sign of Covid infection. A person who has COVID can even shed the virus through his tears long after he has recovered from the disease.
The urgent need for Booster Shots
US has recently approved booster doses for all eligible adults 18 years and above (IE, Nov. 20, 2021). India is yet to approve boosters for its population. However, there is the urgent need to administer booster shots at least for priority groups such as the elderly, co-morbid patients, and healthcare workers.
Increasing the pace of vaccinations, fully vaccinating all eligible people in India, giving booster shots for priority groups and rolling out children's vaccines as soon as possible are some of the initiatives that we need to take up to prevent a new wave or even to fully come out of the current 2nd wave of coronavirus infections.
An expert panel will decide about booster shots for the most vulnerable in India next week (IE, Nov. 20, 2021).
Possible Third Wave - We cannot afford to be complacent yet
It's not yet clear if a new wave of COVID-19 will emerge or not. In India, many experts opine that COVID-19 has already become an endemic and no new wave of pandemic will occur in the country. However, there is a complex interplay of new variants, vaccination rate, waning immunity and booster doses, provision of children's vaccines and easing/enforcement of restrictions and winter crowding etc. that will determine the trajectory of COVID-19 infections. We cannot afford to be complacent yet!
With COVID surging in Europe and other parts of the world, a new wave may be around the corner in India. Kerala may witness a fresh COVID wave in Jan-Feb 2022. The onset of winter, large pockets of unvaccinated people, breakthrough infections, age and other factors are some of the factors that may trigger a third wave in India (IE, Nov. 18, 2021).
When will India begin administering COVID Vaccines on children?
India is likely to begin vaccinating children in the next 6 weeks (CNBC TV, Nov. 20, 2021). Vaccination will start with the two approved vaccines. Children with co-morbidities will be vaccinated in the first phase. All other children will be vaccinated in the second phase.
New COVID Drugs - Xevudy and AMG PERK44
AstraZeneca's antibody treatment has been shown to be over 80% effective in preventing COVID-19. This antibody drug is named AZD7442 (CNBC, Nov. 18, 2021). Xevudy is another antibody treatment developed by Vir Biotechnology and GSK for patients not requiring extra oxygen but are at risk of developing severe symptoms of the diseases. The EU's medicine's authority is currently evaluating the effectiveness of the drug. A drug called AMG PERK44 developed by the University of North Carolina (UNC) has been shown to effectively stop the viral replications. Several other drugs are also in various stages of development.
Urgent measures needed in Manipur
Despite the seemingly improved scenario, we cannot let our guards down yet. Manipur needs to quickly step up to enhance its health facilities. The state must initiate measures to squarely face a possible third wave. The steps may include:
-
Preparations for administering vaccines to kids in Manipur & booster shots to high-risk people (elderly, healthcare workers and people with weak immune systems).
Conducting immediate seroprevalence studies to understand what percent of population in Manipur and in its different districts are still susceptible to the coronavirus.
Speeding up vaccinations in a big way; aggressive vaccinations with monthly targets to cover all eligible population with first doses in the next few weeks (4-6 weeks); and targeted vaccinations of all adult population with second doses in the next 2-3 months.
Regular & repeated COVID testing in hotspots.
Enhancing the ratio of RT-PCT to Rapid Antigen Testing (RAT).
Weekly "awareness messaging" about the pandemic to the public by a designated healthcare official.
Genomic sequencing of a subset of positive cases and surveillance of the variants including the delta variant: which COVID strains are there in Manipur, where are they, and where are they moving towards; and whether any new variants are emerging.
Contact tracing and government-monitored isolation of positive cases, wherever feasible.
Boosting up healthcare provisions such as medical oxygen plants, tankers and cylinders; steroids, antifungal drugs, oxygen concentrators, ventilators, oximeters, masks, PPEs, sanitizers etc.
Strengthening of healthcare infrastructure such as construction of new COVID hospitals.
Provision of more COVID care centres (CCCs), more Covid beds and ICUs in existing hospitals
Constitution of a special taskforce for the third wave; a separate taskforce for pediatric COVID is also highly recommended.
Special provisions for kids such as pediatric hospitals, wards, and ICUs, pediatric oximeters, concentrators, and ventilators and strengthening of staff such as pediatricians and pediatric nurses and paramedical workers etc.
(The views expressed are personal)
