Neither Covid free nor Covid safe

It is merely the reality that we must keep in mind as we go about, and not be under the illusion that we can now be totally free to do as we please

By Dr R NeerunjunGopee

The easing of restrictions that have been in place must not lead us into the false belief that we are Covid-free. We are not, and it is most unlikely that we will ever be. Because the virus is now circulating all over the world, in all countries irrespective of their level of development. Like the influenza viruses, with which we have to live. Unlike the influenza viruses, though, the Wuhan virus or, Covid-19 as it is more commonly known per WHO designation, is not seasonal like the former which are more common in winter and affect mainly the elderly. Further, it is not restricted to the lungs but causes disease in practically all organs in all age groups, not even sparing children under the age of 12 in whom it produces what is known as a ‘Multisystem inflammatory syndrome in children (MIS-C).’

Going out? Help keep you and your family safe. Pic – static.toiimg.com

For a while towards the end of 2020 and beginning of 2021the country may have been Covid-safe. That changed after January 2021 when probably the virus was in the community according to the information that has filtered in trickles. Whatever be, the fact is that after January we ceased to be Covid-safe, and currently therefore we are in a situation where we are neither Covid-free nor Covid-safe.

This is not being alarmist. It is merely the reality that we must keep in mind as we go about, and not be under the illusion – as we were when the lockdown was lifted last year – that we can now be totally free to do as we please. This is what we did last year and until the current lockdown. We dumped all the sanitary measures. There had been much talk and writing about a ‘new normal’ after the lockdown. But we simply went back to our ‘old normal’ – behaving as we used to do before, freely taking part in large gatherings and moving about in crowds.

A recap of what we know about Coivd-19, the virus and the disease, will help explain why we are not Covid-safe.

• As mentioned above, the virus is present in the community, since it is still being detected as tracing and testing are going on systematically – which is as it should be – in different geographical regions around the country. And thus, we may continue to have such rolling regional lockdowns, but how frequently and for how long cannot be known.
• The virus has an incubation period of 7-14 days, during which time the person does not have any symptoms. However, studies have shown that the person in this stage can still transmit the disease, through talking or coughing.
• The main mode of transmission of the virus is through the air, by droplets which do not go too far from the mouth (as in ordinary talking) or by finer aerosols which can spread over several feet, and in a closed room that can be risky for everybody.
• A certain percentage of the tests done turn out to be negative in persons who are infected (false negative), for reasons that we need not go into here. What is more important is what this means for the population: that despite the negative test, the person may still be harbouring, and therefore spreading, the virus.
• Vaccination gives protection or immunity against the virus, but at this point there are insufficient data to indicate how long this immunity lasts. Knowing this will help to decide whether a booster shot of vaccine is required, and when: once a year? And for how many years more?
• Vaccination does not prevent re-infection with Covid-19 – in other words, if you have had Covid once, it doesn’t mean that you cannot have it again.
• The main effect of vaccination is to reduce the severity of disease if one gets Covid, and diminish the risk of death.
• For everybody to be safe, almost all the 7 plus billion people in the world will have to have been vaccinated. Constraints to achieving this goal include:availability of vaccine, having the logistics (storage facilities, enough syringes & paraphernalia, adequate numbers of trained staffand related human resources), overcoming vaccine hesitancy/opposition/fake info. The result: it will take several years for everyone on the planet to be vaccinated.
• Covishield + Covaxin + Sinopharm vaccination locally so far will add up to less than 300,000 people being covered, out of the nearly 1.3 million, that is, less than 25%. We need a minimum of 60% but ideally 70%-plus to be vaccinated to provide us with ‘herd immunity’. When this will happen remains uncertain, because it depends on whether and when we get further supplies of vaccine.
• However, herd immunity is not a guarantee against re-infection, especially because new variants are constantly evolving and being discovered. And they seem to be more transmissible and cause more severe disease.

Another factor of relevance is that, although reduced, there is a degree of air traffic that is taking place. This is likely to increase with the pressure to open frontiers, which in turn will further augment the risk of infection or re-infection, along with the potential introduction of the newer variants.

Moreover, considering the pattern of unfolding of the pandemic worldwide,it is clear that several countries have had third surges as well, and that is what gave rise to the term ‘rolling lockdowns’ as new ones followed the earlier ones. This means, therefore that we have to take seriously the possibility – if not probability – of a third wave.

For all these reasons, therefore, we have to constantly keep in front of us the crucial lesson that this pandemic has taught us: self-protection means that everyone is protected.

And so, for the love of family and friends, and out of a sense of civic responsibility, let us not let our arms down. That is, continue to implement the sanitary measures as long as required.

* Published in print edition on 4 May 2021