New Delhi: A total of 1,317 cases have been reported of H3N2, which is a subtype of Influenza virus in India between January 1 to March 28, according to the government statement. Recently, ICMR (Indian Council of Medical Research) survey also has shown that 50 per cent of the respiratory infection cases admitted to hospitals over the last two months are of H3N2 influenza in India. As the cases see a sudden spike in the country, team Banega Swasth India speaks with Dr. Randeep Guleria, Chairman – Institute of Internal Medicine and Respiratory & Sleep Medicine and Director – Medical Education, Medanta, to know all about the H3N2 virus – its symptoms, precautions one should take and the roadmap for India to tackle any future pandemic:
NDTV: What is H3N2 Virus? What are its symptoms, how severe is the virus and why is there a sudden rise of cases in India?
Dr. Randeep Guleria: H3N2 is an influenza virus, and symptoms are very common to flu. Some of the common symptoms include fever, body aches, runny nose, sore throat, cough and fatigue. Usually, these symptoms last for 5 to 6 days and one can get fit after that. Back and body aches can last for few more days.
The reason, we are seeing more cases of Influenza in India is that from the last 2-3 years, we have been following COVID appropriate behaviour like wearing a mask, washing our hands and maintaining physical distancing. All this has helped prevent the spread of a lot of respiratory viruses, including influenza, in all these years. Therefore, we saw a sudden dip in respiratory diseases during that time, even influenza virus was not getting circulated within the community. Now that, we are moving ahead, and have let our guard down, we are seeing the sudden infection. The second reason is that over the last few years, our immune system has become less responsive to viruses like influenza, as we didn’t have the disease for long, so our immune system didn’t stay alert, therefore we have lower immunity from influenza, for now. Lastly, the virus over the years has changed, it has become more mutative and infectious. With the change in weather and India being one of the tropical countries, we are seeing this sudden spike.
NDTV: What is the key difference between the symptoms of the two respiratory viruses – H3N2 and COVID-19?
Dr. Randeep Guleria: It is very difficult to clinically differentiate between the two. I had patients also, who first thought they had COVID, but when they got themselves tested, they turned out to be negative and later found that they were infected with influenza. Symptoms like fever, cold and cough are very similar.
NDTV: How can people protect themselves against the H3N2 virus, what are the things to keep in mind?
Dr Randeep Guleria: The precautions one should take are pretty similar to COVID-19 – people should wear mask, wash their hands. These are especially required for people with comorbidities and who are immunocompromised. They need to be extra cautious and should try and avoid indoor crowded places. I suggest, if you are healthy, and have no infections, it will be worthwhile to take influenza vaccine. The current vaccine also gives protection against this new mutant which is H3N2.
NDTV: What is the treatment currently for H3N2 virus?
Dr Randeep Guleria: In most cases, we give symptomatic treatment. In those, who have more severe disease, we give them antiviral drug, which is widely and easily available in India. So, once the drug is given, it starts to decrease the viral load. However, a good diet and nutrition plays an important role in the treatment of influenza and one should really focus on that.
NDTV: Why is India witnessing severe cases of the influenza virus, simultaneously with a spike in the incidence of COVID-19. What is the co-relation, should we be prepared for another pandemic or wave?
Dr Randeep Guleria: We are seeing the sudden increase because we are not following proper precautions. Also, the weather is such that the infection rate is going up. COVID-19 and Influenza, both are respiratory viruses, so we are seeing this sudden spike. And I think there are a lot of cases out there than what is being reported as many people are simply taking the rapid antigen test at home and not reporting it.
I don’t think, we will see another pandemic like what we have seen previously. When we started in 2019, we had no immunity, but a lot has happened in last few years, we have got immunity naturally, we have even got vaccinated and now the large part of population has developed a good immune response and immunity against viruses like these.
NDTV: How prepared are India’s hospitals when it comes to dealing with the increased cases of H3N2 virus? Are there any key areas which authorities should focus on right away?
Dr Randeep Guleria: Hospitals have learned a lot from the pandemic, they are prepared to manage cases, in terms of serious cases, isolation, treatment strategy and oxygen requirement. Even in remote areas now, there are good oxygen facilities. What we need is a good surveillance strategy, and it is not just about COVID and Influenza, we should have good surveillance for all the viruses – we need to test and find out, if it is a novel virus, new virus outbreak or it is the virus that is mutated. We need a good action plan and that is what will help us pick up the diseases or outbreaks at an early stage. We need to see the areas which are reporting the surge, we need to identify the clusters and see what we can do to prevent the same.
NDTV: Why are viruses making a comeback on a regular basis after COVID-19 outbreak. Should we be worried?
Dr Randeep Guleria: Viruses have been making the comeback for the last 23 years. In fact, the last 23 years have been the century of outbreaks – from SARS, MERS, H1N1, Swine Flu, COVID -19 and Ebola outbreak. One fact we know is that we will continue to see more and more outbreaks in the coming years. The reason is that we are travelling like never before, so we are carrying the virus from one place to another. Secondly, there is lot of encroachment between animals, birds and humans, which is letting viruses jump species. Also, viruses are evolving into human viruses. There is the concept of one health, it is high time now we understand that everyone’s health is interlinked. We just cannot ignore the health of the environment, animals, plants, species and simply look at human health.
NDTV: What are the steps we need to take to prepare ourselves for present and future pandemics?
Dr Randeep Guleria: For an individual it is important to stay healthy, a good diet, preventive measures like exercising, eating good nutrition, following good hygiene like handwashing is very important. We need to be cautious, we need to wear mask, when going into crowded places. And most importantly, if we have symptoms of any virus, we need to report to the authorities. We should do our bit when it comes to prevention, that’s how authorities will get alerted and tackle the disease from spreading further.
NDTV: How equipped is India’s healthcare infrastructure – in terms of physical and human resource to deal with future pandemics?
Dr Randeep Guleria: Human resources will always be a challenge because we are a big country and our population is also very high. We have learned and evolved a lot both in terms of infrastructure and technology over the last few years. We saw in COVID, how we started to use digital telecommunication for all our appointments, we had developed E-ICUs, there was Arogya Situ app, then there was Cowin platform. We have a lot of technology available, through which we can reach out to places where we have lesser resources and provide healthcare to them using technology, which can further help bridge the gap.
COVID really pushed technology into healthcare, we as physicians were very reluctant to adopt any new healthcare technologies-based items but because of the pandemic we did it and we welcomed the innovations and now it has become a routine. With this telecommunication bit, if we can involve artificial intelligence, then it will be a game changer.
NDTV: There are certain states like Rajasthan that are proposing a Right To Health Bill – do we need a national level policy or law to ensure Health for All and make healthcare more affordable and accessible for everyone?Dr Randeep Guleria: We do need a health for all policy, how do we work it out, we need to plan it. Health should be the fundamental right for all, and it should be irrespective of one’s socio-economic status. National policy is very important but strategy needs to be developed.
NDTV: We are gearing up to celebrate Health Day on April 7 and this year the theme is Health For All, if you had a chance to be the Health Minister of India, what are some the key areas you will priortise and address.
Dr Randeep Guleria: I would really look at how can we provide health for all in an affordable mechanism. Good quality healthcare should be available both in public and private hospitals, to every single person. Secondly, we need a lot of focus on preventive health if we want to decrease the cost of healthcare. We need to prevent diseases rather than treating it. Preventive healthcare includes sanitation, water, prevention of early diagnosis of non-communicable diseases like cancer. Lastly, we need to see how we can include technology to take big leaps in healthcare.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.