Coronavirus Outbreak
Third COVID-19 Wave In India: Where Do We Stand And What’s The Road Ahead?
According to the experts, the hospitalisation due to COVID-19 has increased in the recent past but none of the patients are in a serious state but caution is key to dealing with the third wave
New Delhi: “Third COVID-19 wave has set in India”, said Satyendar Jain, Delhi Health Minister while addressing media on Wednesday (January 5), the day India reported over 58,000 fresh cases of COVID-19. Parallely, the country is reporting a surge in the Omicron cases, the new variant of SARS-CoV-2 which is said to be highly transmissible. Over 2,100 cases of the Omicron variant have been found in India. Though the cases are on a rise, the death rate remains at 1.38 per cent, similar to what it was a month ago at 1.37 per cent. So, is Omicron as virulent as Delta which drove the second wave in India in April-May, 2021?
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A Mild Surge In Hospitalisation Due To Omicron Variant
NDTV spoke to Dr Sandeep Budhiraja, Medical Director, Max Healthcare and also a member of the court-appointed COVID task force to understand the impact of a rise in COVID cases on hospitals. He said that in the last two to three weeks, Max Healthcare has seen a dramatic rise in the number of patients – both in terms of patients seeking video consultations and those coming to the outpatient departments (OPD) in various forms.
In terms of hospitalisation, the number has definitely increased in two to three weeks but that is a very very small proportion and these patients are nowhere as sick as what we saw in the earlier waves. There have been no ICU admissions in our hospitals in Delhi-NCR. Very few of the patients admitted to the hospital require oxygen; none are on the ventilator.
Dr Budhiraja believes that based on the caseload, it is obvious that Omicron is highly infectious. He also said that most of the patients they have seen have had both doses of the COVID-19 vaccine and a significant chunk have had COVID-19 infection in the past.
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Dr SK Sarin, Vice Chancellor, Institute of Liver and Biliary Sciences (ILBS) agreed with Dr Budhiraja and said that the Omicron variant of COVID-19 remains in the upper part of the respiratory tract. Omicron somehow doesn’t go down into the lungs, so, the rush for the oxygen is not there, he said. Talking more about the disease, Dr Sarin said,
The type of patients we are seeing now are those who got COVID and had COVID lung disease due to the Delta variant. Now, when they have come with the Omicron, they are very sick. So, just to say that the Omicron cannot cause sickness may not be true. Those who have got a prior infection with some kind of comorbidity or injury, maybe very sick. Anybody who comes with a COVID-like illness, even if their test is negative, should be considered as possible COVID.
Sharing his experience, Dr Sudharshan Ballal, Advisor, Karnataka COVID Task Force said, hospitalisation has marginally increased and some of the hospitalisations are not needed. He added,
All international travelers who tested positive automatically get hospitalised. We are in discussion with the government to see whether these patients can be managed at home which they should be. Right now, the situation is reasonably comfortable.
COVID-19 Death Rate – What Lies Under The Surface?
Further talking about the death rate which seems to be unchanged, Dr Sarin said,
If you take the total number of people infected, of them, 1.37 per cent may be small if the variant was Delta. But if you have something which is spreading so fast, more people are infected, 1.38 per cent may become massive. Keeping that in mind, we should be ready for more hospitalisations. The data from the US and other countries say that the hospitalisation for Delta was 88 per cent at a given peak. For Omicron, it’s somewhere close to 57 per cent. Maybe 30-40 per cent less hospitalisation but looking at the West, there is a possibility that more hospitalisations – may not be ICU – should be there.
Sharing his thoughts on little to no change in the fatality rate, Dr Ballal said,
We must look at the fact that we still have not completely transitioned to Omicron. We still have a fair number of Delta cases at least in some of the cities. The mortality may not be the true mortality of Omicron.
Dr Sarin shared a caveat that healthcare workers, those who are fully vaccinated and have had COVID infection in the past, are getting the disease at a rapid rate. Dr Ballal shared a similar experience and said,
We are also seeing a lot more cases and unfortunately some healthcare workers who have been vaccinated and exposed to the COVID-19 infection in the past are also getting the infection. Shortage of personnel will be a serious problem rather than hospitalisation.
Experts’ Share Tips For The Government To Fight Third COVID Wave
Dr Budhiraja suggested the government reconsider mandatory institutional quarantine of travelers who are not necessarily Omicron cases, they are Omicron suspects. These travelers stay in hospital till their genome sequencing report comes which used to take 5-7 days but now it takes 7-10 days, he said and added,
They stay in hospitals practically asymptomatic, waiting for Omicron report to come in and once comes positive, they are then to be segregated into Omicron positive ward and if negative, they are sent for home quarantine. This needs to be relooked into as hospitalisation will increase.
Despite the spread of the Omicron variant, gatherings with huge crowds like election rallies are taking place with little adherence to COVID protocols of masking and social distancing. On that, Dr Ballal said,
Omicron is very democratic. It treats everyone equally. The same rule should apply to everyone. Certainly, lockdown is the last resort because it will push us back into the stone age and our economy will go down. We should take all measures to prevent a lockdown. Some of the measures are a warning to the public that corona is here in large numbers so please be careful.
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