COVID-19 second wave leaves doctors in Kerala baffled

The depth of the second wave of COVID-19 that’s sweeping throughout the States is starting to be felt in Kerala, the place the case graph has begun to rise.

Public well being specialists and infectious ailments specialists warn that although the State has began an aggressive vaccination drive in the 45-plus age group, it ought to be prepared with its mitigation plan to counter the second wave, which seems to be extra extreme, intense and fast-paced.

“We still do not have adequate knowledge about the virus and should be very careful about extrapolating its behaviour during the last wave. Unlike in the first wave, we find that the virus is creating more immune mischief now so that our margins for treatment are much narrower and the time to respond, much less,” says Subramanian Swaminathan, an infectious ailments specialist at Global Hospital, Chennai, and a governing council member of the Clinical Infectious Diseases Society.

Relaxation of norms

Premature declarations about India conquering the pandemic appears to have lulled individuals into enjoyable carrying of masks and bodily distancing norms, one of many causes for the present surge in instances, he feels.

“What is worrying is that the burden of infection this time has shifted to the younger age group, who currently do not qualify for COVID-19 vaccination. More than a third of my patients are less than 50 years and I have many younger patients in ICUs, with significant COVID and lung injury,” Dr. Swaminathan says.

In Tamil Nadu, he says the rising pattern in instances started early February however that it has “really taken off” in the previous 10 days. Hospitals in Chennai are struggling to supply beds for everybody.

“My patients are younger, mostly unvaccinated and their disease progression unpredictable, with many worsening in a matter of hours, requiring oxygen. The response to steroids has been unpredictable too and even though the drug Tocilizumab is effective, the therapeutic window of opportunity seems to be quite small. I am also seeing more symptomatic cases and more women patients than before,” he says. The identical is being reported by doctors in Ahmedabad and Mumbai too.

Dr. Swaminathan means that the federal government ought to community with numerous remedy centres, collate medical information and put collectively a harmonised remedy protocol in order that extra lives will be saved.

It remains to be not clear if it’s the emergence of latest variants that has fuelled the present surge in instances, though the Union Health Ministry contends that “the variants of concern have not been detected in numbers sufficient to either establish a direct relationship or explain the rapid increase in cases in some States”.

Little data

“Part of the spread could of course be due to the emergence of mutant variants. We have little information on the clinical relevance of many variants of interest, even though the E484Q and L452R mutations in Maharashtra or the N440K in Kerala are said to confer immune escape and increased infectivity to the virus,” says R. Aravind, Head of Infectious Diseases, Thiruvananthapuram Medical College.

However, the arrival of vaccination appears to have fuelled a false sense of safety amongst individuals and it’s the lax behaviour and violation of masks carrying and bodily distancing norms which have all of a sudden escalated the present transmission, he feels.

“The only cheerful bit here is that the vaccines work and that our healthcare providers are now vaccinated. We have not seen serious diseases in anyone who has completed at least three weeks after the first dose. Accelerating the pace of vaccination is imperative, but we may not have much time,” Dr. Swaminathan provides.