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Asymmetric warfare in the form of the Covid-19 pandemic spread across the world in March last year. The primary drivers that caused severe human vulnerability to the disease in India included population density, mobility, migration and inter-country travels. The subsequent risk of hospitalisation and death witnessed a sharp increase when older people were found infected. The task of following social distancing and clean hygiene to prevent further spread of the virus seemed rather daunting for the second-most populous country in the world.

“Unfortunately, the lockdowns couldn’t establish disease prevention due to the in-country mobility. But it gave the medical fraternity some time to study the virus. What came as a pleasant surprise, however, was the early interim results of the vaccine trials in 2021. The possibility of developing a vaccine in a year’s time was unheard of until Covid vaccines came into existence,” said Dr RR Gangakhedkar, Head/Representative of Division of Epidemiology and Communicable Diseases at ICMR in the recently concluded Global Partner Summit organised by Motilal Oswal AMC.

Terming the underlying belief that Covid 2.0 is over as ‘optical illusion’, the veteran doctor said that if a comparison is made between the lowest number of new cases recorded before the second wave and today, the data isn’t very convincing.

“Today, the lowest number of new cases recorded are somewhere around 39,000. This number was around 8,000 before Covid 2.0 peaked in full volume. To me, the second wave is still not over. This time the outbreak has been severe in rural India where access to testing and oxygen is low. Further, low vaccine coverage only adds to the vulnerability,” Dr Gangakhedkar asserted.

But people might argue that if there is any resurgence of Covid cases hereon, it must be identified as the third wave of Covid-19. What must be understood, according to Dr Gangakhedkar, is both the second and third wave of the disease are semantics. However, answer to certain questions remain a blur. Will there be dreaded surges straining our hospital infrastructure? Will it add to more deaths and impact the livelihood due to potential lockdowns ahead?

“The next wave (2nd and/or 3rd) will be severe in areas that were spared in the first wave and probably rural areas too. North East is a good example. It was spared in the initial wave but has now become a cause of concern. Kerala is on a similar path,” he said.

The second wave of Covid-19 brought challenges stiffer than the first wave. Limited medical infrastructure, fewer ICU beds, and oxygen cylinders, etc. led to an excessive hue and cry amongst people at once. Can it simply be blamed to lower adherence towards Covid appropriate behaviour and low coverage of vaccines? As per Dr Gangakhedkar, perhaps there was another factor that played a major role to the outcome of Covid 2.0.

“The prime objective for the virus isn’t to kill the host but, in fact, to rapidly increase its transmission rate for survival. Thus, the mutation is a key factor behind the surge in Covid cases during the second wave. The majority of these mutations are deleterious for the virus but it manages one mutation every two weeks at the given population level. This adds to the virus’s fitness,” he explained.

While the vaccination drive is still underway, several top doctors in India have said a possible third wave of Covid-19 is impending in August of 2021.