“I’ve noticed a lot of differences in the way my COVID-19 patients responded during the Delta-led second and the Omicron-led third wave in India,” says Dr Rajesh Swarnakar, National Secretary, Indian Chest Society, and Director and Chief Consultant at Getwell Hospital, Nagpur, adding, “Unlike last year, patients in the current wave are recovering faster and are also reporting fewer, milder symptoms. Even if daily cases are surging, we hardly have patients in OPD or in need of intensive care.”
Two years may have passed living under the shadow of COVID-19, but the end gets more elusive with each new dangerous variant. In order to build a richer understanding of the risks involved and a deeper commitment to do all we can to fight it, we invited Dr Swarnakar and Professor V Ravi, Former Head of Neurovirology, NIMHANS and COVID-19 Task Force member, Karnataka, to lead our next Practo Connect webinar, meant exclusively for doctors and healthcare professionals.
“This virus has surprised us since 2020 and continues to do so by repeatedly mutating,” says Prof Ravi, adding that these mutants or variants of SARS-CoV-2 can be categorized into three types based on the risk it poses: variants of interest, variants of concern, and variants of high consequence. “Here, Omicron has been classified as a variant of concern by the WHO because of its increased transmissibility, probability of causing severe symptoms, and variable efficacy of treatment,” he adds.
COVID-19 Testing for Omicron
According to Prof Ravi, the Coronavirus continuously undergoes changes because of mutations, but all these mutations may not alter the behavior of the virus. However, when a new variant of concern emerges – as in the case of Omicron – it spreads across communities because there is no specific immunity to that variant. In fact, Omicron is spreading rapidly, moving from metro cities to smaller towns in India, with COVID-19 testing being irregular and different across states, possibly because of the milder symptoms it produces.
“Many people dismiss the need to be tested because reported symptoms are largely mild, don’t affect the lungs in most cases, have low mortality rate, and are known to be severe only among unvaccinated people,” says Dr Swarnakar, adding, “Given that most of these symptoms are similar to that of flu, like nasal congestion, runny nose, tiredness and loss of appetite, it will be difficult to make a clear distinction if not tested on time.”
According to him, if it turns out to be positive for Coronavirus, treatment can be sought faster and in cases where symptoms are mild, isolation will be taken seriously and strictly followed. However, in many cases, even if patients get tested, there is a sweeping assumption that all current COVID-19 infections are because of Omicron.
“While it is true that there was a huge surge post introduction of Omicron, what must be noted is that even as Omicron spreads quickly, other variants are also circulating in the population,” says Prof Ravi, adding, “So far, we don’t have sufficient data to say that majority of cases in India are Omicron-led. Given that clinical protocols vary depending on the variant, it is important that COVID-19 testing and gene sequencing continue to be prioritized to understand trends and ensuing steps better.”
Managing COVID-19 third wave in India
As per Dr Swarnakar, what is certain is that Omicron is 2-3 times more contagious than the Delta variant. However, this should not be cause for concern if COVID-19 vaccinations in India continue unabated, exemplified by Karnataka that recently registered a 100% first dose coverage.
“COVID-19 vaccinations reduce the severity of symptoms, and this is testified by data from Europe and the US, which is still fighting vaccine hesitancy among its people,” says Prof Ravi, adding, “In these places, hospitalizations have been the same in the Omicron-led current wave as in the previous waves. In fact, US hospitals are stretched beyond capacity, and have also recorded a large number of COVID-related deaths.”
Commenting on the scramble for booster doses, Dr Swarnakar says, “Lower rate of infection and reduced hospitalization is also reported among the population who have taken a COVID-19 booster dose.” Adds Prof Ravi, “There are numerous studies that point to the fact that antibodies – which are the only marker of protection we are measuring – wane after 6-9 months. Thus, boosters work, and should be prioritized for vulnerable populations that include healthcare workers and elderly people with comorbidities who can get moderate to severe forms of the disease.”
According to both, the only way to achieve disease control amid surge in cases is by case finding (by means of increased COVID-19 testing via RT-PCR or rapid antigen), isolation (by following recommended protocols), and COVID-19 vaccination (by ensuring vaccination is complete and booster dose is taken periodically).
Join us every month as we partner with leading industry and doctor associations for our educational webinar series, Practo Connect. Watch this, as well as previous webinars, here.