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NITI Aayog’s Dr Paul lists steps for Indians to avert the third wave

The NITI Aayog’s Member (Health) Dr VK Paul made an appeal to the nation while attending the Union Health Ministry’s media briefing on COVID-19, held at National Media Centre, PIB Delhi on Tuesday. Dr Paul’s message took the AIIMS chief’s third-wave warning a step ahead by providing an action blueprint and an explainer on how and why pandemic waves emerge.

Even as daily COVID-19 cases in India are declining, the country’s premier health institution – the All India Institute of Medical Sciences’ Chief Dr Randeep Guleria has said that a third wave is inevitable. He added that the third wave can hit the country in the next six to eight weeks.

While most people adhere to the appeal of health authorities to stick to the “Stay at home” approach unless extremely necessary to step out, there are others who either must step out in pursuit of livelihood or the revellers who do not think much about COVID-appropriate behaviour. NITI Aayog’s Dr Paul says that we must focus on what is in our hands and make conscious efforts to not give opportunities to the virus.

While addressing the media, Dr Paul reiterated that our behaviour should be such that the virus must fail in making a susceptible host out of us. “There are countries where even the second wave has not occurred. If we do what is required and do not indulge in irresponsible behaviour, then an outbreak should not occur. This is a simple epidemiological principle.” Dr VK Paul said, explaining the reasons behind the emergence of new pandemic waves and how it can be controlled or even avoided by following COVID appropriate behaviours and taking measures such as vaccination.

Why do new waves happen? 

Dr Paul said that there are four elements leading to the formation of a new wave. If we wish to checkmate the virus and stall its onward march, we must try to counter it on all four points.

  1. The behaviour of the virus: The virus has the capacity and ability to spread
  2. Susceptible host: The virus keeps looking for susceptible hosts for it to survive. So, if we are not protected either via vaccination or by the previous infection, then we are a susceptible host.
  3. Transmissibility: The virus can become smart enough where it mutates and becomes more transmissible. The same virus which used to infect three hosts becomes capable of infecting 13! This factor is unpredictable. No one can pre-plan to fight such mutations.  The change of the very nature of the virus and its transmissibility is an X factor and no one can predict when and where it may happen.
  4. Opportunity: ‘Opportunities’, which we give to the virus to infect. If we sit and eat together, crowd, sit in closed areas without masks, then the virus gets more opportunities to spread.

Dr Paul points out what is practically in our hands:
Dr VK Paul opines that we cannot govern the virus’s behaviour but we can certainly stop becoming cannon fodder to its opportunistic behaviour. “Out of the above four, two elements– Susceptibility and Opportunities for infection are totally under our control whereas the other two – Behaviour of the virus and Transmissibility, cannot be predicted or controlled. So, if we are protected and ensure we are not susceptible, then the virus will not be able to survive. We can control the susceptibility by wearing a mask or getting vaccinated. Hence if we decrease opportunities by following COVID Appropriate behaviour and decrease susceptibility to infection, then a third wave will not occur.”

Dr Paul also called for collective efforts of the citizens as well as the system in order to stop another wave. “Some of these require individual efforts, while some others such as isolation of clusters, contact tracing, ensuring testing capacity and building awareness requires the system to act.”

About deliberations over the decision to open schools:
Speaking about easing restrictions and reopening schools, Dr Paul said that the decision has to be taken cautiously and that we should take risks only when we are protected. “School is a crowd, a medium or large gathering, which gives an opportunity for the virus to infect. So, we should take that risk only when we are rather better protected, the virus is suppressed and we are able to sit at a distance. But it is not easy to take this decision to open schools when an unpredictable situation is prevalent.” He also mentioned that the virus is suppressed at present due to discipline and restrictions prevalent in many states, if we ease restrictions and open schools, then the virus gets opportunities to infect.

Don’t become susceptible hosts”

What Dr Paul says fits perfectly well with the established scientific temperament seen in research papers globally.  The mathematics of pandemic waves is best explained in this article in Nature.com. Titled “Multiwave pandemic dynamics explained: how to tame the next wave of infectious diseases”, this article says:

“Pandemics, like the 1918 Spanish Influenza and COVID-19, spread through regions of the World in subsequent waves. There is, however, no consensus on the origin of this pattern, which may originate from human behaviour rather than from the virus diffusion itself…  Nature.com

“As it emerged from the Spanish Influenza that hit the World in three consecutive waves between spring 1918 and the early months of 1919, virus-driven pandemics can feature a wave pattern, even though the origin of this behaviour is not understood…   Nature.com

“Our results demonstrate that the key to controlling the arrival of the next wave of a pandemic is in the strolling period in between waves, i.e. when the number of infections grows linearly. Thus, limiting the virus diffusion in this period is the most effective way to prevent or delay the arrival of the next wave.  Nature.com

 

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