‘3rd wave, if any, may involve kids, pregnant ladies’
Jammu Tawi, May 29: The Covid Advisory Committee (CAC) in its report has predicted relief from the ongoing second wave of COVID-19, saying that it will die down in next few weeks.
The CAC has furnished its report before Jammu and Kashmir’s Chief Secretary and Financial Commissioner Health and Medical Education. In the report, the committee has stated that the second wave of Covid-19 that witnessed steep and abrupt surge in positive cases and deaths in J&K has reached plateau and will die down in next few weeks.
Report accessed by us reads that barring few metropolitan cities, the COVID-19 epidemic in India and the Union Territory of Jammu and Kashmir followed a uniform epidemiological pattern, though J&K lagged the national curve by few weeks.
“COVID first wave was slow, gradual, and had the classical characteristic of involving the elderly and people with co-morbid diseases but COVID second wave was abrupt, steep, and showed a distinct pattern of involving young and middle-aged with no comorbidities, with more severe disease, altered disease pattern, and higher case fatality,” report adds.
There are indications that the second wave has reached a plateau and will die down in a matter of few weeks. The deaths will start declining one, two, or more weeks after the decline of the epidemic, it further adds.
The report further added that the lockdown for the last several weeks had a distinct effect on taming the epidemic faster than it would and needs to have a gradual guarded watchful relaxation to avoid a backlash.
“Apart from droplet spread of disease, the second wave showed a spread of disease through aerosol phenomenon in a poorly aerated closed environment and Superspreader phenomenon within homes. So, COVID’s appropriate policy and advice need to be redrafted with these transmission routes in mind,” it further adds.
There are definite clues that the second wave occurred due to the introduction of 2 variants of concern into the community from North India (UK variant) and other parts of India (Indian variant). This happened because we called COVID appropriate discipline for a toss in late 2020 and early 2021 and our inability to enforce travel advisory protocol, it adds.
The first wave was exclusively caused by the wild strain of the virus and there were no variants in the community in 2020. As of today, around or over 60% of infections are caused by variant strains of the virus, both in Kashmir and Jammu provinces and have nearly replaced the wild strains, it further adds.
The report adds that over 60 percent of the population is still susceptible to the infection.
Meanwhile CAC has also stated that if the third wave of COVID-19 occurs, it may involve children, pregnant ladies, sub-urban population and the population living in far-flung areas.
The report reads that the third wave of COVID-19 can occur and chances of its occurrence shall be determined by the interplay of several factors.
As per the report, the factors include SARS-CoV-2, the virus of COVID-19 with evolving mutations and developments of variants which may be variants of interest, variants of concern and variants of significant consequences, locally acquired variants due to viral load in the community in the UT, high viral replication and consequent mutations, variants introduced into the UT from other states and/other countries due to unrestricted/unsupervised travel, breakdown in COVID appropriate policies and practices, inability to enforce newer innovative protective measures including reverse quarantine to block super spreader transmission in homes, disallow small gatherings in closed ill-ventilated rooms that facilitate airborne aerosol transmission and susceptibility of various population groups to SARS-CoV-2 as evaluated by seroprevalence data as a result of natural infections and vaccination.
“Apart from these factors which will determine the occurrence of the third wave, most major pandemics of respiratory viruses like Influenza have passed through three waves in the affected populations,” it reads.
They suggested that there is a need for intensive continuous surveillance of the above factors for an extended period of 6 months and evaluate/watch the possibility of occurrence of a third wave.
“If we can block/reduce occurrence/development of variants of concerns/significant consequences, adhere to COVID appropriate policies and practices, and reduce the susceptibility of various population groups to SARS-CoV-2 by aggressive vaccination program over this period, COVID third wave in J&K is a non-entity and shall remain a fiction,” the report reads.
The report suggests that if we fail to act appropriately in dealing with these factors, COVID third wave in J&K will remain a reality and will visit our doorstep at any time in the interim period.
The committee members believed that a possible third wave if occurs, could affect any one or more of the population. “However, it is a general rule of the pandemics that during every subsequent wave, the pathogen generally spares the population group affected earlier and finds a more susceptible population group. Here, COVID-19 in the first wave affected the elderly, urban population with co-morbid diseases, and in the second wave urban young and middle-aged adults without co-morbidity were affected.”
The report states that keeping with this trend, a possible COVID third wave may involve one of the other groups, which include children, pregnant women, and sub-urban population and population living in far-flung regions.
“Thus, COVID third wave can occur in one or more of any of the population groups determined by many variables including general population, high-risk group (Elderly population with or without co-morbidities), adult population (18-60 years), pregnant women, pediatric age group (<18 yr.), rural population and those living in far-flung areas, special population groups like government employees, teachers, security forces, etc.,” the report reads.
The report stated that the pediatric populations could be a target for a possible third wave as this age group was not affected in the first and second wave and as of today, the vaccination program has not been extended to the age groups below 18 years, making this age group highly susceptible to infection.
It states that the future variants would develop, which by natural selection and susceptibility would target this age group and it is also difficult to enforce COVID appropriate behaviour in children.
As per the report, another high-risk group for the COVID third wave could be pregnant women and lactating mothers, as it is a known fact that pregnancy is a physiological state of lowered immunity show a special predilection for pregnant women with increased severity and mortality.
“Several viruses are known to infect the maternal-fetal interface and lead to placental damage with consequent obstetric events namely abortions, miscarriage, and premature deliveries. A break in the placental fetal interface promotes the vertical transmission of infection to the fetus leading to fetal abnormalities and intrauterine fetal deaths.”
The report states that neonates are prone to prenatal infections from the mother and often land in neonatal intensive care units. “The data about the relationship of COVID-19 with pregnancy are evolving and the impact on several obstetric and neonatal events is being actively studied. Pregnant women remain a high-risk group for the COVID third wave and if a variant develops, which targets this population, it would complicate obstetric and neonatal management practices.”
It further states that on a similar corollary, the COVID third wave may find sub-urban population and the population living in far-flung areas as a target for infection.
