Fanned by news-reports on the TV, press and social media, there is a wide-spread concern about COVID-19 resurgence including in India. There is no clarity on the precautions and preventive steps but governments and health-administrators need to worry about and take urgent steps before the situation goes out of hands. Govt of India has already started taking stock of the emerging emergency to issue guidelines to contain the epidemic before it goes out of the hands.
There are already reports about an alarming increase of COVID-19 cases in China, US, Japan, South Korea and Brazil. The problem in India may actually assume a worrying proposition because of the huge population and relatively limited resources. It is important to chalk out what one can do for individual and community prevention in this scenario. In China, it is the sub lineage B.7 of omicron variant B.5 which is causing the current surge. The Central Government has already announced to intensify the genome sequencing. One hopes that we shall soon know the variants of concern for appropriate action.
There is little debate about the various public-health measures which need to be taken. Avoidance of crowded places and unnecessary travel is important. Wearing of masks in crowded places is also important. It is the requirement of the additional or booster dose of anti-COVID vaccination which is most crucial to answer. Do we require another vaccine dose? Incidentally, we have no final answer on that issue as yet.
Indians by now are likely to have good immunity against COVID because of several reasons, such as: i. Multiple instances of natural Infections – 1-2 documented COVID infection in many; ii. A large proportion of the Indian population is already vaccinated with one booster dose for many; and iii. Sub clinical exposure of many of people.
There are quite a few important questions regarding the vaccination: i. The booster dose – is it the 3rd or the 4th dose; ii. Which vaccine? iii. The longevity of the booster dose or the third dose of COVID-19 is also unknown. Efficacy of the booster dose is short lived; it has been seen that the effect of mRNA vaccines that have been used as a fourth dose in other countries wanes rather quickly. There is no evidence till date which suggests that a fourth dose is needed. It may however be needed if the vaccine is variant specific like the bivalent vaccine. It has also been suggested that the booster dose is not required for everyone but only for the vulnerable population or those with weak immunological defences
Bivalent Vaccine
Bivalent vaccine is an updated COVID-19 vaccine booster which includes a component of the original virus strain and a component of the new Omicron variant. The bivalent vaccine is likely to provide better protection against COVID-19 caused by Omicron. At present, there are no bivalent COVID vaccines in India. It shall become available if the need arises.
Going by the recommendations of the experts, it is important to strengthen the surveillance system, genome sequencing of infecting strains and public health measures. It is hoped that the vaccine policy will be soon clear. Till that time, one should keep in mind the message of the Health Minister of India: “It is important to be prepared and remain alert against new and emerging strains of Covid-19, especially in view of the upcoming festive season,”