The prediction of an inevitable third wave likely to hit India has created alarm amongst the people. However, the Principal Scientific Advisor (PSA) to the Government of India apart from warning has said that the third wave could be averted if strong measures are taken. Meanwhile, this prediction on the third wave has started assumptions among scientists, media and the lay public.
How possible a third wave is?
The fact that the virus is still actively spreading in the country and the global spread of the Delta variant along with the recent emergence of the Delta Plus strain (AY.1) implies that the virus still can infect people fast and can continue to intensify its ability to do so through fresh mutations.
With only 20% of the adult population getting the vaccine jab so far and about 4% fully vaccinated, many people are remaining vulnerable to get infected, so a third wave is a possibility.
What strong measures can be adopted to avert it?
People who haven't been vaccinated are most susceptible to the virus, have to keep following the Covid appropriate behaviour like wear masks, move or work in well-ventilated areas and avoid crowds, doing all these will reduce the risk of the infection. Indians have to strongly adhere to these disciplines until 60% of the population is inoculated to avert the third wave.
An argument can be raised saying this is unreasonable as people are suffering from pandemic fatigue, tired of lockdowns and want to get back to the bustling lifestyle and socialism.
The decrease in cases can be misinterpreted by many as a clear sign of getting back to normalcy and shed caution. Prevention super spreader gathering may not remain a priority to the authorities, however, the virus is still circulating and both presence and prevention are needed.
When will the third wave arrive?
A top government expert said that a third wave can be expected in 6-8 weeks, that means it could hit in December, while some study suggests it would start in August and end in October. Meanwhile, others said it would start in November.
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The virus has not shown any consistent or seasonal pattern till now. If there is any pattern, it has been disguised by the timing and length of lockdowns, the different forms of unlocking and the behaviour of people when restrictions are lifted.
The models show how the virus functions under certain conditions of its growth and transmission. It is not known if more variants will emerge with greater impacts in the following wave. So, it's uncertain when the third wave will arrive and therefore, we have to prepare our systems for it may come early and hope for a long break between the waves.
Will the virus cause serious diseases in the third wave than in the second wave?
It will depend on the case counts of total infected people, persons infected severely enough to require hospitalisation or the number of deaths.
The virus itself didn't become contagious during the second wave but the massive rise resulted in an unlimited number of serious cases rapidly rising to high numbers.
What happened in the second wave can be prevented by containing the transmission, reducing case numbers and improving home care, so that mild cases are kept away from hospitals.
As per a recent study, by the Indian Council of Medical Research and the Imperial College at London, the third wave will be less wrecking than the second wave. The conclusion is based on the acceptable assumption that people infected earlier would retain their immunity, fully or partially. If new variants override their immunity, the situation can be a bit different. The new strains can infect more people but they might not be severe. That holds true for protection from vaccines too. New variants may show higher levels of vaccine evasion but most vaccines will provide a decent amount of protection against serious disease and death.
The health and administrative systems will be well prepared for the third wave and keeping all these reasons the third wave of the pandemic could be less severe than the second.
Will children be more impacted during the third wave?
Doctors have speculated that children will become sick in the third wave. During the previous wave, children have remained under partial shelter and many adults by that time will have acquired immunity, thus, the proportion of children infected will increase in comparison to adults.
However, the infection rate will be milder in kids. The ACE-2 receptors in the human cells, which the virus connects to for entering the body’s organs and blood vessels, are not as much developed in children as in adults.
Children also have lower levels of associated health conditions like hypertension, diabetes, heart disease and lung disorders that expand the risk of serious Covid disease. A small fraction will suffer from Multi-System Inflammatory Disease of Children (MIS-C) but the majority of kids will have mild symptoms.
Improving healthcare facilities for children, such as intensive care units, will be useful to meet the needs of many other health conditions.
Increasing vaccination rates is a high priority as it will provide higher resistance power. If India achieves 60% coverage, the rates of infection and deaths will drop sharply as seen in the Serrana province of Brazil.
Disciplined covid behaviour like masking, ventilation, avoidance of crowding and non-essential travel, super-spreader events must be banned for the rest of the year. Home care, emergency transport, secondary care facilities with oxygen and tertiary hospitals with intensive care units must be well planned, adept and monitored for response readiness and efficient functioning.
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Temporary hospitals and intermediate care centres built during the second wave should not be pulled apart but kept active by treating non-Covid patients.
People should be engaged in villages and basti level committees and training of citizen volunteers should be intensified.