Chandrika Bahadur said, given the severity of the epidemic in the country, rapid antigen test is a useful method of screening a large number of people, although it is less accurate than RT-PCR test.
There were many reasons behind the second wave of Corona across the country. These include panchayat elections in many states, campaigning in many states, crowding of religious ceremonies and opening of local transport and indoor activities throughout the country along with all sectors of the economy. Chandrika Bahadur, chairman of the Lancet Commission of Kovid-19 India Task Force, interacted with TV9 Bharatvarsha.
Question: Why did our condition become such even after the significant decline in the cases of Kovid in the months of December and January?
answer: India’s good fortune was that in December and January, there was a decrease in corona cases. Whereas in other countries, social interaction and economic activity started increasing as cases started increasing. The same happened in parts of Maharashtra and Punjab at the end of February. Although many experts had predicted the second wave to be fast, but hardly anyone could have predicted such a speed. There were many reasons behind the frightening second wave. These include panchayat elections in states, campaigning in many states, gathering crowds of religious ceremonies and opening of local transport and indoor activities across the country along with all the sectors of the economy.
As soon as the economy opened, the message of putting on masks began to be neutralized. Whereas this was the time when it should have been implemented seriously. When the situation got better, people started adopting the normal way as before. However, the reality was exactly the opposite. For safe activities, it is very important to have Kovid safe behavior, this message could not be conveyed properly to the people.
Question: What were the warning signs?
answer: India’s R (Covid Rate) was more than 1 since mid-February. Which meant that the epidemic was increasing, not decreasing. During March, the rate of increase in new cases was on average 5 percent per day. In March, the average daily number of new cases in Maharashtra and Madhya Pradesh had increased by 5 times compared to February. In Punjab this figure was more than 6 times. It was clear that the pace of the new transition was increasing. Where detailed information about the new type of virus was still being collected. There was evidence that B.1.1.7 (the UK version of Corona, which is considered more dangerous) was spreading widely in Punjab. Therefore, it can be understood from these figures that the wave was increasing rapidly.
Question: How much role do the new mutants play in the second wave?
answer: We have a lot of early information, because the Indian SARS-COV-2 Genomics Consortium (INSACOG), led by the National Center for Disease Control (NCDC), has increased the number of genome sequencing. By the end of April, INSACOG had declared the B.1.1.7 variants to be effective in Punjab. While both B.1.1.7 and B.1.617 variants of Corona were being seen in Maharashtra and Delhi. However, the number of genome sequencing probes is still small. Therefore, to know what is the effect of these variants on the second wave, more research is needed now.
Question: States have been asked to decide the lockdown themselves. Do you think the time has come for the national level lockdown?
answer: The Lancet Commission of the Kovid-19 India Task Force considered this question, in which it was held that the option of national lockdown is not the most effective action. However, this opinion was definitely given that restrictions should be imposed at the level of districts and states according to the epidemic conditions and medical preparedness. The task force provides a blueprint on the basis of which districts are categorized as low or medium risk or hotspots. We recommend putting a lockdown in hotspot areas as it is a priority to save the lives of people by reducing the burden of the medical system and the most effective way of this is to break the chain of infection. Lockout may be required in low or medium risk areas, but not necessarily so.
There should be extensive consultation with businessmen, labor unions, unorganized workers and community leaders before the lockdown. It has to achieve two goals – (1) Effective lockdown with minimal impact on the chain of activities. (2) Uninterrupted movement of essential services and goods, especially providing food and income to the weaker sections. This is the reason why lockdown has been considered as the last option under policy measures. Because it has the most impact on the poor sections of the society.
At this time, wearing masks is mandatory across the country and testing and contact tracing with restrictions on indoor or big events is very important. In addition, speeding up the preparation of the medical system and immunization to deal with wildly rising corona cases are considered two important parts of a successful strategy to prevent the epidemic.
Question: What kind of preparation should be done to deal with the waves of Kovid coming in the future?
answer: For this, there is a need for a strong primary health system, which is capable of immediate treatment of patients, their care at home and refer them to other hospitals. In states where such a system exists, it can be better fought with the waves of the future. But for this, it is very important to have a broad group of community health workers. We have an army of such health workers as hope workers in rural areas. But there is a shortage in urban areas. We must build such human capacity in community and primary health systems so that we can deal with the increase in the corona case.
There has been a discussion on increasing capacity in hospitals in the last weeks. Here I will emphasize the need to provide not only physical but also emotional and psychological support to the doctors and nurses. In the past few weeks, he has faced the horrors of Corona daily and it will still take him a long time to recover from the current wave.
Question: The ICMR recommends postponing RT-PCR screening of healthy people. What is your opinion on this?
answer: As an important way to prevent the epidemic, the task force recommends to increase RT-PCR testing across the country. Although in reality we are facing shortages on the front of test kits, lab equipment and lab personnel. Therefore, priority should be given to such people who are showing signs of infection. Given the severity of the epidemic in the country, the rapid antigen test is a useful method of screening a large number of people, although it is less accurate than the RT-PCR test.
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