Dr.
Gangandeep Kang is among the leading virologists in India.
He was a professor with Christian Medical College, Vellor, and members of the Covid-19 working group under the National Technical Advisory Group on immunization (NTGAI).
In an interview with Toi, Dr.
Kang said Covid was already in an endemic stage in India, where “the virus would continue to be”.
He said citizens, who now have to live with SARS-COV-2, should not be forced to face “irrational steps” such as locking or curfews.
Here is a quote from the interview: In Covid it becomes endemic I think there are many misunderstandings about endemicity, with people think the term means we don’t need to think about the virus anymore.
This is not a case – endemicity implies that this virus and will continue to be present in the population.
And that stage has been reached.
There will be cases and flares-ups, or waves, when the new variant is introduced as we have seen with Omicron, which will require additional steps depending on the burden of the health care system.
With this framing, SARS-COV-2 is endemic.
What’s the way forward at the endemic stage? We have lived with it, but continues to have irrational steps such as locking and curfews.
We need to rationalize testing to be able to identify the proportion of symptomatic individuals, having a feeling of what happens in the community (for example, through environmental supervision), and in some cohorts, conducting studies that tell us about the frequency of infection and its consequences.
We also need to monitor the performance of vaccines, to find out if we need to switch or improve.
As for care, we need to continue to develop a clinical management strategy to ensure the best results for patients.
What about the current vaccine efficacy? Vaccine works.
With Omicron, it doesn’t seem to be a third exposure to improve protection from severe illness.
But it can come from vaccinations through booster like in the West, or from previous infections, such as in Africa and India.
How much coverage do we need for a herd immunity? I think people think of a herd of immunity as a life / dead switch, where infection and disease will disappear when we reach the magical number.
Omicron shows us that we have protection mostly from severe illness and death if we are infected or vaccinated.
It shows that we have several immune levels, which are relevant health goals.
But we don’t have a herd immunity in the sense of prevention of transmission – what is needed to get there with mucosal pathogens can be difficult to define.
What about a new variant? The only thing we know now about the RNA virus is that when they replicate at a high level, they mutate.
The consequences of the mutation are usually towards a better deployment, both from increased transmission or increased immunity.
And the impact on health infrastructure? Anyone who claims they can predict how the variant of the next concern will behave fooling themselves or others.
What we need instead of this obsession with predictions is planning for various types or low and high threat scenarios so that the contingency plan already exists.
I don’t know if this is done at the state or central level, but I hope this.
What about the Covid model in England and Europe? The UK has reached a high level of vaccination and is now regulated to cover young people who are clinically vulnerable.
They opened and I thought they did everything correctly, except that I would suggest continuing to use masks at school or in public locations until the case declined.
Europe does not have a single model, but high vaccination, good clinical management is the response feature of each country.
And the approach is correct.