The vast experience of veteran pulmonologist Dr Ashok Arbat treating SARS, swine flu, Zika and now, Covid-19 makes him an authority to speak on pandemics.
In 2020, when the first nationwide lockdown was declared, he had made some predictions in an interview with TOI.
Right from the second wave to job losses to psychological stress to vaccine availability, most of his predictions came true in the last 15 months.
TOI revisited Dr Arbat as we are now gearing up for total unlock post the second wave.
He says we need a strong exit strategy to avoid or at least delay one more wave, one more lockdown and many long-term devastating consequences.
Excerpts from an interview…
Q.
Where exactly have we reached in this fight against Covid-19? A.
If we consider Covid as a war then we are still in the middle of a strategic formation.
We have reached here by defeating many big threats.
But going back to normal from here is going to be the most important and tough task.
Victory is assured, only if we bring our people out of the war field with complete safety.
For this, we must have a meticulously planned exit strategy.
The virus being an enemy will definitely mutate and come back, but we must have shields ready to avoid its next attack.
Moreover, we must avoid self-destructing moves.
Q.
What kind of self-destructing moves should be avoided? A.
As we were in dire need of beds, oxygen and drugs, we made some mistakes in a hurry.
For example, mucormycosis has emerged as a parallel pandemic.
This was not the case in the first wave.
In the second wave, when conditions were beyond our control, we allowed oxygen beds at makeshift hospitals at places like marriage halls.
Medical oxygen was the need of the hour and so it was catered to through industrial cylinders as well.
It gave the fungus the opportunity to target people with low immunity.
Now, we are using anti-fungal drugs to treat mucormycosis.
We have no option but to use these injections for long periods of time.
Ultimately, this is going to affect people’s kidneys in the next few months.
So, it’s a crucial time for us to stay healthy and avoid infections to stay safe.
Vaccine will definitely help but the overall health needs to be taken care of.
Q.
Should we have vaccinated more people before starting the unlock process? A.
By the time we fully open up these restrictions, we would have vaccinated at least 35% of the population.
But, we are still lagging behind.
With vaccination, we must learn to treat the diseases by lowering the side-effects of the drugs.
If Covid patients are cured and start suffering from mucor and mucor patients are saved and then they start facing kidney problems – it’s not going to be a victory at all.
We need proper management of the treatment to bring life to normalcy.
It will take time and we need to understand that it’s not over yet.
Q.
What kind of problems do you foresee post-unlock? A.
Covid recovered patients are still facing issues like fatigue, weak lungs and most importantly, psychological problems.
According to an estimate, 40% people will face psychiatric problems due to loss of a family member, money and Covid.
Financially, it will take one more year to settle down, if we successfully avoid the third wave.
The next big thing is going to be psychiatric problems like domestic violence, loneliness, professional burnout, post-traumatic stress and so on.
Taking care of these problems is a must while unlocking.
Q.
Do you think there’ll be a third wave and if so, will we need another lockdown? A.
A proper exit strategy from the present lockdown to normal life may skip the third wave.
As far as the lockdown is concerned, I don’t think it stops the spread of the virus.
It is only a short term pause to reduce cases and ramp up our health infrastructure.
After learning from first and second wave, if people continue to follow the preventive measures like wearing masks, sanitization and physical distancing then cases may increase at a lesser pace and we will get more time to accelerate vaccination post-unlock.
The outcome of the present lockdown is going to be very serious.
We can’t afford another lockdown.
Q.
What is the likely outcome if a new mutant infects even the vaccinated lot? A.
This is unlikely to happen.
A vaccine provides a certain level of protection to every individual and we are experiencing its benefits while treating patients.
The virus has kind of disappeared and the case curve is going down rapidly.
This sudden decline in cases gives me a feeling that the virus may have adopted some new strategy and might emerge with a more lethal mutant.
But if we protect a majority of the population from the present mutants through the vaccine then the new mutant might be restricted effectively.
Q.
There are claims that some medicines have cured Covid-19.
A.
Medicines like 2-deoxy-D-glucose by DRDO have been launched and the initial results are good.
But the trials were done on a limited number of patients.
It will take time to establish the efficacy of these drugs.
Let them come into the market.
If proved to be effective, such medicines can be game changers.
Q.
What precautions should people take ahead of the unlock? A.
Unlock is just a beginning to move towards normal life.
We still have a long way to go.
Wear masks and wash hands regularly.
Get vaccinated.
If you can pay for it, please go ahead and pay because this will benefit the poor people who require it free of cost.
Don’t avoid psychiatric problems, get them treated professionally.
Maintain health, immunity, but avoid crowds, unnecessary travel and most importantly, community gatherings like weddings.
‘If Covid is war, then we’re still in the middle of it ’
