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India Likely To Enter In Endemic Stage Of Covid-19 Pandemic, Says Soumya Swaminathan

Chief Scientist of the World Health Organization Soumya Swaminathan has said that coronavirus in India might be entering some sort of phase of endemicity where there is low or medium degree of transmission going on.

It’s the phase when the country learns to live with the virus and take it as a part of life. However, it’s different from the epidemic stage when the virus overwhelms the population.

On Covaxin’s approval, she said she is fairly sure that the WHO’s technical group will be satisfied to give Covaxin approval to be one of its approved vaccines and that could occur by mid-September.

In an interview Swaminathan said given the size of India and heterogeneity of population and vaccination in various pieces of the country, it is “very very feasible” that the circumstance might proceed like this with ups and downs in various parts of the country.

“We may be entering some kind of stage of endemicity where there is low level transmission or moderate level transmission going on but we are not seeing the kinds of exponential growth and peaks that we saw a few months ago,” she said.

“As far as India is concerned that seems to be what is happening and because of size of India and heterogeneity of population and immunity status in different parts of country in different pockets, it is very very feasible that the situation may continue like this with ups and downs in different parts of the country, particularly where there are more susceptible population, so those groups who were perhaps less affected by first and second waves or those areas with low levels of vaccine coverage we could see peaks and troughs for the next several months,” she further said.

She also expressed her confidence that but the end of 2022 “we would be in that position that we have achieved vaccine coverage, say 70 per cent, and then countries can get back to normal”.

Meanwhile, for the parents who are panicking about the third wave affecting children need not to panic, she said.

“We can take from the sero survey and what we learnt from other countries also that while it is possible that children could get infected and transmit, children luckily have very mild illness most of the time and there is a small percentage that gets sick and get inflammatory complications and few will die but much much less than the adult population…But it is good to prepare… preparing hospitals for paediatric admissions, paediatric intensive care is going to serve our health system in many ways for other illnesses children have but we should not panic about thousands of children crowding into ICUs,” said the WHO scientist.

On utilization of medications like Remdesivir, HCQ or Ivermectin for treatment, she said as of now, there is no proof that HCQ or Ivermectin play any part in decreasing mortality or morbidity in individuals imfected with the virus or really keeping individuals from getting disease, hence there are no grounds on which suggestions can be made in utilising both of these medications for treatment or prevention.
“Solidarity trial showed Remdesivir does not reduce mortality, it may have a marginal benefit in subgroup of patients who are ill enough to need oxygen but not ill enough to be on ventilation so there may be a marginal benefit but certainly Remdesivir does not do much in stage of moderately or severely ill patients. It is also very expensive. Drugs like Dexamethasone and Oxygen are the two essential ones that save lives,” she further said.

“The Bharat Biotech submitted their data in the third week of July which was the first data set, then there was an updated data set that came in the middle of August. The committee has gone back to the company with some questions which they must be in process of answering now. I think the technical advisory group that ultimately approves will meet in the first 10 days of September and so we are hoping it happens soon after that,” said Swaminathan.

“So by the middle of September I am thinking, and the reason it took longer was because of back and forth and the need for more data requested from the company and this is the usual process. People think it is taking longer for Covaxin than for others but that is not the case… each company that applied for EUL (Emergency Use Listing) had taken this period of 4 to 6 to 8 weeks to get all the data needed,” she said.

Talking On third wave she said that nothing is clear yer and it’s not possible to predict the third wave.
“It will be impossible to predict when, where the third wave will be upon us and if at all a third wave will come. However, you can make an educated guess on some of the variables that have an impact on transmission,” said the scientist.

While on booster doses, she said that there are both ethical and scientific and moral reasons to not to run for booster doses.

“…so it would also be in self interest of countries who have excess doses now to send those doses out through Covax to countries that desperately need them,” she said.

And at last on vaccine passport, she said, “We do not believe that vaccination has to be a prerequisite at least at the global level to do things like travelling because we haven’t given everyone an opportunity to get vaccinated; there is so much inequity in access to vaccines, so the first thing is to get rid of the inequality then you can allow people vaccinated to relax certain measures.”

Vaccine passports are needed for travelling abroad and only those who are fully vaccinated against the Covid-19.

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