India is near Endemic stage, if worrying variants don’t emerge, says Gagandeep Kang

Reassuring many, Virology professors and a government-appointed Covid Working Group member, has said that “in the absence of the possibility of new worrying variants”, India is at or approaching the endemic stage of the Covid-19.

In a 35-minute interview with The Wire, Professor Gagandeep Kang agreed with what the WHO chief scientist Prof. Soumya Swaminathan said to the media portal on August 23.

In the interview with Karan Thapar to The Wire, Prof Kang said India is likely to see ups and downs in particular locations but a nationwide wave is not likely in any way similar to the deadly second wave of Covid-19 pandemic. It is not the right time for boosters except, possibly, for immuno-compromised people, she said.

Prof. Kang said “we cannot predict a third wave in the absence of a radical change in viral behaviour or a radical change in human behaviour”.

Whilst new variants could emerge “because of mutations or because of some form of recombination”, however she said that we don’t know of them yet and, she cannot understand on what basis the people are predicting or fearing a third wave of the Covid-19.

Elaborating her views that the country is at or near an endemic stage, Prof. Kang said to Karan Thapar that the time had come for India to rethink its attitude towards SARS-CoV-2.

Citing the example of typhoid to illustrate how we should start thinking about SARS-CoV-2, she said typhoid is endemic, we know how it’s caused, how to handle it and therefore we also know that we can do better. It’s not a prime concern. However, SARS-CoV-2 is heading in that direction.

Now it’s time for India to rethink its attitude to Covid and the predominant importance so far given to it, Prof Kang said adding that attention must be given to Covid-19 along with many other health concerns that haven’t got sufficient consideration over the past 18 months, such as cancer, diabetes, tuberculosis and several problems connected with maternal pregnancy.

She said that the time has come not to treat SARS-CoV-2 the way we did at the start of the pandemic… but think of it in relevance to other illnesses.”

The time has also come for us to rethink our attitude to testing. The original emphasis on test and trace, which was at the core of our handling of virus at the beginning of the Covid-19 pandemic, now needs to be rethought and modified as we could be at or near an endemic stage.

Speaking to Karan Thapar about the overall Covid-19 scenario in India Currently, where the seven-day average of daily cases fell from 42,881 cases on September 2 to 37,237 on the Sept 9 and 31,074 on Sept 16, Prof. Kang said that even though the “trajectory is good” it’s also true that “wherever you look at the Delta variant, after a sharp spike is over, the number of cases haven’t returned to the lowest pre-Delta point”. It’s also true of India and therefore possible that the cases can spike around 30-35,000 per day for a long period of time, which is already happening in Britain at present.

Particularly talking about Kerala, where the seven-day daily average cases were 29,804 on September 2, and 26,794 on 9th and 19,505 on Sept 16, but the daily average have once again surged to 20-22,000 levels, Prof. Kang said “we can’t expect the trajectory to be maintained day after day”.

As long as the weekly average of daily cases is declining that is a sign that cases are reducing, she suggested.

Prof Gagandeep Kang further said that another positive note about Kerala is the state’s vulnerability, given that its sero-positivity levels were so low, is now gradually being contended by the very high vaccination levels. Therefore, the size of the vulnerable population is decreasing.

In the interview to The Wire, Prof. Kang also said “it would not be the end of the world” if the country fails to fully vaccinate every single adult by the end of this year. She suggested the high levels of sero-positivity (68%) have given a fair measure of protection, therefore targets are often set and missed. This would be one more.

On being asked about the booster doses, Prof. Kang said “the time is not right for boosters for anyone except, possibly, immuno-compromised people”.

Even though the vaccine efficacy against infection does reduce after six months, she said, the efficacy against serious disease remains high. Therefore, Prof. Kang asked, although boosters may have to be given what is the right time to do so? As the research available internationally does not present a clear and decisive answer and we need more information, she said.

A second concern is that if boosters are given which vaccine should be used? Should it be the same one or a different one? She asked.

In the interview to The Wire, Prof. Kang was asked if there is a percentage level of adult vaccination at which India can feel relatively secure in opening up, as the UK has done, and she said it is very hard to answer this question because the percentage of the population in India comprising children, who are unvaccinated, is much larger than in the UK. So, as she put it, even with every adult vaccinated India’s situation will not be analogous to that of the UK.

Finally, she agreed with the CEO of Azim Premji foundation Anurag Behar about problems affecting vaccination in rural India. However, Prof. Kang explicitly said the centre must make a deliberate and conscious effort to reach out people in rural areas, who are distant and uninformed, to ensure that even they get vaccinated. Otherwise, she said they could be left out and that could be a serious problem.

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