Despite dip in Covid death rate, no room for laxity

Dr R Kumar

President, Society for Promotion of Ethical and Affordable healthCare

The world remained in the throes of Covid-19 during 2020. With the dawn of 2021, India initially saw a sharp decline in the fury of the pathogen and a consequent dip in daily deaths and infections, but states such as Kerala, Maharashtra and Punjab are witnessing a resurgence of cases of late, even as the virus continues to rage in the US and Europe.

The drop in the death rate and the rollout of the nationwide vaccination programme are positive developments for India. A recent decision of the Chandigarh administration to restore the services of city hospitals and other establishments to pre-Covid levels brings hope of normalcy. Similarly, the termination of the services of thousands of doctors in the country, involved in Covid management, indicates that the virus may not last long.

A statement by the AIIMS Director clarifies that “antibodies against the coronavirus may last for up to eight months or longer pursuant to the vaccination.” He further says that the healthy population above 50 years of age will start getting the vaccination from March 2021 onwards. “This will also include population with co-morbidities, between 20 and 50 years.”

A ray of hope is visible with the advent of the vaccine, despite some adverse events, occasional deaths and the uncertainty of extent and duration of its efficacy. Reports from Israel, where scientists claim to have developed a drug which can eliminate the coronavirus from the body by a single dose of nasal spray, may seem too good to be true. Another report from the same country claims that a majority of the serious cases will benefit by the administration of neutralising antibodies. Researchers at the University of Tel Aviv said, “The cocktail of neutralising antibodies represents a promising approach towards effective and safe treatment of severe Covid-19 cases, especially in the elderly population or chronically ill people, who will not be able to easily produce these antibodies upon infection or vaccination.”

If the infection has dipped to a low level even before mass vaccination was started, what will be the role of the vaccine, which has caused so much hype and excitement? Vaccines don’t stop you from getting infected. Vaccines help you fight the disease if you do get infected. It is also believed that successful vaccination may save a patient from reaching a serious stage.

But some questions arise: Is it safe to take the jab when thousands of adverse events and dozens of deaths have been reported in the country? How long will the immunity acquired after vaccination last, when several studies indicate that the antibodies’ level starts falling after 90 days in Covid-infected patients? If coronavirus is dying a natural death or the Indian people are protected due to natural reasons, will it be prudent to invest so heavily in continuing the vaccination programme for long?

With new variants being reported from other countries, especially from South Africa, which are not only more transmissible but might also make the body’s antibodies (acquired either by vaccination or previous coronavirus infection) less able to neutralise the virus, what will be the status of the present vaccines in case of a second wave?

For the prevention of a second wave, measures like avoiding crowded places, social distancing, mask-wearing and hand hygiene should continue.

Regular exercise, good sleep, nutrition and shunning smoking and alcohol could be added to the list to prevent long-term complications in the post-Covid phase. A recent report based on a PGI study that most Covid patients had low levels of Vitamin D and calcium is significant and calls for adequate exposure to sunshine.

Consuming a diet that minimises inflammation may improve and strengthen the immune system against many different infections, including Covid, and is also likely to reduce the prevalence of several non-communicable diseases (NCDs) like dementia, cardiovascular diseases, diabetes and cancer. It includes vegetables, fruits, nuts, seeds, legumes, potatoes, whole grains, breads, herbs, spices, fish, cheese and yogurt, which are in abundance in Indian diet.

Besides the diet, researchers have found that the presence of plenty of AAT protein inhibits the production of ‘neutrophil elastase’, which is a protein that helps the virus enter the receptor cells in the body. The deficiency of AAT is high in Europe and the US, which explains the high death rate in those nations, despite their more robust healthcare systems.

The World Health Organisation (WHO) advocates that building an inclusive, green and resilient recovery is an urgent and shared global challenge. The WHO says that the world cannot afford repeated disasters on the scale of Covid-19, whether they are triggered by the next pandemic, or from mounting environmental damage and climate change.

Environmental damage increases the risk of emerging infectious diseases in humans — over 60 per cent of which originate from animals, mainly from wildlife. Overall plans for post-Covid recovery, and specifically plans to reduce the risk of future epidemics, need to go further, beyond early detection and the control of disease outbreaks. Unchecked human encroachment on nature is one of the root causes of zoonotic pandemics. 

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