Waves of the Covid-19 pandemic continue to sweep across the world. We know much more about Covid-19 now than we did back when the pandemic broke out in January 2020. We have many vaccines to protect ourselves, albeit against moderate to severe illness. Over time we have come to realize that the virus will continue to mutate and produce variants. We are slowly realizing that the new variants might escape the immunity conferred by prior infections or vaccines, thereby reducing their effectiveness in preventing transmission. The level of immunity induced both by infections and vaccines, as evidenced by antibody levels and rising breakthrough infections, might diminish over time, possibly requiring a booster dose.

Let us not keep debating whether the third wave will come or not. Nearly three fourths of the population seems to exhibit immunity as per the last round of national serosurveys. High seroprevalence rates and accelerating vaccination offers hope that we may not see a third wave. The other side of the coin is that nearly 350 million people without any evidence of immunity, are still vulnerable to getting infected. If the immunity doesn’t last for long, more people may become vulnerable. Similarly, if immune evading new variants emerge, the existing immunity may not be effective against reinfection or breakthrough infections. My own guess is that the Covid-19 is more likely to become endemic in India.  

As these realities sink in, we have to learn to live with Covid and get on with our lives. Masking, hand washing, and social distancing continue to offer protection against all variants. These are within our individual control and we will have no one to blame but ourselves if we violate these norms. In addition, these behaviors offer protection against other respiratory ailments from microbes and pollution. Just as helmets and seat belts have become normal behavior, the above will have to become a part of our new normal lives. 

Vaccines will continue to evolve along with the virus. New antiviral drugs might be developed soon, adding to the armamentarium. Home-based rapid tests will become easily available, helping people to self-test and isolate. Hospitals will have more oxygen and ventilator beds. Every hospital will have a backup oxygen generator, just as they have back up electricity generators and uninterrupted power supplies (UPS) against power outages. There will be stockpiles of critical drugs and essential ingredients to be ready for the next wave. Hotel rooms will have gas pipelines for use in emergencies. 

Our surveillance systems might improve. Increased footfalls at hospitals and drug stores may help us raise an alarm. Sudden spikes in the use of tests for a particular infection or of a drug for fever or in insurance claims for hospitalization will alert us about a looming threat. Unusual infections may be brought to light by social media. Dashboards might flash the beginning of a novel infection from health data exchanges established by the National Digital Health Mission.  

We will be better prepared to face the uncertainty that the future holds. We will save up more. We will insure ourselves against disease and death. We will write down our will, lest our family suffers. We will start revisiting the wisdom from our ancient times and start exploring the universal truths. We will savor the present moment. We will learn to shed our individual egos and embrace the oneness of the universe. Along the way, we will also soon realize the immense harm that we are doing to our mother earth. 

Dr Krishna Reddy Nallamalla
President, InOrder
Regional Director, ACCESS Health International 

Photo Credits: Reuters

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