CME INDIA Presentation by Dr. S. K. Gupta, MD (Med), FICP, CFM (France) Clinical Asst. Professor GS Medical College, CCSU, Uttar Pradesh, India. Visiting Consultant, Max Super Specialty Hospital, New Delhi.

“Thankfully, SARS-CoV-2 does not seem to have evolved any such tricks yet – suggesting that we still have an opportunity to stem its spread and the pandemic by pursuing a relatively straightforward vaccine approach,” – Dr. Iwasaki and Dr. Medzhitov (Professors of immunobiology at Yale. On July 31,NT).

“Vaccination offers a slower but much safer approach to crushing a virus”- Laird Harrison, July 21, 2021.

When Will Life Return to Normal After Pandemic?

No natural immunity in Human race against New Virus

  • SarsCov 2 is a Novel Virus on earth. It is  infecting humans for the first time. Human beings (Homo Sapiens) therefore have no inherent  immunity against the said virus.
  • Earlier attempts to boost immunity by Food supplements exercise had not been successful as evidenced by first and second wave.
  • To mount defence immune system of  all the individuals, need to get exposed to the virus (particles) to learn to recognise and neutralize the same in future attacks.

How to promote Herd immunity against Virus?

  • 4th Sero surosuvey by ICMR  in July 21 showed that  67.6% population has developed antibodies against the virus suggesting that ~95 Crore people have  got already exposed to the virus. However,  GOI official figure of  RTPCR positive stood around ~3Crore cases at that time. It means there had been around 31 Asymptomatic cases for one Symptomatic case.
  • Vaccination too could have contributed to Seropositivity. About 15%population had been vaccinated ( by at least one dose ) in July 21. If one excluded these cases it can be safely presumed that around 25 cases of asymptomatic infections  had been present for one symptomatic case.
  • Asymptomatic cases have contributed to Herd Immunity in a big manner.
  • However, to wait for natural infection to occur to all individuals could be a costly affair as witnessed during Second wave.
  • So prudent way forward would be to vaccinate masses for the life to return to Normal. 

Day of Freedom from Virus

  • While the best vaccines are thought to be 95% effective, it would need  a coordinated campaign to stop a pandemic.
  • Vaccinating 70% to 85% of the population may enable a return to normalcy – Anthony Fauci.
  • India  needs a total of 225 crore doses to vaccinate about 80% population.
  • Having injected about 50 Crore doses as on 6th August 2021 India still needs ~175 crore doses.
  • And at current rate of ~55 lakh doses per day India will take about a year to complete vaccination of  the significant population before the advice of mask removal and free travel can be given. So, at it appears that a year from now
  • 15 August 2022 could be the day of freedom from Corona Pandemic for India.
  • But it is to be noted that  having an established human reservoir  the Virus will remain  Endemic affecting people with lowered immunity sporadically

Courtesy: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/when-will-the-covid-19-pandemic-end#

Can we walk faster bring D day closer ?

  • Presently,  Vaccine shortage is the limiting factor but as newer vaccines get approved, manufacturing is ramped up for current vaccines; the  shortage will decrease and India might be able to speed up vaccination  leading to earlier return to normalcy

Factors which can change the day of Freedom

  • However, any mutation in Virus can turn tables making things take a U turn but the possibility of virus mutation into virus substantially decreases  with increasing vaccination and lowering  number of cases.
  • As chronic lingering  infections in immunocompromised hosts decrease in society, the virus gets little chance to mutate
  • Though no effective anti-viral seems in sight . but discovery of one has the potential to change fortunes!

Till then

  • Mask appropriately
  • Motivate all for Vaccination

CME INDIA Tail Piece

  • Recently several studies indicate that the post vaccination antibody titre and also in people infected with COVID infection has dropped significantly after 2 to 3 months.
  • These findings have sparked fears about waning immunity.
  • It is well known that natural immunity and also post-vaccination immunity serve the same function.
  • Fading antibodies does not mean vaccine failure.
  • Believe on T-Cells.
  • T-cells are the main agents of long-term immunity.
  • “We have growing evidence now that the cell-mediated immunity that is also elicited after a natural infection and after vaccination is preserved against the variants,” -Pauline Vetter, MD, an infectious disease specialist, Switzerland.
  • There is a growing consensus that now what waves are making news is the epidemic of unvaccinated population?



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