Third Wave. Third wave threat

The country faces a dilemma today: how to open up an economy laid low by the second wave of Covid without triggering another nasty round of infections and casualties. India’s active caseload has fallen below 15 lakh for the first time in over 50 days, prompting some States to gradually unlock their economies. Delhi, Tamil Nadu, Maharashtra, Uttar Pradesh and Gujarat have eased their lockdown rules. Maharashtra’s five-level unlock plan is based on the positivity rate and oxygen bed occupancy level in each district. Districts/municipalities with a positivity rate of 5 per cent and an oxygen bed occupancy level of below 25 per cent can open up fully. For others, restrictions will operate, in a graded way, in terms of timings of shops and the permissible capacity in malls and offices. While a calibrated, decentralised approach seems to be the best way forward to keep the economy going amidst a pandemic, it requires reliable data collection at a grassroots level. The moot issue here is to ensure comprehensive testing to arrive at a correct assessment of positivity rates across districts. Tamil Nadu has eased curbs in 27 districts and Uttar Pradesh in all except a handful of districts. India’s daily testing levels, at 20 lakh, are not adequate to manage a careful opening of the economy. The Centre and States should use the ebbing second wave to ramp up testing, hospital facilities for children who are feared to be the next targets of the virus and, most importantly, vaccinations to reduce the severity of infections and ensure that the virus gets fewer chances to mutate. While it will take a couple of months for vaccine supplies to pick up, the interim period should be used to counter social hesitancy over vaccination and even testing.

The severity of any third wave would depend on the numbers untouched by the second wave and the possibility of new mutations breaching immune systems. Experts have noted that in any event vaccinations will curb severity and incidence. However, a real worry here is whether it will impact children hard. It is just as well that some States have set up a paediatric task force. Covid facilities in hospitals will have to be revamped to cater to children. This includes re-sizing oxygen masks and doing away with the concept of isolation ward. The need to vaccinate the young adult population has become more important than ever, as vaccines for children are still in the pipeline. Oxygen supplies should be prepared for a peak daily demand of liquid oxygen of over 9,000 tonnes per day, as in end-April.

The ICMR should draw up a treatment protocol that can be used where paediatricians are not available. The black fungus fiasco should not recur. In short, the government should start planning its strategy now for the next wave. It would be tragic if lessons from mistakes of the second wave — in terms of data gathering, preparation and treatment methods — are not learnt.

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