By Dr. Ekta Jain, PhD Epidemiology, Public Health

In April, vaccination against the novel coronavirus was extended to all Indians above 18 years of age. This time, the Central Government made it mandatory to seek an appointment for visiting the vaccination centres. This can be done via the Arogya Setu mobile app or online on Soon there were reports that the system crashed due to the overwhelming number of people trying to log onto the website. Reportedly, there were more than 27 lakh hits per minute.

Co-WIN app for registration for COVID-19 vaccination and schedule vaccination slots at the nearest vaccination centres

In the previous rollout, making an appointment was not mandatory. An individual could walk into any centre to get their vaccinations provided they were registered via these portals and carried their identification proofs.

The situation now is drastically different since the first phase of the vaccine roll-out. India currently is witnessing a record high number of infections daily. The positivity rate in Delhi was well over 40% on 25 April 2021. In comparison to the first wave, a substantially higher number of people are rushing to hospitals for life-saving aid. Although medical doctors say up to 15% are in need of hospitalization, it isn’t clear whether this 15% includes those who have managed to arrange oxygen cylinders at home and thus can do without a hospital bed.

It is also not clear if this 15% includes those who may be severe and are being treated at home with all medical equipment but otherwise would be classified to be needing a hospital bed. There is a huge shortage of oxygen and the scarcity extends to drugs such as Remdesivir that have been used in the treatment of COVID-19 patients previously.

Remdesivir injection has been one of the most sought-after drug for treating Covid-19

With cases soaring daily, there is a cause of concern. However, there is no warrant for panic. Efforts are being made at war footing to tackle the second wave. Meanwhile, what we can do is to follow covid-appropriate behaviour, and get vaccinated.

Here I discuss some of the questions and misconceptions that people may have regarding the novel coronavirus disease– covid19.

What is the double mutant coronavirus?

Viruses are mutating all the time. This is particularly true for those that contain RNA as their genetic material. This includes coronaviruses and the family of influenza viruses. There is nothing to be alarmed about a mutant variety of coronavirus. Also, the term ‘double mutant’ is a misnomer as viruses can have multiple mutations. This term refers to the Indian variant of the mutated coronavirus, scientifically labelled as the B.1.617 variant. 

The two mutations in the Indian coronavirus variant have been identified to be the E484K and L452R which were present in other variants as well, but separately. The E484K mutation is present in the strain found in Brazil and South Africa, whereas the L452R is present in the strain found in California. The Indian variant contains these mutations together along with other mutations, of course.

Is the double mutant coronavirus more transmissible?

The variant in California containing the L452R mutation was found to be up to 20% more transmissible. Again, the California variant has other mutations as well. For the Indian strain, there is so far no evidence on higher transmissibility. There are also other variants found in India. These include the B.1.1.7 (United Kingdom variant) and the P.1 (Brazil variant). The WHO, as of now, has classified the B.1.617 variant as a ‘variant of interest’ and not as a ‘cause of concern’.

What precautions can I take to stay safe from getting infected in the second wave of covid-19?

Overall, the ground rules are the same as in the first wave of the covid-19 pandemic. Due to the sheer high number of infections, it is advisable to avoid all non-essential outdoor activities. If possible, post-pone all out of station travel and restrict any unnecessary visits at home. Where possible, work from home is a safer option.

The use of a double-mask should be adopted when stepping out of your house. Avoid use of lifts and use of other enclosed spaces.

Double-masking is must

Reducing physical inactivity and performing moderate-to-vigorous physical activity has shown to aid health benefits. In a recent study, high physical inactivity was identified as a risk factor of severe covid-19 illness.

Read More: Bizarre Things Indian Uncles/Aunties Have Said In Support Of Offline Board Exams During COVID-19 Wave

Should I wear a mask when inside my home?

If you are living with a covid positive person then wearing a mask at home will reduce the risk of contracting the infection, even if the person is in isolation.

If no one in your family is covid positive but you have people visiting your house then it is advisable to keep a double mask on and ensure the rooms are well ventilated.

If you/your family are self-isolating then wearing a mask at home may not be required. However, do ensure that your house is not sharing ventilation or centralized air-conditioning.

I am healthy, can I donate plasma for other covid-19 positive individuals?

Those who have recovered from covid-19 infection should donate plasma for other critical covid-19 individuals. Those who have been vaccinated are also eligible to donate plasma.

The government has recently released guidelines regarding plasma donation and these can be found on the mygovindia Twitter handle: 

I am covid positive and own dogs. Can my dogs be walked outside as it is an essential requirement? 

As per protocol, even if a family member has been tested negative for covid-19 they still cannot break quarantine rules to walk the pets. However, a dog walker can be called and a mechanism be set up wherein the dogs are handed over without any contact, ensuring that proper sanitary distance is being maintained.

Dogs do not contract covid-19 and thus cannot pass on the infection. As a safety precaution, you can clean the paws of the dogs before letting them in or out. The dog walker should also wipe the dogs before leashing them for their walks.

You may need to seek assistance from your RWA in this regard. For any hindrances, you can always contact the Animal Welfare Board of India. There are several pet boardings that are accepting dogs from covid-19 affected families. You may find it more convenient to send your dog to a verified boarding.

Why do we need to register and select an appointment for the phase 3 vaccination drive (for people above the age of 18)?

There is always a risk of overcrowding during the walk-in for the vaccination system. Thus is an increased chance of contracting the virus from these centres themselves. To prevent this from happening and given the current situation appointments have been made mandatory.

You can select the hospital or vaccination centre nearest you to get your vaccine dose.

What should I do if I feel unwell on the day of my vaccination appointment?

If you have a fever or sore throat or any other symptoms suggesting covid-19 then:

  1. consult a doctor, and
  2. inform the vaccination centre so that your appointment can be rescheduled.

Do not attempt to get vaccinated should you be exposed to covid-19. You can be vaccinated once you have recovered.

What all vaccines are available, and how are they different?

India has allowed the use of Oxford-AstraZeneca’s Covishield and Bharat Biotech’s Covaxin. There is also the Russian Sputnik-V which has been allowed for emergency use in India but it is yet to be made available to the Indian market.

All vaccines work on the principle of injecting a dead or non-virulent virus into the bloodstream. Our body on recognizing the foreign agent, begin to form anti-bodies against that particular foreign agent. These antibodies then help provide immunity in case the individual contracts covid-19.

Covishield is manufactured by the Serum Institute of India. It uses a modified version of inactive adenoviruses, found in chimpanzees, to mimic the inactive novel coronavirus. Manufactured by Bharat Biotech, Covaxin is completely indigenous. While Covishield has already completed its 3 phases of clinical trials, Covaxin’s phase 3 study has only been completed recently. Data from the final analysis is not yet available.

Covaxin’s preliminary analysis on ~ 27,000 individuals show the efficacy of 78% and 100% against severe covid-19 illness. These findings are provided by Bharat Biotech, but is not yet peer-reviewed at the moment. The efficacy rate of Covishield is 70.4% as shown in a peer-reviewed analysis.

Do these vaccines offer immunity against all variants of Covid-19?

All vaccines will offer some immunity against the covid-19 variants. This is because the vaccines will elicit an overall antibody response which even if less effective on the covid-19 variants will prevent escalation of the symptoms. Studies have shown that both Covaxin and Covishield are effective against the Indian variant. Covaxin is effective against the variant from the United Kingdom as well.

Author Bio: The author was awarded a PhD research scholarship at the National University of Singapore. She is now based in Gurgaon and currently analyzing COVID-19 India Data.

Image Source: Google Images

Sources: WHO, Bharat Biotech, Independent, British Journal Of Sports Medicine

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This post is tagged under: coronavirus, Indians, Central Government, appointment, Arogya Setu mobile app, CoWin, website crash, walk-in vaccination, COVID-19, COVID-19 vaccination, coronavirus infections, Delhi, first wave, hospitals, Indian healthcare system, mandatory appointment, doctors, hospitalization, oxygen shortage, oxygen cylinder, Remdesivir, coronavirus misconceptions, double mutant coronavirus, RNA, influenza virus, ‘double mutant’ is misnomer, B.1.617 variant, Indian variant, Brazil, South Africa, Claifornia, variant of interest, avoid non-essential outdoor activities, work from home, double-mask, reduce sedentary behaviour, isolation, donate plasma, mygovindia, covid protocols for dog owners, Animal Welfare Board of India, Oxford-AstraZeneca, Covishield, Bharat Biotech, Covaxin, Russia, Sputnik-V, anti-bodies, Serum Institute of India

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