The surge in Covid cases in the second wave has caught the country off guard. The first wave led us to believe that we were better off than the rest of the world. However, with about 4 lakh daily cases and 4,000 daily deaths, India has broken all global records. The healthcare infrastructure is stretched to its limit, people are dying in hospitals and many more are dying due to the lack of access to one.
How did we get here so quickly?
Rapidly spreading, more dangerous variants of Covid-19 could be the reason behind the surge.
The UK strain was found in 50 per cent samples sent for genome sequencing from Delhi in March, according to the National Centre for Disease Control (NCDC), Delhi. On April 23, NCDC director Sujeet Kumar Singh said at a webinar on ‘Genome Sequencing of SARS-CoV-19’, “The UK strain directly correlates to the Delhi surge.”
The Centre, too, has acknowledged that the B.1.1.7 or the UK variant leads to 50 per cent increased transmission and severity. Out of the 1,877 documented cases of the UK variant in India, Punjab has the highest, 516, followed by Delhi with 482 cases.
Government data suggests that the spread of the UK variant is now declining in proportion and the current surge over the last one-and-a-half months in some states shows a correlation with the B1.617 variant of Covid.
This double mutation or Indian variant is predominant in Maharashtra, which has reported 761 cases of B1.617, followed by Karnataka (146). West Bengal , which is also seeing a surge in cases, has reported 124 cases of the double mutation, followed by Delhi (107) and Gujarat (102).
Referring to this, the World Health Organization’s chief scientist, Soumya Swaminathan, has said, “A COVID-19 variant spreading in India is more contagious and may be dodging vaccine protections, contributing to the country’s explosive outbreak. B 1.617 is likely to be a variant of concern because it has some mutations which increase transmission, and which also potentially could make it resistant to antibodies that are generated by vaccination or by natural infection.”
Why is there a rise in demand for oxygen?
Government data on April 19 showed a 54.5 per cent higher demand for supplemental oxygen requirement in the second wave (Mar-Apr 2021) as compared to 41.4 per cent in the first wave (Sept-Nov 2020). Data also showed 47.5 per cent patients reported “shortness of breath” as a symptom in the second wave as compared to 41.7 per cent in the first wave.
Government data so far has not linked virus mutation to the rise in oxygen demand.
Dr. Jalil Parker, Pulmonologist at Mumbai’s Lilavati Hospital, says, “There appears to be a mutant strain driving the increase in demand for oxygen, even among the young. The sheer increase in Covid numbers doesn’t appear to be the only reason. However, there is no data to substantiate this and thus the treatment protocol remains the same. If we understood the mutation better, perhaps there would be a change in treatment.”
Can the rise in demand for oxygen be linked to air pollution?
While there is no data to establish this link, Dr Parker believes it cannot be denied either. “Lungs are compromised because of air pollution and when you are hit with Covid pneumonia, it can worsen the situation. However, this too can only be corroborated with a baseline pulmonary function test or CT before Covid,” he says.
However, Dr Anjan Trikha of AIIMS Delhi says there is no correlation between increased demand for medical oxygen in Covid patients and air pollution. “The demand for oxygen is high simply because the number of cases has risen exponentially,” he says.
India is now seeing varying degrees of lockdown across states. Given the rapidity at which the virus is mutating and spreading, breaking the chain is the only way forward.