Does the apparent mildness of the Covid caused by Omicron have more to do with us and less to do with the virus? Yes, believes Dr Rajeev Jayadevan, renowned epidemiologist and former head, Indian Medical Association. According to him, those whom the new variant is infecting might be mounting a more robust defence against the virus thanks to prior infections and vaccinations.
He goes on to note that while variants change, it is important to remember that it’s the same virus after all. "The changes we are talking about (in the case of Omicron and all these new variants) are very, very small... For instance, the spike protein is 1273 amino acids long. These basically are the building blocks of the protein. And these mutations only occur in a few of those," he explains to buttress his argument. Dr Jayadevan says he will only agree with Omicron being milder if data shows it to be less lethal both in the older groups and those who are not vaccinated.
When it comes to the wildly popular notion many have been peddling on social media that Omicron may confer natural immunity and help end the pandemic, he is dismissive. "Viruses have this habit of coming in cyclical patterns. That is the nature of the beast.” It will come back like it has earlier and with renewed vigour to reinfect people, he stresses, unless there is a dramatic change either in our vaccination strategy or in “viral behavior”.
But then it is not all doom and gloom. More good news, if you can call it that, comes in his reading of the wave that Omicron will unleash. He cited findings from a published study in South Africa, where Omicron was first discovered, which went on to establish that the spike in cases was near vertical and the wave came down as quickly. So, it will be remarkably shorter than the delta wave, he underlines.
What other predictions does he have on how India will fare? Dr Jayadevan thinks we will follow the South Africa pattern since the weather and density of the population in Gauteng from where the study was published is almost the same as it is in India.
The key to it all will be the 90 million adults who have not been vaccinated here. "We do not know how many of them have been infected. What the Omicron variant does in our country will depend on what happens with that segment (the unvaccinated, uninfected) of the population," he suggests.
As for those who have been vaccinated, Dr Jayadevan’s faith in their ability to fight the variant has not waned despite the scary headlines about the waning immunity conferred by vaccines.
"The death rate from Covid among those vaccinated is near zero... This has not declined in any part of the world including India, I can confirm.... Yes, the ability of vaccines to prevent infections has fallen, but it was never good to start with," he notes.
Dr Jayadevan goes on to say the infection will be mild or asymptomatic in a vast majority of people. No medication is needed for them.
"Have plenty of fluids if there is fever, but stay away from all kinds of scam treatments. No supplements, no antibiotics. Those without symptoms must stay away from unnecessary medicines," he says.
For those with moderate to severe symptoms, doctors will have to come up with a tailor-made approach. He is of the belief that dexamethasone can be the game-changer in these cases, but experts who can take the call on the right moment to employ them are needed. "I emphasise the need for experts making this call because it is important to note that medications like steroids, when given to COVID-19 patients who do not need it, can cause more harm than good," he goes on to add.
What then should be the priority now when the cases are surging? Minimise or avoid indoor gatherings. If we do this on our own for the next two-three months, the wave will settle down and we will have fewer people infected. Don't trivialise it until this wave passes, he emphasises.
"We will go through several months of what I call low tide after that and then we can have all the festivities without straining our healthcare system," Dr Jayadevan says.
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