THIRUVANANTHAPURAM: Two years ago, on January 30, Kerala reported the country’s first Covid case when one of the samples of three medical students who had arrived from Wuhan, China, tested positive. Two years on, the situation has only worsened, if one looks at pandemic metrics.
People, who were yearning for a change after a tumultuous 2021, were puzzled by the third wave and reacted to the arrival of the Omicron variant with an unpleasant mixture of fatigue and déjà vu. The year gone by was marked by the second wave of Covid that overlapped with the first and third waves at the beginning and the end, respectively.
All the variants of SARS-CoV-2, the virus that causes Covid, namely Alpha, Beta, Gamma, Delta, and Omicron as designated by the World Health Organization, made their presence felt here. Last year began with a hope of reopening the economy, due to the availability of vaccines, even when there were concerns of a new variant (Alpha), detected first among travellers from the United Kingdom.
Post assembly elections, the second wave led by the Delta variant wreaked havoc as the number of deaths followed the rise in Covid infections. It tested the preparedness and the historical advantages of the state’s healthcare system as the number of patients swelled.
However, the situation here was far from the chaotic scenes witnessed in other parts of the country. But authorities faced sharp criticism since the over-cautious approach in the first wave resulted in creating a large population susceptible in the second wave.
The under-counting of people who died of Covid too was a point of criticism. After much prodding for more transparency by experts and opposition parties, the state started to reconcile more deaths even though the government kept extending restrictions on normal life. There were some well-intended measures to open up life towards the end of 2021 with schools and colleges reopening after a long gap.
But the restrictions are back in force as the government remains watchful for the next two weeks. Amid the gloom, the scientific community is upbeat that the pandemic could run out of fuel this year. It might not be possible to return to the pre-Covid period, but there is a growing consensus backed by scientific evidence that a new normal is possible. TNIE spoke to two eminent health experts who explained why the pandemic phase is getting over.
“The present pandemic situation may settle down by March-April. As far as the virus is concerned, it needs only to replicate and transmit, not kill the host. So we have Omicron, probably the last variant of SARS-CoV-2. Even if it further mutates, it will be less virulent. The common cold is caused by several viruses including four coronaviruses. So if a new virus comes it may become the fifth one,” said Dr B Ekbal, public health activist and head of the expert panel advising the state government on Covid.
“It will become endemic. Except for those viruses whose definitive host is human beings such as Smallpox and Polio, the pandemic may not go extinct. When it becomes endemic, you can control it with appropriate behaviours, vaccines, and antivirals,” he said.
Dr V Ramankutty, a health economist, epidemiologist, and an emeritus professor at the Sree Chitra Tirunal Institute for Medical Sciences and Technology, said the emergence of Omicron was unexpected, but it may bring an end to the pandemic.
“We will be better off in 2022. The wild spreading of Omicron is expected to build immunity among people. The probability of another virus with superior mutation is less, though we cannot completely rule it out. It may become endemic and persist at a low level. But, the vulnerable groups should still have to be careful,” he said.
Even if Covid becomes endemic, it will leave its mark in the form of multifold challenges before the state, said public health experts.
A highly mobile, but largely morbid, population, with a high proportion of elderly makes Kerala’s challenges unique in the post-pandemic world.
“There is a need to strengthen the surveillance rather than the ad hoc arrangements we adopt as part of the reactive approach. We need to develop independent capabilities by using manpower and technology at our disposal. The preventive aspects should be strengthened in the healthcare system. The government should also promote open discussion on the topic. Providing access to the data is the first step in this direction,” said Dr Ramankutty. Dr Ekbal also wants attention on public health aspects to deal with the upcoming challenges.
‘Public health intervention needed’
“The state will find it challenging to manage post- Covid syndrome and a backlog of non-Covid cases. We should be prepared to confront the health challenges. The state’s problem needs to be addressed
through public health intervention. The focus should be on disease prevention and health promotion,” said Dr B Ekbal.