BENGALURU: R Giridhara R Babu,, a renowned epidemiologist and Covid Technical Advisory Committee member, speaks to The New Sunday Express about the Covid-19 pandemic teaching us how the complex links between human, animal and environmental health require coordinated multidisciplinary and multipronged collaboration to address threats from zoonotic diseases. “The global public health community needs to act decisively now. ‘One Health’ is the need of the hour,” he said. Excerpts.
Officially can we declare this the end of the third wave?
In terms of understanding the end of the third wave or end of pandemics we need to avoid using some confusing terms. End of wave or end of pandemic or even endemic doesn’t mean the end of a virus. It will probably find ways to replicate and sustain its own life cycle. While it’s doing that whether it is infectious or virulent to human beings is what is important for us. Often the end and endemic are used synonymously and that’s not correct. Even if it becomes endemic, it will not stop being harmful to humans. There is TB, malaria and other diseases that are endemic, but deaths are far higher than Covid. Endemic doesn’t mean it’s a good thing and endemic in no way means it is an end of the virus. The end of the third wave also does not mean that there will be no future waves.
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I don’t think it’s fair to compare India’s scenario with Zimbabwe’s as is done in this model. Even within India, it is completely heterogenous. If you take Karnataka’s example, over 50 per cent of cases come from Bengaluru, so can we take rural Karnataka as the prototype for Bengaluru? The model will not hold good if we base it on a particular homogeneous assumption. I agree with them on only one possibility that there will be future waves.
Do we know the timing of the next wave?
Timing depends on several things but we can’t reliably forecast the next wave without understanding clear data inputs from several parameters. Agent-the virus itself; Host- human beings; and Environment. The virus is capable of evolving much faster and if there are more infectious, virulent variants we will be in for a surprise. For humans, it has been documented that the antibody will not sustain beyond three to six months. Will that be sufficient to mount a response when a virus represents next time? That is something we need to understand. Environment is following Covid-appropriate behaviour.
Is there clarity on which variant is predominant in countries that are seeing the surge?
There is no uniformity in getting the genomic sequencing data. Predominantly it is available from the UK, some European countries and the US. Of late, India is doing well in genomic sequencing at least to understand which variant is driving the wave. BA1 and 2 are the predominant ones. There is also the combination of delta and omicron in some parts. Recent reports show that viruses are capable of showing new forms much faster by adopting to both delta and omicron.
What about precautionary doses for all adults and vaccines for children below 12 years?
Booster doses are necessary for people with high-risk conditions, elderly and those with comorbidities and immunocompromised conditions. Data suggests that the booster dose for everybody will help in reducing or at least ensuring the antibodies are present. We have to take collective global responsibility to vaccinate everyone in all parts of the world. There is considerable debate about children’s vaccination. There have already been approvals from FDA and CDC to vaccinate children aged seven and above. There is data of only two to three years and it is not sufficient to know how the virus is going to affect them.
Isn’t it time for us to look into non-Covid diseases? There is a lot of talk on ‘One Health’...
Covid is a reminder to us that in days to come, over 80 per cent of all disease outbreaks are going to be zoonotic. ‘One Health’ is governing the fears of animal health, human health and environmental health. We can’t forget about these interfaces and not pay attention to them. That’s not the way to approach other aspects of ‘One Health’. This is the time to start tracking diseases which can spread in human beings from animals and how the environmental aspects are going to be regulated. In Bengaluru, BBMP has created the ‘BBMP One Health’ task group involving several agencies. This is a good step.
We should have clear surveillance platforms, strengthening of the laboratories and ensuring that we are tracking both diseases in animals and humans so that we are not caught by surprise.