INTERVIEW | COVID-19 fight may take up to nine months: Dr Anup Warrier
KOCHI: The fight against coronavirus is going to be a long one and the pandemic will end only when a section of the population develops resistance, says infectious diseases expert Dr Anup R Warrier. Kerala has done well so far but now it all depends on how the state handles the situation once the lockdown is lifted, he tells TNIE in an interview.
So far, more than 9,000 people have tested positive in India. Do you think these numbers truly represent the spread of the virus? Where are we headed?
We are dealing with a global pandemic, and that means the disease can be present anywhere. This is a respiratory virus that is highly transmissible. Its endpoint is when the population develops herd immunity and the virus is no longer able to spread. But, till then it is a long haul and we have to wait and see whether we can go on with the advantage that we have gained now. It may take six to nine months -- till a part of the population acquires resistance.
Which stage are we as far as the pandemic is concerned?
Since we are dealing with a pandemic, we can talk about stages only from a global perspective. In this regard, we are in Stage 6 now. Hospital admissions and deaths are an important parameter of the severity of the disease.
But the numbers are low here compared to other countries. But, we seem to have missed the WHO alert. When WHO declared it as a pandemic, we should have closed international borders for all. Instead, we first blocked arrivals from China, and then Italy, while gates were open for the Middle East and Europe for long.
Do you think the lockdown has helped?
Yes, the lockdown has helped us to buy time for making necessary arrangements. ICU beds, PPE, testing kits, infrastructure and trained manpower -- all must be made ready. However, those working in the frontline are not supplied with sufficient PPE and masks even now. There is a supply issue and we are forced to learn to reuse masks.
India is seeing a large number of asymptomatic cases. Why do you think this is happening?
Asymptomatic and mild symptomatic cases are a danger. Such people help in spreading the disease and the scenario helps the virus to survive. It is not a trait specific to the coronavirus. Generally, all viruses have this hidden danger.
What do you think of the situation in Kerala?
Lockdown has benefitted us. There is no community spread yet. Now, it all depends on how the state handles the situation once the lockdown is lifted.
Compared to other states, the mortality in Kerala has been low.
The mortality rates cannot be compared unless we have all the details -- age profile, co-morbidity and stage of the disease etc. But an important factor here is the access to good healthcare in Kerala. Below particular social strata, access to healthcare is superior in Kerala compared to other states.
Do you agree with India’s testing strategy?
Testing can be done for treatment and also to know the magnitude of the disease. Since, we have mechanisms here to know where the disease stands, testing is not a concern.
Do you have any suggestions regarding the treatment protocol?
The treatment protocol may get stabilised in a month or so. We cannot authoritatively prescribe any particular medicine for Covid-19. Trials are progressing. Availability and familiarity of the drug is the key for using one now.
There’s lot of hype around hydroxychloroquine (HCQ)
HCQ is cheap, readily available and is a familiar drug. That is why it is being used widely. Clinical trials are going on. On an experimental basis, the drug can be used if somebody is suffering from pneumonia and the condition is worsening. In such cases, the risk from the disease is more than that from the drug. So, we can experiment.