NEW DELHI: Even though the World Health Organisation (WHO) has declared that Covid-19 is no longer a global emergency, India needs to continue wastewater surveillance along with monitoring hospitalised cases of acute severe respiratory infections as the virus is still around, posing a threat, experts said.
The age-old process of wastewater surveillance is used to detect and monitor the spread of viruses and pathogens including cholera, poliovirus, noroviruses and influenza. The emergence of COVID-19 has reiterated its role as a cost-effective tool for disease monitoring and the early detection of community infection.
“The virus is still very much with us. So, the risk of infection remains. However, the risk of serious illness is very low with the Omicron variant, which is presently dominant,” said Dr K S Reddy, Distinguished Professor Public Health Foundation of India (PHFI) and former member of India’s Covid-19 task force.
However, he said, India should continue surveillance by testing and genomic profiling all hospitalised cases of acute severe respiratory infections; home-based syndromic symptom-based surveillance of all persons with respiratory infection by primary healthcare teams; wastewater surveillance in urban areas and incoming international flights.
‘One Health’ surveillance linking microbial detections across wildlife, veterinary and human populations also needs to continue, apart from strengthening healthcare delivery and emergency medical transport systems, he said. He said the WHO announcement means that now the world can resume regular travel and lift most of the restrictions imposed on people as the virus no longer poses a high threat at the population level.
The WHO on Friday ended its highest level of alert for Covid-19, over three years after its original declaration, saying that countries should now manage the virus along with other infectious diseases. However, the world health body also said the decision did not mean the danger was over and cautioned that the emergency status could be reinstated if the situation changed.
Experts said the ending of the alert status does not mean that Covid-19 will disappear as the virus can mutate, causing severity. The focus should now be on the long-term management of the infection. Describing the WHO move as a “technical” announcement, Dr Rajeev Jayadevan, co-chairman of the National Indian Medical Association (IMA) Covid-19 task force, said that WHO has clearly stated that the pandemic is still very much active. “It is now up to individual countries to take the steps required,” he told this paper.
Unfortunately, he said, the danger of such an announcement is that many people will now believe that Covid is over. “This can worsen the spread, especially as the virus is now surging in the eastern hemisphere,” he added.
Gautam Menon, Professor of Physics and Biology at Ashoka University, agreed that there is always the risk that a new, more virulent and transmissible variant might emerge. But, he added that in the background of large-scale hybrid immunity, this seems less likely.
Stressing improved routine surveillance, not just for Covid-19 but also for other infectious diseases, he said, wastewater surveillance should be done to monitor the emergence of new variants. “Improved surveillance methods, more comprehensive routine sequencing of potential new pathogens and more investment in public health should be emphasised,” he said.
The experts agreed that old people, those with severe comorbidity or immuno-suppressed, should continue wearing masks in ill-ventilated crowded settings as they are at high-risk. “We should still acknowledge that the elderly and immunocompromised remain at risk and, on general grounds, allow those who are unwell to be able to isolate themselves,” Menon told this paper.
What is most important is to realise that this virus has spread not only in man, but also in several mammals, including rats, and is constantly generating mutations, some of which could potentially lead to greater or lower pathogenicity, Jayadevan said.