Each new booster dosage should be effective against existing and foreseeable Covid strains: Randeep Guleria

According to former AIIMS director Randeep Guleria, the Covid vaccines currently being used in India are covering the original Wuhan strain, but if the need for another booster dose is felt as new variants emerge, it should be able to provide protection against all circulating as well as future strains.

When questioned whether it was time for another preventive dosage over a year after the first one with the current spike in Covid cases, he emphasized the necessity for two data sets - first to identify whether the degree of protection is decreasing and secondly if the vaccinations need to be changed.

"Today, the Wuhan strain is protected against by the vaccinations available in India. After that, we had a huge variety. Thus, if we need a new vaccination, it should cover the circulating strains much as our influenza vaccine does "explained he.

The renowned pulmonologist, who served on the national Covid task force, emphasized the importance of conducting research to create vaccines that will protect against both the prevalent strains of the disease and any new variants that may emerge.

His remarks come as Covid instances around the nation are on the increase. On Wednesday, Prime Minister Narendra Modi convened a high-level meeting to assess the Covid situation and assess the state of public health readiness.

Dr. Guleria described the new XBB.1.16 variant as a "new kid on the block" that may be responsible for the recent increase. He added that new variants will continue to appear as long as the virus keeps evolving, but "as long as they don't cause severe illness, hospitalization, or deaths, it is okay because it helps in giving the population some degree of immunity if they have mild illness."

"Even if we observe a spike, there is no reason to concern as long as it does not convert into hospitalization and fatalities," he stated in response to the question of whether XBB 1.16 has the ability to cause a new wave of cases or result in a major increase in cases in the coming days. When asked whether Covid is now endemic, he said, "Covid has, in my judgment, essentially turned into an endemic condition. We are quite immune to most things. Cases will go on, and this will happen. Although some waves of new cases will continue to come and go, they won't be as large as the ones we experienced over the previous two years. We'll have to adapt to it in order to survive." Dr. Guleria commented on the spike in Covid cases and the rise in H3N2 cases, both of which are subtypes of the seasonal influenza virus.

There has been an influenza virus for a very long period.

"In 1918, the H1N1 pandemic also struck. As a result, the virus has always existed, but it is always evolving, with the H3N2 strain now in circulation "explained he.

It acts very much like the flu-like syndrome and causes symptoms such as fever, sore throat, body pains, and runny nose in addition to a cough that may be bothersome and persistent.

Moreover, he noted, some members in the high risk category may develop pneumonia, which may be more dangerous and need hospital hospitalizations.

According to him, influenza may spread to anybody who comes into touch with an infected person.

We all sometimes catch the flu, but certain people are more susceptible to a severe illness that might need hospitalization or even result in death. According to him, those who are old and have co-morbidities are more likely to have more serious infections.

On the effects of H3N2 infections on those who have already contracted Covid and on the health situation in general, Dr. Guleria said that people who have already recovered from Covid shouldn't have any issues.

"Yet, there is a limited number of individuals who have Covid-19, which resulted in lung injury and lung fibrosis. So, their lungs were already somewhat impaired, and in certain cases, their immunity is also poor. So, this tiny number of individuals who took Covid and still experience its symptoms are at greater risk of developing a more serious illness "explained he.

About the effects of H3N2 outbreaks on the health situation, he stated, "India is already under a tremendous amount of pressure in terms of hospitals, ICUs, and beds and then we get an epidemic where there is a spike in patients." Dr. Guleria, who oversaw AIIMS-Delhi during the height of the epidemic, emphasized the need of creating a plan to make sure that the regular care of other illnesses is not interfered with while controlling an environment.

"One of the drawbacks or collateral damage we found with Covid was that many patients suffering from other illnesses such as cancer and TB suffered a great deal since the emphasis was primarily on treating Covid-19," the author said. "During the epidemic, we were unable to control these infections. The wrong timing was not used to diagnose the patients. There was a delay in the delivery of the treatment. Hence, we devise a plan to control the epidemic while maintaining the viability of our health systems, policies, and programs "explained he.

Dr. Guleria also emphasized the need of planning ahead and using active monitoring. "So that we should be able to pick it up early and identify that there is an epidemic that is occurring if there is a jump in number of cases, whether it of influenza or Covid or any other new viral illness," he added.

He also emphasized the necessity for strong laboratory networks, hospital- and clinical-based monitoring systems, and the ability to analyze samples in the event of an epidemic.

According to Dr. Guleria, if there is a concentration of cases in one location and a medical professional notices a lot of people arriving with unusual symptoms, they should immediately report that there may be an outbreak developing so that it can be investigated, managed, and stopped from spreading.

Then there is sentinel monitoring, in which hospital admissions are monitored to determine whether more hospital admissions and fatalities are occurring in conjunction with an increase in cases.

Dr. Guleria said that the measures in terms of Covid-appropriate behavior would guard against all these viruses for both Covid and influenza.

"The antiviral medication oseltamivir (Tamiflu), which is effective against the influenza virus, is accessible if you have a confirmed diagnosis of influenza. We used it often even during the H1N1 pandemic. In order for the medicine to be administered to a high risk group in the event of a confirmed diagnosis in addition to symptomatic care, "He clarified.

Lastly, he said, if you fall into the high-risk category, you may get a vaccination that protects against both influenza and Covid.

Dr. Guleria said when asked whether, three years after the epidemic, we were more prepared "We have learned a lot from Covid, and as a result, we are more prepared than we were in the past. The difficulty, of course, is in continuing to apply what we have learned as time goes on and our memory of Covid fades." He said that the nation has seen several outbreaks over the previous 23 years, including those of the H1N1 swine flu, Covid, the Nipah virus, and monkeypox "From what we have witnessed over the last two decades, we should understand that preparation is necessary. The level of preparation must include effective monitoring and a plan of action for upgrading our medical facilities' infrastructure and human resources."