Need To Protect The Young From Third Wave

0
30

By epidemiological parameters even without extension of lockdown or state level stringent lockdown the ‘second wave’ in Goa could be automatically over between May 15-20

Nandkumar M Kamat

The second wave would be over soon even without any lockdown, and Goa needs to immediately prepare for the third wave because it would target the below 34 age groups. The population of Goa is estimated to be 16 lakhs. The below 19 years population forms 30 per cent or 4,32,035 individuals. Lockdowns even if imposed by the Indian army will not have any effects among the adventurous, party and picnic loving section of this young population.

During every lockdown we have seen various types of outdoor games in villages and towns in presence of a large number of onlookers. Noisy modified bike racing on deserted roads is rampant during lockdowns. That is precisely what local people mean by demanding lockdown- excuse to come out and play- mostly the games of football and volleyball. The markets and streets may seem empty but look at the playgrounds and paddy fields- there is no lockdown effect there especially in the evening. Lockdowns never stop the virus but give a little more breathing time to the administration and the frontline staff.

40 per cent people or about 5.3 lakhs among those tested with RT PCR had been found negative. They can get infected only if they abandon Covid19 appropriate behaviour. Now when we add these two big numbers the 30 per cent below 19 years population and the 40 percent adult covid19 free population then we get a big number- about 9.6 lakh or 70 percent population of Goa. So somebody has to explain from where the new infections would arise from the remaining 6.4 lakh people when the vaccination has already covered about three lakhs and more than 90 thousand Covid positive patients carry the antibodies against the virus. Because as testing frequency increases a saturation point would be reached. By epidemiological parameters even without extension of lockdown or state level stringent lockdown the ‘second wave’ in Goa could be automatically over between May 15-20.

Going by the declining test positivity rate for the past two days Goa seems to have crossed the peak of the ‘second wave’ by April 29 and any spikes that would be seen till May 5 could be traced back to April 23 turnout of 123456 voters in municipal elections. The evidence comes from spikes in active cases in Mapusa, Margao, Sanguem, Quepem and Curchorem after April 26. After May 5 however in any case without any lockdown the test positivity rate is expected to decline further. But some people are smart and need to attribute the crashing of the second wave to the lockdown if it gets extended from May 3 just to embarrass the government. The second wave was caused by the failure of the government in patrolling the border with Maharashtra after fresh eruption of the cases in February. The Goa government was more interested in permitting the tourism industry to make some quick money in February 2021 using the glamour of official carnival celebrations. It was not a coincidence that within a week of carnival celebrations new infections began to increase.

April 2021 was the month of horror and witnessed 338 deaths. But without looking at the age composition of the dead having majority of the deceased above 45 years professionals began to make statements that “many young people “are dying due to Covid-19. They need to check their definition of the youth. Such scare mongering during the second wave may have been aimed to pressurize the government to vaccinate the younger section. And it is important to preferentially vaccinate the age group of 10-29 with high priority before the third wave strikes Goa. This needs to be done only after those who have received their first vaccine shots are administered the second dose.  If the backlog of second vaccine doses is completed before May 31, then Goa would reduce the rate of community transmission significantly.

The state government has failed on two fronts of systematic and scientific pandemic management- genomic surveillance and immunosurveillance. The first gives one clear picture of the diversity, dominance, and distribution of all the SARS COV2 variants circulating in the tested population. The second is required to assess the community level total percentage herd immunity- either naturally existing, produced after infection or produced after the vaccination due to artificial antigenic immunogenicity.

Goa is likely to witness a ‘third wave” from August 2021 to October 2021 and the new variant admirably adapted to target the young population could attack the age group below 34 years specifically. The available age pyramid from 2011 census data shows that we have more than 4.3 lakh individuals in the zero to 19 age group. Add another 3.9 lakh youth in the age group 20 to 34 years. The total vulnerable young population becomes 8.2 lakhs. There are hints from the disease progression of the second wave that is quite different from the first wave. The new variants circulating in India are more infectious, highly transferable within the household or families, produce symptoms more rapidly and make the patient sicker than the previous wave. Interestingly as compared to morbidity there is relatively less mortality.

Amazingly the cumulative case fatality rate of Goa has declined despite a large number of deaths in April 2021. However, the state government has not been calculating or disclosing the ‘R’ or reproduction value which gives an idea of the overall severity of the pandemic. If the government fails to release the R value it would impact the management of the third wave. In anticipation of the third wave the normal academic timetables of all the educational institutions would have to be drastically changed. No offline classes would be possible till November 2021 or before the ‘third wave” lessens in its ferocity and intensity.

Having tasted its teeth in the adult population, the unknown and new seasonally adapted SARS COV2 variants could preferentially target the youth with poor body mass index (BMI), stunted growth, obesity, nutritional deficiency, and pre-existing comorbidities. Therefore, pre-emptive, and preventive anti-Covid19 counselling of 488235 individuals in the age group 10-29 years becomes essential in the anticipation of the coming seasonal “third wave”. The 1000 statutory parents and teachers’ associations could be immediately roped in for this purpose so by the time first cases of infection among the young are detected further transmission can be easily prevented and the new variant is not permitted to play havoc in the local population.

Unfortunately, the priorities of forthcoming assembly election politics may engage the minds of government and the opposition parties till the ‘third wave’ strikes and the vulnerable young population miraculously saved until now from morbidity and mortality due to two waves of Covid19 could get mercilessly attacked by the dangerous new variants from August 2021.