Will a vaccine be here before the second wave?

Everybody has their eyes peeled on just one thing — the shot that can save us from coronavirus. City is likely to see the second wave in 3 months from now, so even if vaccine comes to India before that, experts advise caution

Will the vaccine be able to offset the second wave? That is the million-dollar question on every Bengalurean’s mind? A sero survey conducted in Karnataka depicted a seropositivity of around 45 per cent amongst the residents of the state. Theoretically, this indicates some degree of herd immunity. And our covid-19 caseload is at its lowest currently, since we scaled the first peak.

If we compare the trends across the world, it indicates that around three months from December, India may theoretically be in the throes of a second wave.

Dr Satyanarayana Mysore (Consultant and HOD, Sleep Medicine Specialist, Manipal Hospitals, Old airport road) said, “In the natural course of covid-19 infection, four antibodies are produced by the immune system against the four known domains of the virus. The antibody produced against the spike protein of the virus has been seen to be protective to a certain degree. However, the antibody produced against the receptor binding domain may immunologically coat the virus inducing immune cells like macrophages to engulf the viral particles. This can lead to the accelerated presentation of the virus to the immune system, causing a cytokine storm. So, vaccines, either mRna or DNA-based that produce an immune response against the viral spike protein, can prevent the infection or re-infection.”

Dodge the wave?

If a proper system of covid norms are observed, it is also possible that the city can avoid a second wave, but doctors say you cannot rule out a second wave entirely. Dr Ravindra M Mehta (Senior Consultant and HOD – Pulmonology and Interventional pulmonology, Apollo Speciality Hospitals, Jayanagar) said, “There are enough susceptible people out there who when they move out can cause or be part of a second wave. There are also temperature considerations like the cold weather. So, the possibility of having a second wave is real. If it comes, it will come in the first quarter of next year. The hope is for a lesser intensity, management for healthcare and better readiness.”

We are banking on the Oxford-AstraZeneca vaccine which has to go through initial approvals, followed by manufacturing, and the vaccine will be given in order of priority – all this will take a long time

–Dr Ravindra M Mehta, Apollo Speciality Hospitals, Jayanagar

Other experts said that the second wave can start any time now. Dr Jagadish Hiremath (Medical Director at Ace Suhas Multi-Speciality Hospital) said, “Our history is full of instances where the second wave was more dangerous than the first one. In the case of Covid, we are not sure how long immunity will last after infection; we are not certain of long term immunity. Covid is highly contagious which means when the number of people who can be potentially infected is high the next outbreak can happen. This means it can happen any time now.”


Immunity puzzle

Referring to Europe example which is seeing a deadly second wave, experts in the city say that the second wave is intrinsic to a viral outbreak. Dr. Pradeep Rangappa (Senior Consultant – Critical Care, Columbia Asia Referral Hospital Yeshwanthpur) said, “The effect of the second wave also depends on immune mechanisms in people. There are two types of immune response: innate and adaptive.

Asymptomatic or mild symptomatic patients are assumed to have this innate immunity. The second type, adaptive immunity happens when there is extensive viral replication in the body and they go through turbulent recovery, however they develop long-term immunity. Re-infection is common in patients with innate immunity. During the first wave we see patients with adaptive immune response and during the second wave it is usually patients with innate response.”

With various Covid vaccines being rolled out there is hope that a vaccine can halt the second wave. Dr Chinnadurai R (Lead Consultant, Department of Critical Care, Aster RV Hospital) said, “The vaccination process in India may start in January and we will get effective immunity after about one or two months.

By the end of March, we will have a mix of people who have developed immunity from the vaccination and/or from previous Covid infection.” However, Dr Mehta feels that it is highly unlikely that the vaccine will come in time to prevent the second wave.

The biggest concern is that with the announcement of the vaccine, many people have actually stopped adhering to the necessary precautions required to keep the transmission of the Covid-19 virus at bay. Dr. Sunil Kumar K (, Lead, Interventional Pulmonology, Aster CMI Hospital) said that due to increased public gatherings during the festive season there can once again be a significant rise in the number of cases during the second wave of the virus.

Just get ready

What people and govt must do:

  • Governments should work on stockpiling masks and PPE.
  • Hospitals must address non-Covid backlog
  • And we should follow the three self-vaccine protocols of hand hygiene social distancing and wearing masks.
  • World Health Organisation has warned countries not to wait for vaccines and take all precautions against the spread of this disease.

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Sagar Biswas

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