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From India's largest Newsroom. 
I'm Warren Gorge. 

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And this is the times of India 
podcast. 

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The number of covid cases has 
been rising across India, but 

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worryingly. 
So our cases of seasonal 

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influenza or flu. 
Three years after the covid-19 

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pandemic began visiting a fresh 
spike in cases and a few 

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reported deaths across the 
country. 

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People with symptoms, like 
coughing and fever are being 

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advised to mask up in today's 
episode. 

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Mike illegal. 
Am I speaking with dr. 

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Vaishali solo about these two 
waves of infections, dr. 

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Sewell ow. 
Is the head of critical care at 

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the Fortis Hospital in, Mumbai. 
She talks about the cases that 

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they're seen presently and what 
are the issues of concern. 

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She also talks about how we need
to deal with this double wave of

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infections. 
They'd be a sing presently. 

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You must be seen that many covid
cases are rising since last two 

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weeks, we are seeing the numbers
have gone up, especially in 

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Bombay. 
So being an expert, can you tell

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us why? 
There is a sudden rise? 

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In covid-19 cases, is it H3N2? 
The influenza is rising or 

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spreading in the in the 
community or the covid-19. 

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Thank you mother for having me 
here, first of all. 

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So yes, we are seeing a spike In
the number of cases in both the 

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viruses that is the covid-19 
virus as well as the H3N2 which 

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is the variant of the influenza 
virus. 

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Right now. 
The first part of your question 

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is why are we seeing the rise in
the number of cases? 

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Influenza is usually seasonal 
and whenever we see the rice, 

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there are usually three factors 
which come into play. 

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One, is the virus itself and the
viral factors. 

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Second is the environmental 
factors and third is the The 

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host factors. 
So host, here is US usually 

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anywhere between November to 
February due to the winter 

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season. 
The temperature goes down and 

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that makes the virus survive 
longer and multiply more and 

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transmit more. 
So, that's why we see a peak of 

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influenza in the wintertime that
is between November and February

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and then the virus factored. 
So, the viruses are the most 

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smartest sort of beings on this 
Earth and Both covid-19 as well 

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as the influenza they mutate, 
right? 

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So every year, when it comes to 
influenza every year, you will 

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see a new sort of mutation 
coming up and this time it is 

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the H3N2 which is a predominant 
one. 

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And in covid-19 again, you 
already know that the mutation 

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of xbb 1.16 is the predominant 
one. 

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And I think 60% of the cases are
now being attributed to this new

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variant. 
All the three factors come into 

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play. 
That is the winter season making

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the virus survive, longer 
multiply more the host is more 

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susceptible because usually our 
immunity goes down in the winter

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season and of course, the virus 
factors. 

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The virus has mutated. 
We have not developed immunity 

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to. 
So that is why there is a spike 

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in the covid-19. 
You just explain about the new 

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variant XP, deep 01 .16. 
It's being circulated in 

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Maharashtra and Gujarat. 
So can you tell us about these 

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this new variant? 
So xdb 1.16 has mutations at two

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places one in the spike protein 
and one in the open reading 

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frame, now the water, some 
mutation is one air, which is in

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the spike protein and that 
mutation will make it a little 

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bit immune evasive. 
That means you and I, if we have

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had an infection, or if we have 
had vaccinations, we should be 

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immune to developing. 
A new infection with covid-19, 

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but with this variate, which is 
that xbb 1.16, there are chances

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that this variant will evade our
acquired immunity to covid-19. 

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Now, should we be worried now? 
That's a question, which is the 

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most important in everyone's 
mind? 

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No doubt about it because 
there's so much information 

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everywhere. 
So, let us be a clear that as 

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the virus is evolving and 
mutating the fresh. 

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Screens are weaker, right? 
So this xbb 1.16, so far, 

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whatever data has come in is not
giving rise to very severe. 

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Infections write the rate of 
hospitalizations are not 

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alarmingly high. 
They are increasing. 

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Yes as you said just a week back
we didn't have a single 

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admission with the covid-19 and 
now every hospital has a few but

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most of them are still in double
digits out of those 

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hospitalizations also Oh, those 
people who are requiring oxygen,

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the percentage of patients who 
are required and oxygen is not 

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very high. 
So the first thing to understand

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is that it does not cause a very
severe illness. 

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So it is not a cause of panic, 
but yes, the vulnerable 

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population need to take much 
more precautions than average 

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healthy individuals. 
And these vulnerable subset are 

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basically people who have 
cardiovascular diseases, those 

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who are diabetic elderly, I'm 65
years, old, and obese 

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individuals, if there is 
immunosuppression for any 

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reasons, suppose, they have 
undergone some organ transplant 

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in the past and they are on 
drugs, which suppress their 

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immunity. 
They are also vulnerable. 

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And, of course, the biggest 
vulnerability is, if you are not

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vaccinated. 
So, these people need to be 

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extra cautious, they need to 
take more precautions and those 

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precautions are basically 
adhering to the covid up. 

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Appropriate behavior. 
So do not panic, but take 

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adequate precautions because 
this virus is still evolving and

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we don't know the entire impacts
as such so better to take 

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precautions than to face the 
effects of it. 

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Are there any long-term risks? 
You know that come with a 

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reinfection? 
So like lab last year? 

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Somebody was having some other 
variant. 

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Now the another reinfection 
happened this year also. 

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So what do you think there is 
any risk of risk comes with a 

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re-infections also? 
So the long-term effects will 

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only be in patients who have 
developed a severe covid. 

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That means either they required 
oxygen or they were in the 

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Intensive Care Unit, no matter. 
My which variant right if they 

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developed an infection, which 
affected the lungs, they 

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required oxygen. 
And how, how much of those lungs

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were affected. 
Yes, then there is a scarring on

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that lung and that scarring 
gives rise to long-term effects 

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in terms of requiring oxygen 
over a few months to a year. 

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You must have seen that in the 
last few wave. 

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Some people also required to 
undergo lung transplantation 

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because of very severe. 
Covid leading there. 

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Lungs, very scarred. 
That are that is one aspect. 

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The other aspect in the elderly.
For those who are developing 

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repeated infections is that it 
is a taking a toll on their 

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mental health as well as 
physical health. 

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See, it is difficult for people 
more than 65 years to cope with 

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any infection. 
And for them to come out of 

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those infection. 
Also, it takes longer so more 

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and more people are reporting 
cognitive decline. 

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Cognitive decline is in layman's
term. 

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It is called as brain fog, if 
you remember. 

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You know, there was so much talk
about this brain fog. 

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Basically, it was a deficit in 
their analytical skills and 

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their, their ability to think 
clearly. 

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Which is what many elderly 
started reporting after the 

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kögel all. 
Fatigue, a lot of fatigue, not 

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able to get back to normal level
of activity, which they used to 

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do before covet. 
But mind you, these were all 

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after severe covid, not mild 
infections. 

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So healthy individuals who 
develop mild infections. 

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Usually don't tend to have any 
long-term effects but elderly 

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those who have had severe 
infections required oxygen were 

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in the ICU for long duration, 
same a one week, or sometimes 

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even two to three weeks, they 
have reported a lot of I'll 

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long-term side effects, as well 
as respiratory. 

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Also, where they required oxygen
for a few months to a year and 

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the lungs did show some 
scarring. 

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So, yes elderly are vulnerable 
in that sense. 

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There are, there are two 
experts. 

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We've explained that you know, 
right now what is happening, you

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know, influenza and covid-19 
both are spreading and you know,

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the viruses are doing the rounds
at the same time. 

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Is there any any, any kind of 
like, you know, doctors experts 

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are saying that it will be, we 
need to be very She's in terms 

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of whether we have to go for 
vaccines to the flu vaccine will

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be more available, you know how 
to protect yourselves. 

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So as a critical care specialist
which I am, I am more worried 

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about the H3N2 right now as 
compared to the XP 1.16 billion 

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to the forward because this H3N2
can give rise to a severe 

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respiratory illness in the 
elderly. 

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And we have seen influence of 
patients coming to the ICU and 

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getting on The ventilator and 
taking a week or 10 days to come

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off it as we have been 
observing, the severity of the 

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covid-19 is not so much as 
compared to the last two wave 

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about this H3N2. 
Now, this variant is a variant 

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of the influenza A virus. 
It is known to cause severe 

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infections and especially 
elderly, when they develop these

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infections, the chances of 
Landing up in the Intensive care

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are higher and they take longer 
time to come out of the ICU 

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also. 
So it is a preventable illness 

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normally in India as compared to
the West. 

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The influenza vaccination rates 
are very low, you know, they are

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in sub, 10% levels and people 
are not very keen on taking 

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influenza vaccination. 
It is advisable that anyone 

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who's above the age of 50 should
take. 

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A flu shot every year, right? 
And that to just before the 

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wave, because it takes around 
three to four weeks for the 

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antibody levels to sort of build
up. 

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So it is scientifically and 
medically advisable to take the 

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flu shots, especially for the 
elderly people. 

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And also the other one. 
The rebel group is less than 

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five years but we are we need to
raise this awareness of 

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influenza vaccination and 
increase the acceptance of the 

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influenza vaccination, mind you 
Ear. 

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It has to be once a year every 
year and preferably in that 

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season, which is November to 
February is when it Peaks, if we

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have parents at home, our 
in-laws at home elderly, we must

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encourage them to take the flu 
shots every year. 

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It's a preventable illness and 
it cuts down the rate of 

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severity, considerably of the 
influenza respiratory illness. 

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People have like almost 
forgotten. 

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The covid-19 appropriate 
behavior. 

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Are we taking this? 
These waves to casually. 

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Do you want to say something on 
this? 

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So, yes, a complacency has set 
in in the average population 

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about the covid appropriate 
behavior. 

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Now, you have to understand that
this covid appropriate behavior,

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not only prevents covert but it 
will also protect you against 

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the influenza. 
So both are you know sort of 

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transmitted by the cough and the
sneezing. 

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So currently seeing the spike, 
it will only be wise to mask up.

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now you and I we may not develop
severe infections but we go home

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and we expose our parents and 
our elderly Do that, and then 

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they get seriously ill. 
So it's not just for protecting 

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us, but it is for protecting. 
T the elderly at home, we 

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interact with every day. 
So at an individual level, it is

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only wise to mask up. 
Take appropriate precautions, if

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you are coughing or sneezing, 
try to do it in the elbow. 

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Keep Your Hands Clean, watch the
hands regularly. 

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And if you see somebody whose 
symptoms Attic around you. 

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It is best to avoid close 
interaction with such a person 

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till such time that the person 
is fever free. 

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We have not reached a stage 
where the government needs to, 

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you know, sort of start shutting
down public places because the 

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financial and the economical 
impact of all. 

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Those measures are tremendous 
and looking at the rate of 

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hospitalizations, it is not even
warranted right now, but 

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individuals do need to take 
precautions because even if you 

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Develop a severe illness, you 
are exposing your elderlies, 

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back home and even children, you
are exposing your children who 

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are less than 5 years to say, h 
3 and 2. 

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And they will pay a bigger price
because you didn't take enough 

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precautions. 
What should people do if they 

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exhibit, you know, symptoms, 
what is happening right now. 

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People are not going for testing
it just taken as a, as a, as a 

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normal viral fever, you know? 
Do you think it's it is 

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advisable to go for testing and 
isolate yourselves. 

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So there are 2 pi aspects to 
this. 

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So say a 30 year old person, 
develops symptoms, like cough, 

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fever and cold right now. 
He doesn't have any other 

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comorbidities. 
He's a healthy individual who 

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has developed symptoms of flu. 
Now, such an individual. 

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Once he starts developing fever,
should ideally stay at home and 

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not go to work because you might
land up exposing others at work 

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and during your commute, and it 
will be advisable that he stays 

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at Home till the fever lasts. 
Right now, is it needed that 

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every such individual healthy 
individual who has these 

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symptoms? 
Undergo testing. 

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Know, if you don't have any 
comorbidities and you have mild 

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illness like just a mild fever 
cough, and sneezing. 

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You can stay at home, take 
symptomatic treatment like 

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decongestants or paracetamol for
the fever and usually it's a 

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self limiting illness in these 
individuals. 

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Now individuals who have a 
long-lasting fever Art 

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developing shortness of breath, 
right? 

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And the cough is not subsiding. 
These individuals need to seek 

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medical help, especially 
elderly. 

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So when people above 65, start 
developing symptoms of fever 

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cough, or even the slightest 
breathlessness, they should seek

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medical attention. 
And yes, they should undergo 

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testing because they have a 
higher likelihood of developing 

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a severe illness, but a young 
healthy individual Flipping some

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symptoms can stay at home, 
isolate himself till the time. 

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The fever is gone, take 
symptomatic treatment and can 

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get back to work once the fever 
has subsided. 

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I just want to add one more 
question here about the 

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Pediatrics cases. 
You know, they are going to 

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schools, say something about how
to protect your children. 

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So, the children are vulnerable 
age group for the H3N2. 

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No doubt about it. 
And the parents need to get over

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the vaccine hesitancy, as far as
the flu vaccine is concerned, 

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especially this year, because 
it's H3, and to, which is much 

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more severe. 
So it is very essential that 

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more and more of Awareness about
the flu vaccination is is 

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generated amongst parents and 
whatever hesitation they have 

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towards giving flu vaccinations 
to the children. 

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They need to overcome it so that
the number of cases amongst the 

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children come down the vaccine 
hesitancy needs to be, needs to 

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be combated at a community level
at a government level and at 

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individual level also, and it is
essential to immunize their 

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children with the flu shots. 
With the influenza and H3N2 and 

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the covid-19, both both patients
simply have the similar 

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symptoms. 
The first line doctors they are 

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the GPS, they generally, 
misdiagnosed the patients, is 

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there any other way? 
In terms of the symptoms, we can

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identify the patient is 
suffering from viral influenza 

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or the covid-19. 
Young healthy individual 

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developing fever, cough, and 
cold. 

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You don't need to do the test. 
It could be either influenza or 

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it could be the new variant of 
covid-19. 

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The treatment is symptomatic now
in the elderly do more than 65 

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years, depending upon the 
severity of the symptoms. 

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The testing is advisable because
influenza, you can give an 

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antiviral or drugs and it is 
treatable if given early enough 

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while covid-19 again. 
Also, if it is severe enough, 

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there are antiviral drugs, which
can cut down the severity. 

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So again, elderly are the one 
who need to seek medical 

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attention early. 
And Get themselves tested, but 

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not every young individual who's
developed symptoms needs to be 

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00:17:36,100 --> 00:17:38,300
tested. 
Is there any other way of 

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00:17:38,300 --> 00:17:40,200
differentiating? 
Apart from testing? 

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00:17:40,500 --> 00:17:42,900
There is no way. 
The symptoms are the same for 

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both. 
So unless you test, you would 

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00:17:45,500 --> 00:17:48,000
not know which of the two you 
have. 

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Again, I am emphasizing that the
elderly and the vulnerable 

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group, that is those who have 
diabetes, those who have 

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cardiovascular illnesses, or 
those who are obese. 

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00:17:56,300 --> 00:17:58,700
Yes, they need to have a lower 
threshold to seek medical 

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00:17:58,700 --> 00:18:00,300
attention and get themselves 
test. 

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Give and take the appropriate 
treatment. 

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Today's episode was produced by 
Gerard sing. 

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00:18:11,200 --> 00:18:14,600
So now I'm arathi and on Vijay 
Singh for a daily Spotlight on 

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00:18:14,600 --> 00:18:18,400
people ideas and stories that 
matter, subscribe to us, we're 

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00:18:18,400 --> 00:18:22,700
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00:18:25,200 --> 00:18:29,600
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