From India's largest Newsroom. I'm Warren Gorge.
And this is the times of India podcast.
The number of covid cases has been rising across India, but
worryingly. So our cases of seasonal
influenza or flu. Three years after the covid-19
pandemic began visiting a fresh spike in cases and a few
reported deaths across the country.
People with symptoms, like coughing and fever are being
advised to mask up in today's episode.
Mike illegal. Am I speaking with dr.
Vaishali solo about these two waves of infections, dr.
Sewell ow. Is the head of critical care at
the Fortis Hospital in, Mumbai. She talks about the cases that
they're seen presently and what are the issues of concern.
She also talks about how we need to deal with this double wave of
infections. They'd be a sing presently.
You must be seen that many covid cases are rising since last two
weeks, we are seeing the numbers have gone up, especially in
Bombay. So being an expert, can you tell
us why? There is a sudden rise?
In covid-19 cases, is it H3N2? The influenza is rising or
spreading in the in the community or the covid-19.
Thank you mother for having me here, first of all.
So yes, we are seeing a spike In the number of cases in both the
viruses that is the covid-19 virus as well as the H3N2 which
is the variant of the influenza virus.
Right now. The first part of your question
is why are we seeing the rise in the number of cases?
Influenza is usually seasonal and whenever we see the rice,
there are usually three factors which come into play.
One, is the virus itself and the viral factors.
Second is the environmental factors and third is the The
host factors. So host, here is US usually
anywhere between November to February due to the winter
season. The temperature goes down and
that makes the virus survive longer and multiply more and
transmit more. So, that's why we see a peak of
influenza in the wintertime that is between November and February
and then the virus factored. So, the viruses are the most
smartest sort of beings on this Earth and Both covid-19 as well
as the influenza they mutate, right?
So every year, when it comes to influenza every year, you will
see a new sort of mutation coming up and this time it is
the H3N2 which is a predominant one.
And in covid-19 again, you already know that the mutation
of xbb 1.16 is the predominant one.
And I think 60% of the cases are now being attributed to this new
variant. All the three factors come into
play. That is the winter season making
the virus survive, longer multiply more the host is more
susceptible because usually our immunity goes down in the winter
season and of course, the virus factors.
The virus has mutated. We have not developed immunity
to. So that is why there is a spike
in the covid-19. You just explain about the new
variant XP, deep 01 .16. It's being circulated in
Maharashtra and Gujarat. So can you tell us about these
this new variant? So xdb 1.16 has mutations at two
places one in the spike protein and one in the open reading
frame, now the water, some mutation is one air, which is in
the spike protein and that mutation will make it a little
bit immune evasive. That means you and I, if we have
had an infection, or if we have had vaccinations, we should be
immune to developing. A new infection with covid-19,
but with this variate, which is that xbb 1.16, there are chances
that this variant will evade our acquired immunity to covid-19.
Now, should we be worried now? That's a question, which is the
most important in everyone's mind?
No doubt about it because there's so much information
everywhere. So, let us be a clear that as
the virus is evolving and mutating the fresh.
Screens are weaker, right? So this xbb 1.16, so far,
whatever data has come in is not giving rise to very severe.
Infections write the rate of hospitalizations are not
alarmingly high. They are increasing.
Yes as you said just a week back we didn't have a single
admission with the covid-19 and now every hospital has a few but
most of them are still in double digits out of those
hospitalizations also Oh, those people who are requiring oxygen,
the percentage of patients who are required and oxygen is not
very high. So the first thing to understand
is that it does not cause a very severe illness.
So it is not a cause of panic, but yes, the vulnerable
population need to take much more precautions than average
healthy individuals. And these vulnerable subset are
basically people who have cardiovascular diseases, those
who are diabetic elderly, I'm 65 years, old, and obese
individuals, if there is immunosuppression for any
reasons, suppose, they have undergone some organ transplant
in the past and they are on drugs, which suppress their
immunity. They are also vulnerable.
And, of course, the biggest vulnerability is, if you are not
vaccinated. So, these people need to be
extra cautious, they need to take more precautions and those
precautions are basically adhering to the covid up.
Appropriate behavior. So do not panic, but take
adequate precautions because this virus is still evolving and
we don't know the entire impacts as such so better to take
precautions than to face the effects of it.
Are there any long-term risks? You know that come with a
reinfection? So like lab last year?
Somebody was having some other variant.
Now the another reinfection happened this year also.
So what do you think there is any risk of risk comes with a
re-infections also? So the long-term effects will
only be in patients who have developed a severe covid.
That means either they required oxygen or they were in the
Intensive Care Unit, no matter. My which variant right if they
developed an infection, which affected the lungs, they
required oxygen. And how, how much of those lungs
were affected. Yes, then there is a scarring on
that lung and that scarring gives rise to long-term effects
in terms of requiring oxygen over a few months to a year.
You must have seen that in the last few wave.
Some people also required to undergo lung transplantation
because of very severe. Covid leading there.
Lungs, very scarred. That are that is one aspect.
The other aspect in the elderly. For those who are developing
repeated infections is that it is a taking a toll on their
mental health as well as physical health.
See, it is difficult for people more than 65 years to cope with
any infection. And for them to come out of
those infection. Also, it takes longer so more
and more people are reporting cognitive decline.
Cognitive decline is in layman's term.
It is called as brain fog, if you remember.
You know, there was so much talk about this brain fog.
Basically, it was a deficit in their analytical skills and
their, their ability to think clearly.
Which is what many elderly started reporting after the
kögel all. Fatigue, a lot of fatigue, not
able to get back to normal level of activity, which they used to
do before covet. But mind you, these were all
after severe covid, not mild infections.
So healthy individuals who develop mild infections.
Usually don't tend to have any long-term effects but elderly
those who have had severe infections required oxygen were
in the ICU for long duration, same a one week, or sometimes
even two to three weeks, they have reported a lot of I'll
long-term side effects, as well as respiratory.
Also, where they required oxygen for a few months to a year and
the lungs did show some scarring.
So, yes elderly are vulnerable in that sense.
There are, there are two experts.
We've explained that you know, right now what is happening, you
know, influenza and covid-19 both are spreading and you know,
the viruses are doing the rounds at the same time.
Is there any any, any kind of like, you know, doctors experts
are saying that it will be, we need to be very She's in terms
of whether we have to go for vaccines to the flu vaccine will
be more available, you know how to protect yourselves.
So as a critical care specialist which I am, I am more worried
about the H3N2 right now as compared to the XP 1.16 billion
to the forward because this H3N2 can give rise to a severe
respiratory illness in the elderly.
And we have seen influence of patients coming to the ICU and
getting on The ventilator and taking a week or 10 days to come
off it as we have been observing, the severity of the
covid-19 is not so much as compared to the last two wave
about this H3N2. Now, this variant is a variant
of the influenza A virus. It is known to cause severe
infections and especially elderly, when they develop these
infections, the chances of Landing up in the Intensive care
are higher and they take longer time to come out of the ICU
also. So it is a preventable illness
normally in India as compared to the West.
The influenza vaccination rates are very low, you know, they are
in sub, 10% levels and people are not very keen on taking
influenza vaccination. It is advisable that anyone
who's above the age of 50 should take.
A flu shot every year, right? And that to just before the
wave, because it takes around three to four weeks for the
antibody levels to sort of build up.
So it is scientifically and medically advisable to take the
flu shots, especially for the elderly people.
And also the other one. The rebel group is less than
five years but we are we need to raise this awareness of
influenza vaccination and increase the acceptance of the
influenza vaccination, mind you Ear.
It has to be once a year every year and preferably in that
season, which is November to February is when it Peaks, if we
have parents at home, our in-laws at home elderly, we must
encourage them to take the flu shots every year.
It's a preventable illness and it cuts down the rate of
severity, considerably of the influenza respiratory illness.
People have like almost forgotten.
The covid-19 appropriate behavior.
Are we taking this? These waves to casually.
Do you want to say something on this?
So, yes, a complacency has set in in the average population
about the covid appropriate behavior.
Now, you have to understand that this covid appropriate behavior,
not only prevents covert but it will also protect you against
the influenza. So both are you know sort of
transmitted by the cough and the sneezing.
So currently seeing the spike, it will only be wise to mask up.
now you and I we may not develop severe infections but we go home
and we expose our parents and our elderly Do that, and then
they get seriously ill. So it's not just for protecting
us, but it is for protecting. T the elderly at home, we
interact with every day. So at an individual level, it is
only wise to mask up. Take appropriate precautions, if
you are coughing or sneezing, try to do it in the elbow.
Keep Your Hands Clean, watch the hands regularly.
And if you see somebody whose symptoms Attic around you.
It is best to avoid close interaction with such a person
till such time that the person is fever free.
We have not reached a stage where the government needs to,
you know, sort of start shutting down public places because the
financial and the economical impact of all.
Those measures are tremendous and looking at the rate of
hospitalizations, it is not even warranted right now, but
individuals do need to take precautions because even if you
Develop a severe illness, you are exposing your elderlies,
back home and even children, you are exposing your children who
are less than 5 years to say, h 3 and 2.
And they will pay a bigger price because you didn't take enough
precautions. What should people do if they
exhibit, you know, symptoms, what is happening right now.
People are not going for testing it just taken as a, as a, as a
normal viral fever, you know? Do you think it's it is
advisable to go for testing and isolate yourselves.
So there are 2 pi aspects to this.
So say a 30 year old person, develops symptoms, like cough,
fever and cold right now. He doesn't have any other
comorbidities. He's a healthy individual who
has developed symptoms of flu. Now, such an individual.
Once he starts developing fever, should ideally stay at home and
not go to work because you might land up exposing others at work
and during your commute, and it will be advisable that he stays
at Home till the fever lasts. Right now, is it needed that
every such individual healthy individual who has these
symptoms? Undergo testing.
Know, if you don't have any comorbidities and you have mild
illness like just a mild fever cough, and sneezing.
You can stay at home, take symptomatic treatment like
decongestants or paracetamol for the fever and usually it's a
self limiting illness in these individuals.
Now individuals who have a long-lasting fever Art
developing shortness of breath, right?
And the cough is not subsiding. These individuals need to seek
medical help, especially elderly.
So when people above 65, start developing symptoms of fever
cough, or even the slightest breathlessness, they should seek
medical attention. And yes, they should undergo
testing because they have a higher likelihood of developing
a severe illness, but a young healthy individual Flipping some
symptoms can stay at home, isolate himself till the time.
The fever is gone, take symptomatic treatment and can
get back to work once the fever has subsided.
I just want to add one more question here about the
Pediatrics cases. You know, they are going to
schools, say something about how to protect your children.
So, the children are vulnerable age group for the H3N2.
No doubt about it. And the parents need to get over
the vaccine hesitancy, as far as the flu vaccine is concerned,
especially this year, because it's H3, and to, which is much
more severe. So it is very essential that
more and more of Awareness about the flu vaccination is is
generated amongst parents and whatever hesitation they have
towards giving flu vaccinations to the children.
They need to overcome it so that the number of cases amongst the
children come down the vaccine hesitancy needs to be, needs to
be combated at a community level at a government level and at
individual level also, and it is essential to immunize their
children with the flu shots. With the influenza and H3N2 and
the covid-19, both both patients simply have the similar
symptoms. The first line doctors they are
the GPS, they generally, misdiagnosed the patients, is
there any other way? In terms of the symptoms, we can
identify the patient is suffering from viral influenza
or the covid-19. Young healthy individual
developing fever, cough, and cold.
You don't need to do the test. It could be either influenza or
it could be the new variant of covid-19.
The treatment is symptomatic now in the elderly do more than 65
years, depending upon the severity of the symptoms.
The testing is advisable because influenza, you can give an
antiviral or drugs and it is treatable if given early enough
while covid-19 again. Also, if it is severe enough,
there are antiviral drugs, which can cut down the severity.
So again, elderly are the one who need to seek medical
attention early. And Get themselves tested, but
not every young individual who's developed symptoms needs to be
tested. Is there any other way of
differentiating? Apart from testing?
There is no way. The symptoms are the same for
both. So unless you test, you would
not know which of the two you have.
Again, I am emphasizing that the elderly and the vulnerable
group, that is those who have diabetes, those who have
cardiovascular illnesses, or those who are obese.
Yes, they need to have a lower threshold to seek medical
attention and get themselves test.
Give and take the appropriate treatment.
Today's episode was produced by Gerard sing.
So now I'm arathi and on Vijay Singh for a daily Spotlight on
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