Preprint
. Post-Omicron Peregrination .
RAMA PRASAD T.
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre,
Perundurai, Tamil Nadu, India.
Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com WhatsApp +91 98427 20393 BLOG https://drtramaprasad.blogspot.com
WEBSITE www.rama-scribbles.in Twitter @DrRamaprasadt Facebook T Rama Prasad
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A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 119 No. 3 March 2022 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
. Post-Omicron Peregrination .
RAMA PRASAD T.
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre,
Perundurai, Tamil Nadu. Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052.
Specially Contributed to “The Antiseptic” Vol. 119, No. 3
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ABSTRACT
A few of the enigmatic and debatable issues connected with our Covid peregrinations are mentioned in this article for thought provocation.
Key words: Omicron, Covid, SARS-CoV-2 variants, Covid endemic
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“To be, or not to be: that is the question.”
-- Hamlet’s soliloquy, Act III, Scene 1
Introduction
The famous quote seems to be appropriate for our situation with Covid now in March 2022. It’s a dilemma for the whole world. “To lift the Covid restrictions, or not to: that is the question.” The characters in the William Shakespeare’s ‘Hamlet’ grapple with issues of mental distress and depression. So are the people on the planet now, more so with the ‘war’ in Ukraine. Incidentally, on March 8, 2022, Ukraine’s President Volodymyr Zelensky, invoked the ‘Hamlet’ as he delivered the historical ‘Churchill-like’ first-ever virtual speech by a foreign leader at the British Parliament, in the context of the ongoing ‘war’ with Russia. He said: “The question for us now is, to be or not to be; now I can give you a definite answer – it is yes, to be.” Suddenly, the world’s focus has shifted from the “Cold War” with Covid to the “Potential Third World War.” There is a compelling commonality between these two. The cardinal objective in these two issues is to save lives and economy as well.
Since the pandemic began more than two years ago, Covid claimed six million lives so far in the world -- 9,60,311 in the US, 6,52,341 in Brazil and 5,15,210 in India. The milestone comes as the number of deaths and infections continue to plummet in March 2022 in most of the regions in the world, except in Asia, where Hong Kong is suffering its worst-ever outbreak, and Oceania, where New Zealand has recorded a jump in the cases. In India, the daily number of the infections has plunged to a mere 3,993 with over 179 crore vaccine doses given. But we are not sure whether another ‘disastrous Delta-like variant’ is on the horizon. Hence the dilemma of “to be or not to be” is in focus. Some of the randomly related aspects of the problem are briefly highlighted below.
Grave portents
Over two years, we have failed to charter the territory in our battle against the better-equipped virus. “A journey, especially a long or meandering one” is the dictionary meaning of the word ‘peregrination’. In our ‘Covid journey’, we have reached a crucial road junction – one road leads to ‘surrender to the virus’, and the other to ‘struggle further’. The course of our further meandering journey depends upon the wisdom of our choice. Death is one single factor which pushes everything else into the background. That’s what Covid did to the world. And again, there are two ways of dying – one is due to the virus, and the other due to enormous economic collapse. Again, the choice is ours. The low fatality rate of Omicron is pushing us on to the road of ‘surrender to the virus’. Notwithstanding accumulation of tremendous loads of information, we are unable to come to valid and robust conclusions on various aspects of the Covid. We are right now in an enigmatic scenario, not knowing how to navigate further from the ‘locked lives’ – with a sense of surrender or victory; out of fatigue or hubris.
“To ‘unlock’, or not to, that is the question.” Two years on, the light at the end of the tunnel still seems to be an illusion. Should we travel back the tunnel to the drawing board or proceed with indefinite destination ? The roadmap of the voyage is crucial. Controversies, arguments, confusion, suspicion, assumptions, presumptions, conjectures, hopes, disappointments, fear, stress – all seem to be rolled into one ‘CORONA phenomenon’. Notwithstanding the tremendous strides that the science and technology have made, we seem to be still groping in the dark corridors of Covid. Uncertainty, doubt and shifting strategies to control the seemingly invincible scourge have been the hallmark of this pandemic. The pandemic has been filled with hopes and despairs. At the end of the ‘first wave’, ‘second wave’ and now the ‘Omicron wave’ there has been a hope of the pandemic transitioning into an epidemic. In the first two instances, some scientific predictions of the transition crashed and the hope ended in despair. While we are rejoicing the fag end of the third one, a team of researchers from the Indian Institute of Technolology (IIT) of Kanpur has predicted that a ‘fourth wave’ will hit India in June 2022 and last for four months, peaking in September-October 2022. The prediction is based on statistical methodology to study and forecast future waves, using the model that they have developed on data from Zimbabwe. But we are impatient. Protests against the ‘Covid restrictions’ spilled violently on to the streets in several countries, with high decibel tones. Opposition parties stepped up their voice by several octaves. Because of the previous unexpected disasters, scientists are a tad tight-lipped now and delivering statements against lifting curbs all of a sudden. But the governments are pressurised to ‘unlock’ everything out of economic compulsions and the demands by the exasperated public.
Is it right ?
British Prime Minister Boris Johnson ended almost all pandemic-related legal restrictions in England in February 2022 under a “Living with Covid” plan at a time when the ‘Omicron wave’ had not yet touched the base line. This example is naturally followed by many other countries amid scientific unease with the decisions. Matthew Taylor, the Chief Executive of the NHS Confederation said that “the government cannot wave a magic wand and pretend the threat has disappeared entirely.” David Nabarro, the World Health Organization’s (WHO) special envoy for Covid said that the scrapping of the curbs was “really very unwise indeed.”
Mathematical models are different from ground realities. The cavalier calculations remained a mirage – where is that ‘peak’, ‘decline’ or ’community spread’? The scientific hubris backfired -- cases increased from around 500 to around three million and the deaths from around 10 to around 60,000, after the lockdown in just about five months (March to August 2020), in India. Virtues of a martinet governance have been an illusion. Governmental obfuscation which took on mythic proportions and infected policymaking, is a matter of concern. It is highly complex -- it’s not like switching-on and switching-off a light. With just an order everything can be locked down, but can’t be opened the same way.
A study published in The Lancet (February 2022) said that of the 20 countries studied, India accounted for the highest number of children orphaned by Covid-associated death of at least one of their parents during the initial 20 months from March 2020 till October 2021 spanning the first two waves that devastated many families. During the period 19 lakh kids lost at least one parent to the Covid. The study done by the CDC of the US, the Imperial College of London, the University of Oxford and the World Bank proposed immediate integration of care for the children into every national Covid-19 response plan. The post-Omicron or post-Covid journey for these unfortunate children should be supported by governments, NGOs and philanthropists. Even small contributions from individuals would play a great role. On my part, I contribute some of the amount received from my patients at my “PAY WHAT YOU CAN Clinic” where patients may pay whatever amount they wish for the service. To know more about this service, one may go to https://drtramaprasad.blogspot.com/2017/04/what-you-can-clinic_30.html . There are lessons here for society as a whole.
Paradoxical
On one hand, we lament shortage of vaccines at a global level. Here in Mumbai, 1.5 lakh Covid vaccine doses lying with a bunch of the city hospitals are set to expire on March 5, 2022 and thrown out as waste as there are no takers. It is said that if the government is not dragging its feet on the policy of giving boosters for the 45-plus age group, this wastage could have been avoided.
New vaccines
As long as there is widespread infection, new variants would keep coming, especially from Africa, as only about 15% were vaccinated there. Since the vaccination drive in January 2021 over 70% of India’s adult population has been vaccinated so far. Globally it is 56%. Unless the entire population across the world is fully vaccinated, new variants will keep cropping up which could be ‘vaccine-resistant’. Omicron BA2 seems to have already replaced Omicron BA1 as the most common Covid-caiusing SARS-CoV-2 variant in circulation in India today. R. Vinod Scaria of the Delhi-based Institute of Genomics and Integrative Biology said that reinfection is rare and mild which may occur more in the younger and unvaccinated people. It must also be noted that a ‘positive test’ before 120 days could be due to a ‘residue’ of a virus from an earlier infection. The eminent American physician-scientist Dr. Drew Weissman who was conferred the Genome Valley Excellence Award 2022 said that his team is working on a pan-coronavirus vaccine that would be effective against all Covid-19 variants in the coming days. Right now, ‘tweaking’ of the old vaccines to modify them to tackle the existing variants is in progress. There have been three coronavirus epidemics in the past 20 years and there will be more.
Fatigue and surrender
During the first fortnight of February 2022, many countries had lifted various ‘Covid curbs’ to facilitate return to ‘normalcy’. Is it scientific ? The tempo maintained for over two years could no more be sustainable. Science, perforce, is being bent by extraneous factors. The US had informally called an end to the coronavirus pandemic on February 9, 2022 -- more out of fatigue and surrender than from conquering it. As with most of the matters connected with the pandemic, many other nations just copied the strategy though the ‘cases’ had been surging and deaths could not be prevented in some countries. Some data may be found under the subheading ‘Compromising’ below. This is an enigma. Even those who had been staunch supporters of preventive protocols have yielded.
Warning
A warning now (February 9, 2022) comes from the World Health Organization (WHO). “Omicron will not be the last variant you will hear us speaking about. The next variant of concern will be more fit and what we mean by that is it will be more transmissible because it will have to overtake what is currently circulating. The big question is whether or not future variants will be more or less severe,” said Maria Van Kerkhove, Covid-19 technical lead at the WHO. The WHO also said that the present vaccines may be less effective due to ‘more immune escape’ and that the world may see seasonal patterns for infection surges, as the coronavirus is a respiratory pathogen. The WHO and the Centers for Disease Control and Prevention (CDC) of the US are leery of premature relaxations of Covid-appropriate preventive measures. The WHO chief Tedros Adhanom Ghebreyesus said that it would be ‘premature for any country to surrender, or to declare victory’. In contrast, the WHO’s ‘Europe continent’ director, Hans Kluge expressed on February 11, 2022 of a bright prognosis that here after the pandemic would pass through a “long period of tranquillity and ceasefire.” The WHO’s Chief Scientist, Soumya Swaminathan also expressed concern about the future variants but stopped short of commenting on lifting the existing ‘restrictions’. An enigmatic scenario ! Having been bitten severely by the disastrous impact on the economy, such of these warnings and pacifications would keep our heads reeling for a long time to come.
Omicron effect
The Omicron which spread across the globe at a lightning speed didn’t finally cause overwhelming hospitalisations or deaths. This made the world lulling itself, perhaps mistakenly, into a sense of normalcy again and sown the perils of rushing to proclaim victory over Covid-19, notwithstanding the still high burden of recent cases. Multiple States in the US, the UK and some other countries have now been rolling back ‘Covid-appropriate restrictions’ including ‘mask mandates’. Quickly, the Maharashtra health minister in India spoke about seeking expert advice to make the State ‘mask-free’. It may be perilous to ape the wealthy developed countries as they would have taken decisions in the background context of their high vaccine booster coverage, access to antivirals like Plaxovid and high-end health care.
Compromising
The US said that the Covid-19 pandemic is almost over. State after State started to dump strict protocols and ‘mask’ mandates, after perceiving that they had enough of being bunkered down. Anthony Fauci, the ‘Covid medical chief’ of the US, said on February 9, 2022 that the US is past the full-blown pandemic and it is okay for local authorities and individuals to relax restrictions depending on local numbers, and that there will be more people making their own decisions on how they want to deal with the virus. This is a lot unexpected from Anthony Fauci who vociferously opposed any relaxations during the pandemic, incurring the displeasure of political heavyweights like Donald Trump. And also, it’s a lot unexpected because the US has reached 2,600 Covid-related deaths of a seven-day average recently (the highest in a year), and accounted for 100,000 of the half million deaths from the Omicron variant.
At the same time, there seems to be some epidemiological reasons for easing curbs in India. There has been a decline from three lakhs of cases a day on January 24, 2022 to 58,000 cases a day now in mid-February 2022 in the India’s daily trajectory. This precipitous fall is an enigma which popped the question whether it could be due to a change in the ‘testing’ attitudes.
Compelling
What is this compromise in attitude due to ? Clearly, the prime driver for the ‘relaxations’ appears to be due to fatigue, frustration and resignation over complying with ‘restrictions’ over a long period of time. It’s a ‘surrender’ to the virus than conquering it. This factor is captured in many surveys. A Monmouth University poll and a Kaiser Family Foundation poll showed that about 70% of adults were ‘tired and frustrated with the unduly prolonged mandates, and acknowledged that Covid is here to stay and that they need to get on with their lives’.
Risk remains
So long as the whole world is not fully vaccinated, the risk of emergence of new variants persists. The ability of our immune systems to swiftly outmuscle the virus is a shield against the rise of new mutants. Vaccine inequity is very obvious. The self-interested wealthy countries are focussing on ‘boosters’ while many countries in Africa are grossly under-vaccinated. These under-vaccinated countries make a fertile territory for new variants to arise and then to spread across the world. It would be to their peril if the rich countries do not donate vaccines to poorer countries and stop the Covid pot boiling. It would be an exercise in futility to give booster after booster and making specific vaccines for variant to variant without tackling the root cause. After ‘Omega’ (the last -24th- letter in Greek), what name are they going to give to the yet another new variant !
Confounding
The most enigmatic, confounding and perplexing scenario of this pandemic is about the published facts about its impact in the US compared to that in China, or in India. The US which is highly empowered with grand health infrastructure and which boasts of the crème de la crème status of health care crumbled like a cookie under the weight of the Covid, with around 800,000 deaths in a population of just 0.3 billion with 20% of GDP spending on health infrastructure and a 19-trillion-dollar economy. Compare it with the figure of much under 10,000 deaths in the less-profiled China with a population of 1.4 billion, or a much less developed India’s figure of about 500,000 deaths out of a population of 1.3 billion with just around 1% GDP of Rs 200 lakh crore spent on health infra structure.
The lockdown myth
Mathematical models are different from ground realities. The cavalier calculations remained a mirage – where is that time-table of ‘peak’, 'flattening', ‘decline’, ’community spread’ and ‘endemicity’ ? The scientific hubris backfired. For example, in India, the cases increased from around 500 to around three million and the deaths from around 10 to around 65,000, after the lockdown in just about five months. Today (mid-February 2022), India has a record of around 425 lakhs of confirmed cases and around five lakhs of deaths, while the world has around 4,092 lakhs of cases and around 58 lakhs of deaths. Virtues of a martinet governance have been an illusion. Governmental obfuscation which took on mythic proportions and infected policymaking, is a matter of concern all over the world. It is highly complex -- it's not like switching-on and switching-off a light. With just an order everything can be locked down, but can't be opened the same way. Again, there is the question: Is the ‘Zero Covid’ tolerance policy of lockdowns in China the cause for its low fatality rate, and, if so, how long would it be sustainable ? An enigma.
The latest shocks
A new study by the CDC of the US said on February 11, 2022 that the efficacy of ‘booster’ (third) doses of the Pfizer and Moderna ‘mRNA’ vaccines wanes substantially by the fourth month, indicating the need for further ‘booster’ doses. A study from the Imperial College of London (just posted as a preprint on server Research Square) found high viral shedding in asymptomatic people. All these two years we were thinking otherwise ! A research publication in the journal Frontiers in Medicine (January 2022) showed that 8% of people infected with SARS-CoV-2 may be able to infect others for more than two months without manifesting any symptoms; some even for 232 days. Dr. Gangandeep Kang, virologist and professor at Christian Medical College, Vellore has described the expensive ‘Covid monoclonal antibody therapy’, as is being used without clear cut indications in India, as “unethical, immoral, and unscientific,” and urged private doctors to practise better medicine (TNIE, January 25, 2022). She also said that India no longer needs to continue with “irrational measures like lockdowns and curfews.” Amusingly, “disinfectant tunnels” were used to ‘disinfect’ people on the roads from the virus – an absurd and hazardous practice ! Recent scientific studies have shown that masks do indeed impact children’s ability to learn, read, recognise emotions, recognising faces and verbal communication. Two years on, concerns on use of masks in schools on the linguistic, emotional and social development of children are taking centre stage. An enigma. During the past two years, various authorities sanctioned and suspended use of various drugs in the treatment of Covid-19. On February 11,2022, the WHO had ‘prequalified’ Tocilizumab. Earlier the WHO had ‘prequalified’ three different compositions for the steroid Dexamethasone as well as Remdesivir, although that ‘prequalification’ has since been suspended.
An enigma
People and even the Covid experts are confused with the way in which the pandemic navigated and compelled authorities to revise their technical advisories and programming strategies quite often. The knowledge we gained during the past two years about this virus is diverse and fragmentary, an academic Rubik’s cube with a lot of possibilities. We said “YES” to so many things and later said “NO” and vice versa. There were numerous study reports in favour of and against as well – not conclusive on almost all matters concerned with this virus. This ambiguity can be perceived in my 18 articles published over the previous 18 months on various subjects related to Covid in The Antiseptic, a journal of Medicine and Surgery, and in Health, a journal devoted to healthful living.1,8,9,12,13,14,15,16,17,18,19,20,21,22,28,29,38 And some other Covid information may be found on my blog and other media.2,3,4,5,6,7,10,11,23,24,25,26,27,30,31,32,33,34,35,36,37 The volcanic explosion of information over the past two years, full of confusing and contradictory details, has made the common man (who is fully soaked by media with every ‘Covid detail’ every day) totally unable to differentiate sense from nonsense. In this article, excerpts of such enigmatic incongruities and observations drawn from three of my published articles cited above are briefly quoted. For more details, the original articles and the references cited therein may be looked into. Let me start from the last (‘Omicron – a paper tiger ?’… February 2022) to the first (‘Is the “Lockdown Medicine” too toxic ?’ … October 2020).
‘Omicron – A Paper Tiger ?’ (The Antiseptic of February 2022) 40
“ … Just when the world was getting ready to the idea of learning to live with the existing variants of SARS-CoV-2, a report on November 24, 2021 of the existence of a superfast variant named as ‘Omicron’ jolted the whole world sans evidence of high virulence of the microbe. And just two days after the report, the World Health Organization (WHO), at a viral speed, designated it as a ‘Variant of Concern (VOC)’ on November 26, 2021 and named it after ‘omicron’, the 15th letter of the Greek alphabet. Immediately, flights were suspended by some wealthy countries. Blunt and blanket measures that are not evidence-based or effective on their own were introduced by many countries once again. The wisdom behind these measures is arguably debatable. … On the basis of the ‘Sutra’ mathematical model of the Indian Institute of Technology, Kanpur, the ‘third wave (Omicron wave)’ will manifest in India in January 2022, may ‘peak’ in February 2022 with 1.8 lakh daily cases, and would end in April 2022.35 After that the Covid would become an ordinary endemic. It is predicted that 1 in 10 will need hospitalisation and that two lakh beds may be needed by the middle of March 2022.35 The professor behind the ‘Sutra’ model, Mahindra Agrawal warned that election rallies can prove to be super-spreaders of the virus.35 … mathematical projections like: "In a very short period of time, 80 lakh cases may be reported in India with 1% mortality which would mean 80,000 deaths" rattled everyone. And, based on the current scenario in the UK, scientists are predicting a huge 14 lakhs of cases a day in India shortly. … Some experts feel that a sudden huge surge of infections, though of a low fatality rate, may overwhelm hospitals with a sudden demand for intensive care. This is the reason why governments have built up facilities to deal with a probable ‘tsunami’. …
… The Omicron may just be a ‘paper tiger’, scaring us, infecting a lot without causing much of a serious illness or death, and it may even be benefitting us by improving our ‘herd immunity’ through its infection which may cause only mild symptoms or no symptoms.24 It may even turn out to be just an endemic like flu which doesn’t require this much of hullabaloo of tracing, tracking, isolating, restricting, locking down, etc. As it affects upper respiratory track more than the lungs, it may not produce serious illness. Much ado about nothing ? … Most of the beds in many Covid Care Centres are vacant as of mid-January, 2022. The ‘preparedness’ may prove to be a good ‘mock drill’ exercise to handle efficiently any future ‘real tigers’. Or, will they be overflowing after a couple of weeks ? We don’t know, but unlikely. … However, it can be predicted that the Omicron’s scenario in many countries would be similar to that in South Africa – fast and huge rise followed immediately by a sharp fall, without causing much serious illness or death. …”
This is what I wrote in early January 2022, for publication in The Antiseptic, and now, as the events are turning out as of mid-February 2022, it appears that my observations were very near the ground realities. 40
‘Covid, Children and Schools’ (The Antiseptic of September 2021)22
“ … Seropositivity levels in children are comparable to those in adults – keeping children at home has not served the purpose of keeping them from becoming infected. This is a point whose importance has been insufficiently stressed: if children are as likely to pick up an infection from the community while staying at home, there is little reason to keep them out of school. Given the state of the Indian epidemic as well as the likely possibility that COVID-19 will transition into endemicity, there seems to be little reason to continue to have schools closed.”3 On the other hand, there had been a humongous loss in multiple ways (long-term consequences of disruptions in learning and socialization, etc.) by the closure of the schools which can’t be compensated in a lifetime. In our overzealous attempt to protect children, we had ended up depriving them of educational, developmental, social, emotional, physical and mental well-being by closing schools for too long. …
. … Most of the knowledge we have about Covid is patchy and cloudy, right from the origin of the virus to treatment to prevention to emergence of variants to vulnerability of children.18 There had been unscientific opinions and amusing attitudes, even by responsible world leaders. A president of a country said that Covid vaccines may convert people into crocodiles !19 To our consternation, he (the Brazilian President Jair Bolsonaro) who is not vaccinated has arrogantly aired that he had decided to attend a United Nations General Assembly meeting in New York next week (September 21, 2021) despite the mandatory requirement of ‘vaccination proof’ for all the attending leaders and diplomats. The irony is that while the UN Secretary General can’t prevent the entry of the unvaccinated president, the Mayor of New York can stop him ! Another president touted for Hydroxychloroquine and entertained us with the idea of injecting disinfectants to control the Covid !20 Nothing seems to be certain about Covid. Even specialists are unable to give a certain opinion on many matters. As such, people have been taking all the ominous signs as lightly as that of a weather forecast. … ”
This is an excerpt from my article which gives a hint of the enigma surrounding this virus.22
‘Is the “Lockdown Medicine” too toxic ?’ (The Antiseptic of October 2020)
“ … Lockdown, a blunt instrument, has become the default strategy and an epidemiological fashion, based on mathematical models of a limited theoretical frame. An indefinite country-wide blanket ban of all activities just to tame one disease in a country like India is an example of profound insanity. Further lockdowns may further vitiate a nebulous situation. Can we lockdown for another two years ? During a press briefing in Geneva on August 21, 2020, Dr. Tedros, the head of the WHO said: “We hope to finish this pandemic in less than TWO YEARS, especially if we can pool our efforts.” … Instead of using this sledgehammer to crack the nut, strict following of the troika of masks, distancing and hygiene, along with prompt ‘testing’, ‘tracing’ and ‘treating’ would have been sufficient for India. Improving the creaky health structure of 1.3% of GDP is imperative. Of course, we can’t fix decades of neglect while in the throes of a pandemic. …”
This is what I wrote as long ago as October 2020, and now, after one-and-a-half-years, my observation is broadly accepted. What an enigma !
The way forward
Going forward
For a full two years, we didn’t exactly know the direction which was ideal in the Covid world. The leadership in the pandemic came mostly from the well-developed countries which was not ideal for all the countries and which was not without vulnerabilities and vested interests. The WHO is no exception. Learning from the mistakes and doing the right thing in collaboration with others when no one knows what needs to be done is of paramount importance. It is this wisdom which made Homo sapiens coming out stronger over the better-endowed Neanderthals. And it is this wisdom of collective team efforts cutting across geographies and functions that helped in developing Covid vaccines and rolling them out in the shortest possible time. To go further forward, the global leadership should develop an analytical approach with a heart filled with empathy and a deep caring for the society. Profit with a humane purpose should be the credo of the pharma industry as it evolves a humane face to lead the new post-Covid world where we have to marry the ‘tech’ with the ‘touch’ in a judicious manner. In a parochial technical way, each one tried to project the imaginary good of a product on a scientific platform, not without selfish motives. This had complicated the pandemic and led to controversial decisions on matters to control it. It would be the unique ability of blending a secret sauce using hardware, software and ‘humanware, that’s going to save us, while getting rid of redundancies and adjusting to the changing paradigms.
A cursory glance at the spectrum of Covid events during the past two years paints an enigmatic picture of Covid. We all thought that development of a vaccine sees the end of this virus. But it is now evident that it’s not so. Varied results from international studies of booster doses have led to a broader acceptance that the Covid cannot be eliminated by vaccines alone but can be repelled, over time, with a mix of approaches such as wearing masks, vaccination, enhanced hygiene and accepting short localised lockdowns. Moreover, the chances of ‘herd immunity’ to ensure elimination of this virus are bleak as ‘breakthrough’ infections and ‘reinfections’ are rife. The inevitable ‘reopening of everything’ implies that the world must learn to prioritise equitable health care and improve hygiene – yet move forward, reclaim, and repair the social and economic remnants of the pre-pandemic times. Equitable distribution of vaccines all over the world is paramount to prevent emergence of more dangerous variants. Volumes of ‘the way forward’ were written but none seems to be fool-proof and practicable. The course of the pandemic had been and would be dictated more by the virus than human interventions.
The future
The future would be a bumpy ‘endemic’ road with ‘spikes’ here and there, now and then. Smoothness of the voyage would depend upon the number and characteristics of the mutations that the future variants of concern may acquire. Earlier, we thought very optimistically that we had entered endemicity before the arrival of the Delta and the Omicron variants, and before knowing that fully vaccinated people may also get COVID-19. But now we are humbled not to make such statements. It is possible that a more virulent variant may emerge. With the stereotypical shifting (like alternating ‘lockdowns and ‘unlocking’) strategies and the monotonous advisories over the past two years, people have become sceptical and consequently let their guard down. Even in doctors’ families we see recklessness and blundering, perhaps because we are all human beings, not programmed machines. With the exponential transmissibility and the ‘vaccine-escape’ capability of the variants, everyone could test ‘positive’, with symptoms or no symptoms, vaccinated or not. The recent ‘relaxations’ of ‘restrictions’ all over the world are an indication that "Learn to live and die with Corona" is far better than "Learn to live and die with Lockdowns."
At the famous ‘Stanford University Commencement Address’, Steve Jobs, the CEO of Apple Computer said the following about ‘The Future’. Reading the whole address, which is in the references, may be profitable. 41
“Again, you can't connect the dots looking forward; you can only connect them looking backward. So you have to trust that the dots will somehow connect in your future. You have to trust in something — your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.” -- Steve Jobs
REFERENCES
1. Rama Prasad, T. Covid Variants. The Antiseptic. 2021 May; Vol.118; No.5; P: 11-14; Indexed in IndMED -- www.theantiseptic.in
2. "Classification of Omicron (B.1.1.529): SARS-CoV-2 Variant of Concern". World Health Organization. 26 November 2021. Archivedfrom the original on 26 November 2021. Retrieved 26 November 2021.
3. Meyer, David (26 November 2021). "What's Omicron? Here's what we know and don't know about the new COVID variant that's roiling markets and air travel". Fortune. Archived from the original on 26 November 2021. Retrieved 26 November 2021.
4. Torjesen, Ingrid (29 November 2021). "Covid-19: Omicron may be more transmissible than other variants and partly resistant to existing vaccines, scientists fear". BMJ. 375: n2943. doi:10.1136/bmj.n2943. ISSN 1756-1833. PMID 34845008. S2CID 244715303. Archived from the original on 2 December 2021. Retrieved 2 December 2021.
5. "Omicron coronavirus variant partly evades Pfizer vaccine's protection, study shows". CNN. 7 December 2021. Archived from the original on 8 December 2021. Retrieved 7 December 2021.
6. "Pfizer And BioNTech Provide Update On Omicron Variant" (Press release). New York City and Mainz: Pfizer. 8 December 2021. Retrieved 8 December 2021.
7. Sandra Ciesek (2021). "Reduced Neutralization of SARS-CoV-2 Omicron Variant by Vaccine Sera and monoclonal antibodies" (PDF). doi:10.1101/2021.12.07.21267432. S2CID 244950946. Retrieved 9 December 2021.
8. Rama Prasad, T. Covishield or Covaxin ? The Antiseptic. 2021 April; Vol. 118; No. 4; P: 12-16; Indexed in IndMED – www.theantiseptic.in
9. Rama Prasad, T. The Science and Nonsense around COVID. The Antiseptic, 2021 November; Vol. 118; No. 11; P: 8-14; Indexed in IndMED -- www.antiseptic.in
10. https://drtramaprasad.blogspot.com/2017/04/tuberculosis-in-india_29.html
11. https://drtramaprasad.blogspot.com/2020/06/coronavirus-covid-19-sars-cov-2_43.html
12. Rama Prasad, T. Disastrous Second Covid Wave in India. The Antiseptic. 2021 June; Vol.118; No.6; P: 20-27; Indexed in IndMED – www.antiseptic.in
13. Rama Prasad, T. Is the “Lockdown Medicine” too toxic ? The Antiseptic. 2020 October; Vol. 117; No. 10; P: 13-15; Indexed in IndMED – www.theantiseptic.in
14. Rama Prasad, T., Versha Rajeev. The Conundrum of COVID-19 Vaccines. The Antiseptic. 2021 January; Vol.118; No.1; P: 10-17; Indexed in IndMED – www.theantiseptic.in
15. Rama Prasad, T., Versha Rajeev. Antiseptics, Disinfectants and COVID-19. The Antiseptic. 2020 November; Vol.117; No.11; P: 26-28; Indexed in IndMED – www.antiseptic.in
16. Rama Prasad, T. 40+15 Hypoxia Test in COVID-19. The Antiseptic. 2020 December; Vol. 117; No. 12; P: 13-17; Indexed in IndMED – www.antiseptic.in
17. Rama Prasad, T. Mucormycosis and COVID-19 in India. The Antiseptic. 2021 July; Vol.118; No.7; P: 21-26; Indexed in IndMED -- www.antiseptic.in
18. Rama Prasad, T. Vagaries of India’s Covid Vaccination Policy. The Antiseptic. 2021 August; Vol.118; No.8; P: 10-16; Indexed in IndMED – www.antiseptic.in
19. Rama Prasad, T., Versha Rajeev. Tea and Covid. Health. 2020 October; Vol.98; No.10; P: 4-6.
20. Versha Rajeev., Rama Prasad, T. Fear and Covid. Health. 2020 November; Vol.98; No.11; P:31-32
21. Rama Prasad, T. India’s Third Covid Wave. The Antiseptic. 2021 September; Vol.118; No.9; P: 14-20; Indexed in IndMED – www.antiseptic.in
22. Rama Prasad, T. Covid, Children and Schools. The Antiseptic. 2021 October; Vol.118; No.10; P: 08-18; Indexed in IndMED -- www.antiseptic.in
23. https://drtramaprasad.blogspot.com/2020/
24. Rama Prasad, T., Versha Rajeev. https://drtramaprasad.blogspot.com/2017/04/covid-crocodiles.html
25. https://drtramaprasad.blogspot.com/2017/04/hydroxychloroquine-hcq-and-coronavirus_29.html
26. https://drtramaprasad.blogspot.com/2017/04/corona-and-charles-darwin.html
27. https://drtramaprasad.blogspot.com/2017/04/modern-medicine-good-bad-and-ugly_30.html
28. Rama Prasad, T., COVID and Tuberculosis. The Antiseptic, 2021 December; Vol. 118; No.12; P: 11-17; Indexed in IndMED -- www.antiseptic.in
36. @jsphctrl, @mroliverbarnes: https://ft.com/content/0ee745ce-ac55-46a9-9766-0b419821a79d
38. Rama Prasad, T., Ominous Omicron of COVID. The Antiseptic, 2022 January; Vol. 119; No. 1; P:25 – 29; Indexed in IndMED – www.antiseptic.in
39. https://nypost.com/2020/04/18/americas-junk-food-diet-makes-us-more-vulnerable-to-coronavirus/
40. Rama Prasad, T., Omicron – A Paper Tiger. The Antiseptic, 2022 February; Vol. 119; No. 2; P:12-21; Indexed in IndMED – www.antiseptic.in
41. https://www.iss.nl/sites/corporate/files/Pablo_Ruiz.pdf
A quote from the article titled “OMICRON – A Paper Tiger” published in The Antisepticjournal of Medicine and Surgery of February 2022 – Vol.119; No.2; Page No.14
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