Mumbai: Even as Mumbai has been reporting a rise in Covid-19 cases, doctors said that the current surge and the level of infection are far from the initial two waves. After a shortage of anti-viral drugs and steroids in the first and second wave, it is paracetamol that is dominating doctor’s prescriptions in the present surge.
Calling the present surge, driven by the Omicron variant and its sub-variants, a blip, Dr Vasant Nagvekar, infectious disease expert and state Covid-19 task force member, said it has been the mildest form of Covid-19 since the pandemic has started. “Most patients are only being prescribed paracetamol for fever which settles within 48 hours. We are only admitting patients with multiple comorbidities for observation,” he said.
Observing all the three waves, Dr Nagvekar said the first wave was moderate where they struggled with medications initially and treated patients symptomatically.
“We initially didn’t have anti-viral drugs. Remdesivir, a broad-spectrum antiviral drug, was only available by early June 2020 but was not widely available. The second wave was the severe one where we saw lung involvement as the virus evaded the immune system. Both mortality and hospitalisation were high and we saw fungal infections too. Anti-viral drugs like remdesivir, favipiravir, tocilizumab and steroids were used. It is from the third wave when we have seen less hospitalisation and the disease is self-limiting but highly transmissible,” he said.
Dr Rajesh Sharma, respiratory medicine specialist, Saifee Hospital, said patients testing positive take 2-3 days to recover. “They are either asymptomatic or mildly symptomatic wherein they have throat pain, malaise- a general feeling of uneasiness, cough and fever, which last for 2 days,” he said.
Dr Sharma said plain paracetamol is what is being prescribed for fever unless the patient has high-risk factors like multiple comorbidities and if the fever continues to stay beyond three days. “In a few patients, we do see malaise lasting a little longer along with post-viral bronchitis in which the person can face persistent cough for two weeks. But no other post-Covid complications like we saw in other waves,” he said.
Dr Pradip Awate, epidemiologist and state surveillance officer said while it is for the ICMR or National Taskforce to decide whether to call it endemic, the present trend looks like we are getting into an endemic state.
“In the second and third wave, doubling time for cases was on the second and third day which isn’t the case now. The number of cases are remaining the same for almost a week and then rises. The rising trend is different. It doesn’t look like a wave and within a few weeks it should settle,” he said.
Dr Awate said the admission rate in Maharashtra is 4.5% and 95% of the cases are asymptomatic or mild. “We are in regular touch with the clinicians and we have not got any significant inputs from them regarding the new Covid-19 cases,” he said.
Maharashtra’s public health department said the June surge can be attributed to Omicron subvariants – BA.2 and BA.2.38 – that were seen in the recent whole genome sequencing reports.
“The virus will keep mutating. We will have more variants and subvariants. We need to be vigilant for new variants to check the virulence. This can be done by testing and genomic surveillance. The present subvariants of Omicron are highly transmissible but milder,” said Dr Subhash Salunkhe, epidemiologist and member of the National Taskforce.