Indian Journal of Health Sciences and Biomedical Research KLEU

GUEST EDITORIAL
Year
: 2021  |  Volume : 14  |  Issue : 3  |  Page : 295--296

COVID-19: Is it merely about the third wave


Madhav Prabhu 
 Department of General Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India

Correspondence Address:
Dr. Madhav Prabhu
Department of General Medicine, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka
India




How to cite this article:
Prabhu M. COVID-19: Is it merely about the third wave.Indian J Health Sci Biomed Res 2021;14:295-296


How to cite this URL:
Prabhu M. COVID-19: Is it merely about the third wave. Indian J Health Sci Biomed Res [serial online] 2021 [cited 2021 Nov 28 ];14:295-296
Available from: https://www.ijournalhs.org/text.asp?2021/14/3/295/327253


Full Text

COVID-19 has left the world devastated like never before. It is the pandemic of this generation, a calamity of proportions never seen by us before. In plain terms, pandemic consists of two words Pan and Demos which mean involving everyone in the world. Quiet literally the pandemic has influenced the entire planet. Several theories have been making the rounds as to the origin of the pandemic but most of them are nothing but food for conspiracies. Then, there are the threats of the waves to come which have put most normal individuals into the realms of paranoia. The talk of the town now is the third wave, however, the one fact that people are largely unaware of or may not be doing the rounds is the scars that COVID-19 has given us or rather the long-term effects that the waves that have come and gone have already inflicted upon us.

Most of what has happened or what may happen comes from drawing parallels to historical data. Let's explore the influenza pandemic of 1918–1919 for example, it was called the Spanish Flu, and claimed millions of lives, some claim the actual figures were much more than those announced just like the present pandemic. But what is important is that it had the same epidemiological proceedings as that of the present COVID-19 pandemic. It spread by droplets, caused respiratory illness, killed in millions, and put the entire health fraternity at strain. If we follow the curves of the Spanish Flu pandemic, we can readily see the multiple waves, we can see that the second wave was deadlier than the first and the subsequent waves did not create as much damage, something which the present pandemic may follow [Figure 1]. One major difference, however, in the present pandemic is the early discovery of vaccines. The influenza vaccines came into use in 1945 almost two decades after the pandemic, and the world had to recover on its own that is not the case in COVID-19 where we already have an effective vaccine, and this may play an important role in blunting the peak of the waves to come. We know from our observations that in the waves that follow the previous ones, only the susceptible are infected, now that most adults are either infected of immunized there has to be some amount of immunological protections that we may have achieved. Perhaps, this is the reason why there is an opinion that children may be more susceptible to infections as they are not vaccinated. This, however, is a theory and the pediatric cases that we have seen till now have been mild most of the times. The multisystem inflammatory syndrome in children is luckily not very common. Thus, children have been exposed to the disease too, they too must be having some immunity by now and yes they have a wonderful capacity to heal, thus the assumption that children may be victims seems to be a little farfetched. The NITI Aayog and the government experts have put the peak of the third wave in October but this may be a much-truncated one.{Figure 1}

The real problems could be bothersome and are hereto unaddressed seems to be the ones that the waves that have already gone by have left for us to deal with. Posttraumatic stress disorder (PTSD) for one needs to be addressed and like any other psychiatric disorder is simmering under the surface and can have major consequences on the mental well-being of the country. As per one meta-analysis, it was found that the pooled prevalence of postpandemic PTSD across all populations was 22.6%. Health-care workers who have been at the front have the highest prevalence of PTSD, followed by infected cases 23.8% and then the general public 19.3%. These figures are alarming and if reflecting the state of things will have severe consequences. PTSD could be serious and difficult to treat mental disorder that occurs following exposure to stressful life experiences including disease. The patient suffering will go through the painful episodes again and again through flashback-like dissociative reactions, efforts to avoid trauma-related thoughts, feelings, places, or people, persistent negative cognition and mood, and hyperarousal, such as anxiety, sleep difficulties, and irritability. If an individual fails to recover from PTSD individual's social function, family life, and personal health, all suffer thus effecting the health of the nation. Imagine the very health-care workers who have to be at the front being victims to PTSD, this could effect the outcomes of the next waves for sure.

The government, the hospital authorities, and society at large need to respond to this emergency and have an effective plan to identify and manage post-COVID PTSD.

Another looming problem of this pandemic is the economic recession; it has induced which has pushed an estimated 85–115 million people globally into extreme poverty and unemployment, which is expected to rise to 150 million this year, the first rise in global extreme poverty cases in 20 years, a calamity of massive proportions. It is obvious that poor financial conditions ultimately lead to stress-induced crimes. COVID-related loss of jobs, increased spending on health to deal with the pandemic will lead to poor working conditions, decreased social security because of decreased spending on welfare projects by governments, and inflation of essential commodities all these have been witnessed in India in the past few months. This is alarming as crimes may go off the chart. One study in India has shown that the lack of jobs has pushed many people into criminal activities as unemployment rates have grown exponentially from 7% before the lockdown to a peak of 27.11% in April last year. There has been a higher crime rate in both individual and organized crime. The individual crimes have been alarming with domestic violence and crimes against the vulnerable which threaten the very fabric of our society, this can be attributed to the lack of policing due to most of the force being employed in enforcing lockdown. There now seems to be an urgent need to device methods and effective strategies to prevent crimes. Policing may not be effective in preventing these crimes and may need changes in the governance and policymaking. Jobs need to be created, confidence needs to be reinstated, only this will bring us back on the tracks.

Overall, it is not merely the third COVID wave that needs to be addressed, there is a multitude of problems and solutions are not that simple. The health of the country and its economy are in intensive care and need to be oxygenated with the right policy decisions.[1],[2],[3],[4],[5]

References

1The American Influenza Epidemic of 1918–1919: A Digital Encyclopedia Largest Digital Collection of Newspapers, Archival Manuscripts, and Interpretive Essays Exploring the Impact of the Epidemic on 50 U.S. Cities (Univ. of Michigan) http://chm.med.umich.edu/research/1918-influenza-digital-archive/. [Last accessed on 2021 Sep 27].
2Dr.V.K.Paul “Warning Signal, Next 100-125 Days Critical”: NITI Aayog On Covid. https://www.aninews.in/news/national/general-news/dr-vk-paul-member-niti-aayog-busts-myths-on-indias-vaccination-process20210527144746/. [Last accessed on 2021 Sep 27].
3Yuan K, Gong YM, Lu L, Sun YS, Tian SS, Wang YJ, et al. Prevalence of posttraumatic stress disorder after infectious disease pandemics in the twenty first century, including COVID 19: A meta analysis and systematic review. Mol Psychiatry 2021; 1 17. https://www.nature.com/articles/s41380-021-01036-x. [Last accessed on 2021 Sep 27].
4Suyash Das.Soumya Bhowmick. Pandemic Induced Unemployment in India: Criminal Activities on the Rise. India Matters 2021. https://www.orfonline.org/expert-speak/pandemic-induced-unemployment-india-criminal-activities-rise/. [Last accessed on 2021 Sep 27].
5Statement by the FATF President: COVID 19 and Measures to Combat Illicit Financing, Paris April 2020. https://www.fatf-gafi.org/publications/fatfgeneral/documents/statement-covid-19.html. [Last accessed on 2021 Sep 27].