‘World inching forward to elusive herd immunity’

11 January,2022 07:52 AM IST |  Mumbai  |  Hemal Ashar

Top doc Zarir F Udwadia decodes Omicron, busts myths about a beast different from Delta variant

A college student receives a dose of COVID vaccine in Thane on Monday. Pic/Sameer Markande


The online world was buzzing as consultant chest physician Zarir F Udwadia, ZFU, as he is sometimes known, spoke at a webinar, moderated by well-known physician Dr Tushar Shah. The online meet, under the aegis of a host of organisations, was titled: ‘Omicron Update: Beginning of the end or end of the beginning'.

Muscular, mobile

Dr Udwadia began, "Our world has been battered for two years by the pandemic. We have vacillated between hope and despair. We are at a very strange and different place compared to where we were in 2020. This virus has a lot of unfinished business with us. We can hope that the might of science will help us to keep us abreast. Three days after Omicron was announced, the WHO labelled it a Virus of Concern, the most exalted title a virus can aspire to. It has been reported in 140 countries in two months including a remote Antarctica sub-station. Once a virus takes off, there is no stopping it."

Testing times

Pointing to this variant which is "horribly mobile" the doc stated that it was "reasonable to assume that the vast majority if not all the new cases you encounter in the latest wave are Omicron". He added that Rapid Antigen Tests will increasingly be resorted to as pressure increases on RT PCR. "When using a RAT at home, use a quality assured FDA kit. Bugbear of RAT is that they have a high false negative rate, especially in Omicron. If somebody tests negative on a home antigen test, then he could still be positive on an RT-PCR. If he is positive then, there is no doubt. Isolate if you have symptoms, for at least three to five days."

Dark ‘n' light

It was not all dark though. Dr Udwadia, managing patients at three top Mumbai hospitals, added, "Omicron is less severe than Delta. This is just not the same disease as seen earlier. We have to ask, is the virus itself intrinsically milder or is it that the population itself which is protected by vaccination/or immune from prior infection that is making it so? Nobody knows the answer but scientists are working feverishly to find out. Deaths from COVID-19 are at their lowest globally than at any time in the pandemic."

That bright spot though was followed by a warning from Dr Udwadia that there is "no cause for complacency. Even a small number of sick or deaths is significant when numbers infected are so huge. The head of nursing at one of the Mumbai hospitals I work at told me recently that 103 nurses are sick from COVID. So, who is going to do cancer care or look after dialysis patients?"

The antibody

The doc did acknowledge the huge immune escape scope of this "wily variant" but, he added, "Vaccines retain their efficacy against severe infection, hospitalisation and death. I am tired of people asking me which vaccine should they take. Be grateful that you have had any vaccine. Antibodies and antibody levels are not the sole correlates of immunity. Antibody is just one of the dishes in the buffet of dishes measuring your immunity. It may not be the main dish at all but it may be the simplest to measure and that is why we are so focused on it. Boosters definitely do help. Today, Israel is giving a fourth dose, but boosters are also a sign of inequality. Vaccinating the whole world is not only morally but also the strategically right thing to do. There should be no dichotomy between vaccinating your own country and vaccinating the world, as that can prevent mutations. When will politicians realise that they need to look beyond their narrow borders?"

The end

At the end of an extensive session, Dr Udwadia advocated masking up with an N-95 for precaution and home treatment "for a majority of patients, with a few exceptions though". He also said to people who are asking him for some good news that, "The Omicron outbreak in SA [South Africa] is on the decline already. As millions are infected by Omicron, the world inches forward to that elusive concept of herd immunity."

The poet T S Eliot said in his poem The Hollow Men: "This is the way the world ends; not with a bang but with a whimper." In the same way, Dr Udwadia said as he closed a riveting presentation though there are no timelines, "The pandemic will end, because all pandemics burn out in the end, not with a bang, but a whimper." The world cannot wait for that prophecy to come true.

4k
Approx no. of Omicron cases in the country

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