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COVID-19 May Already Be Endemic to India: Soumya Swaminathan

COVID-19 May Already Be Endemic to India: Soumya Swaminathan

Dr Soumya Swaminathan. Photo: The Wire

Dr Soumya Swaminathan, chief scientist of the World Health Organisation (WHO), has said, “India could have reached some sort of stage of endemicity” in terms of the overall COVID-19 situation. “That’s what seems to be happening.”

“It’s very feasible we may continue like this, with a few local ups and downs” but they are unlikely to be severe and certainly not like the devastating second wave of April-May 2021.

The endemic stage is when a disease-causing pathogen becomes restricted to a population and causes repeated outbreaks there.

The latest seven-day average of new daily cases in India is now under 32,000 – lower by 12% compared to the week before. The R number is hovering around 1.

Dr Swaminathan also said she expects WHO to clear Covaxin as one of its authorised vaccines by mid-September. She said the decision will be taken by an independent assessment committee that will meet in the first 10 days of the month.

One reason for the delay in Covaxin’s approval, according to her, was that Bharat Biotech “took time to compile its dossier” and submitted it to WHO only in the third week of July.

In mid-August, the committee raised further questions, to which Bharat Biotech recently responded. The committee will then review the application in early September and decide by mid-September. Dr Swaminathan clarified that the process hasn’t been unusually long or delayed.

In a 43-minute interview to Karan Thapar for The Wire, Dr Swaminathan – a former director-general of the Indian Council of Medical Research (ICMR) also said, “No one has a crystal ball and it’s impossible to predict a third wave” nor how long or bad it will be.

However, she said that while it is possible for children to get infected in large numbers during the third wave, it is unlikely that they will fall seriously ill. She specifically said there is no need to panic on this count, even as it’s advisable to be prepared for more infections among children.

About Kerala, Dr Swaminathan said there is definitely “ongoing transmission” there, which raises the prospect of new variants emerging in Kerala – but at the same time said the state has also “managed cases very well”. However, she added, Kerala needs to step-up vaccinations even if already has one of the highest vaccination rates.

Asked about news reports that the Indian government plans to stockpile remdesivir and ivermectin ahead of the third wave – two medicines that WHO has unequivocally said “do not have any role to play in reducing infections and mortality” – Dr Swaminathan said neither is useful.

Also read: What Next for the Delta Variant?

In May 2021, Dr Swaminathan herself had tweeted: “WHO recommends against the use of ivermectin for COVID-19 except within clinical trials.” However, she wouldn’t comment specifically on the decision to stockpile.

Next: at what percentage level of adult vaccination India could start to feel reasonably secure and start to open up, as Britain has done – given that it is widely considered unlikely that India will achieve the government’s target of fully vaccinating the adult population by the end of the year?

Dr Swaminathan said that at the UK’s levels of adult vaccination, i.e. 70-75%, India could feel reasonably secure. At the moment, only 9.5% of India’s adult population has been fully vaccinated.

Used syringes lie discarded in a bin after they were used to administer the coronavirus disease (COVID-19) vaccine in Mumbai, India, August 11, 2021. Photo: Reuters/Francis Mascarenhas

Dr Swaminathan also said we need the full phase 3 trial results of the Zydus Cadila vaccine, and not just the 66% efficacy figure the company has shared. Specifically, we need to know the confidence bands within which the 66% figure sits because only then can we judge its credibility.

Dr Jammi Nagaraj Rao raised the same issues, and others, in a recent article for The Wire Science.

Speaking about booster doses, Dr Swaminathan said that as of yet we don’t have enough data that suggests we need booster doses, and that only when such data becomes available can we decide which sort of people need boosters and when. She said the UK, the US, Israel, France and Germany were going ahead with boosters because they feared immunity levels after vaccination were dropping, but WHO’s position is to wait for more data.

Dr Swaminathan also said there is also a moral argument to be made against administering booster doses to people who are already fully vaccinated. When the vast majority of the world hasn’t received a single dose, it is wrong for rich countries to keep using vaccines for their own population and disregard everyone else.

She also said that if COVID-19 continues to spread among the world’s unvaccinated majority, new and more dangerous variants could emerge and devastate the vaccinated populations of Europe and America. No one is safe until everyone is safe, she said, so it’s in the interest of rich nations to ensure everyone everywhere is vaccinated.

Finally, Dr Swaminathan said she agreed with the view that the most likely outcome is that COVID-19 will shift from its current ‘epidemic’ status to ‘endemic’ status, helped by vaccinations and COVID-appropriate behaviour, and that in a year or so, it will be no greater a threat than influenza.

She added, “We cannot reasonably hope to eliminate or eradicate the virus,” but once it becomes endemic, we can learn to live with it.

Watch the full interview here.

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