Are children easy to kill for the Delta Plus variant? Is India ready for the third wave?

Vikas, an 8-year-old boy in Thane, wakes up in his neighbor’s house, with a heart full of hope that today his parents are returning from the hospital they were taken to a month ago. But, the daily reality weakens him a little more and produces doubt in his innocent mind. Pratham, a 4-year-old child in Mumbai, awaits his parents’ return from a business trip he was informed about by his uncle. These children are unaware of the bitter truth that their parents will never come back. Their lives changed forever and they didn’t even know it. There are hundreds of children not only in Maharashtra (the worst COVID-19 affected state in the country) but also in other states.

The future of these children is in the dark, with strict adoption laws in the country making it almost impossible for them to have a secure life. Relatives of some of these unfortunate children have informed non-governmental organizations (NGOs) who hope that these children will be adopted soon. However, adoption rates in India are low: only 3,351 children were adopted in the year to March 2020, despite tens of thousands of children being orphaned. In the United States, more than 66,000 children were adopted in 2019.

Covid has wreaked havoc on Indian families, leaving many orphaned children and devastated families. The second wave of the virus caused by the Delta variant proved to be extremely deadly for Maharashtra, and many succumbed to the disease.

But, just as cases are dwindling in the state, human life is ready to fight again and earn a living, the virus is ready to strike again. This time he has mutated to the Delta Plus variant and experts believe it could attack children. Maharashtra is preparing for the third wave of Covid-19 which is expected to arrive within 1 to 2 months.

What is the Delta plus variant?

The Delta variant of the new coronavirus mutated again into the “Delta plus” variant. This particular variant is said to have been spotted in Europe since March of this year and was released into the public domain on June 13. To add a bit of breathing space, from now on, the Delta plus variant has been classified as the variant of interest (VOI) and not a variant of concern (VOC).

According to the data provided, this variant cancels the use of a monoclonal antibody. This means that the variant is resistant to the treatment with monoclonal antibody cocktail which was recently authorized in India. A reason to worry!

What else do we know about this variant?

  • B.1.617.2.1, often referred to as AY.1 (Delta plus variant), is identified by the acquisition of the Mutation K417N.
  • The mutation is found in the SARS peak COV-2 protein, which facilitates virus entry and infection of human cells.
  • GISAID has so far found 63 Delta genomes (B.1.617.2) carrying the new K417N mutation.
  • According to Public Health England, Delta plus was found in six Indian genomes as of June 7 (PHE).
  • In India, the frequency of variation of K417N is now quite low. The majority of the sequences come from Europe, Asia and America.

Is our country prepared for the third wave?

The first wave of the virus proved fatal for the elderly population. The second wave was totally different and it highlighted the shortcomings of our health infrastructure. It was an embarrassment for the largest democracy not to be able to meet the basic health needs of its people. The shortage of vaccines has added to the shame with extremely low vaccination rates. Ventilators sent from other countries have proven how weak our country is when it comes to health infrastructure. The whole government and its policies have been called into question. With such a shameful performance, is our nation ready to face another blow from the enemy? What should India’s step be to prevent the third wave? Of course, the vaccination rate will be the most important factor in determining whether or not a generalized third wave occurs. In addition to vaccinations, certain measures must be taken to mitigate the effects of a potential third wave of the virus.

Increase the number of testing facilities

The key to reducing Covid-19 infections is to timely test and isolate affected patients. Access to testing facilities determines whether or not people are tested in a timely manner. If the testing center is one kilometer from their home, a symptomatic person is more likely to be tested than if they are 20 kilometers away. Paid and free tests (in public facilities) are likely to have an impact, especially for the poor.

According to the Indian Medical Research Council’s (ICMR) Covid-19 Sample Collection Management System, testing facilities in places like Bihar and Uttar Pradesh are significantly out of balance. According to the data, the median number of sample collection centers (including mobile units) in districts of states like Karnataka and Gujarat was 90 and 68, respectively, as of June 12. In states like Bihar and Uttar Pradesh, that number was only two. . It is important to remember that these are median figures, meaning that half of the districts would have fewer sample collection centers.

Thirty-one of the country’s 735 districts listed on the portal do not have sample collection centers, while 99 have only one. This clearly needs to change if the pandemic is to be adequately monitored.

People (especially the poorest) should be encouraged to see a doctor

Admittedly, adding test centers will only solve part of the problem. The National Statistics Office (NSO) 2017-18 Health Consumption Survey shows why. In India, whether or not people see a doctor when they are sick is determined by their financial situation. According to monthly consumption expenditure per capita (MPCE), the poorest 20% of people are almost three times more likely than the richest 20% not to see a doctor. The poor are more likely than the rich to avoid seeing a doctor due to a lack of nearby and affordable health facilities. The most common reason for not seeing a doctor in all classes is that the disease is not considered serious.

Because Covid-19 begins with basic symptoms like a fever or a cold, a transformation of thinking is needed when it comes to suspicious patients seeking early testing and treatment.

Recognize the financial burden due to hospitalization for Covid-19

There is no precise estimate of the cost of healthcare caused by Covid-19 infections. The NSO survey can be used to quantify the impact of the health expenditure shock on the household budget. According to the report, family income or savings covered 81% of hospital costs (excluding childbirth); the loans covered 11% of the costs; 3.5 percent of the costs were covered by contributions from friends and relatives, and 0.4 percent required the sale of tangible assets.

Admittedly, the ONS assessment revealed that the average cost of hospitalization was Rs 22,380 per case. Loans, contributions from friends and family, and the sale of tangible assets have all climbed dramatically to the top 10% of the expense category, which includes expenses of Rs 50,550 or more. The average cost of a Covid-19 hospitalization case is expected to exceed Rs 50,000. These figures seem extremely stressful for low-income groups in our country.

The extension of health insurance coverage is a need of the hour

According to the NSO 2017-18 survey, nearly three-quarters of hospitalization cases in India were among people who were not covered by health insurance. The fraction of hospitalizations not covered by any insurance drops from 68% among the richest 20% to 85.5% among the poorest 20% as incomes rise. Even when health insurance was available, it did not cover the full cost of treatment.

According to the ONS survey, health insurance only covered 10.2% of medical costs and 9.1% of total costs (which includes patient transport costs as well as the costs of food, accommodation, transport and other household expenses) in cases where hospitalization has been required.

To be clear, the survey was carried out prior to the implementation of the Pradhan Mantri Jan Aarogya Yojana (PM-JAY), which aims to cover 107.4 million families or 500 million beneficiaries with health insurance. As a result, the insurance coverage figures may be underestimated. According to the PM-JAY website, the program has resulted in 18.6 million hospital admissions since its inception.

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