Dr Gagandeep Kang
FOLLOWING A SPIKE in Covid-19 cases, the Union ministry of health issued an advisory on preventive measures. While some people have started worrying again, others are not ready to follow Covid-appropriate behaviour. Virologist Dr Gagandeep Kang, professor at Christian Medical College, Vellore, does not find the rising numbers a problem yet. Excerpts from an interview:
Q/ Why the sudden increase in Covid cases?
A/ While there is an increase in the number of cases, we should look at the rate of change. What we are seeing here is not a steep hill. It is not that this week there are 100 cases, and next week there are 10,000 cases. So, this is reflective of a population that has a certain level of immunity. It is also complicated by the fact that we are not testing every person with symptoms. Your cases are decided on how many people decided to get tested or their doctors decided that they had enough symptoms to get tested.If there was a huge wave, then you would start to see rapidly that almost all of the illnesses that we were seeing in people were Covid. That is not the case. A few people are hospitalised, or are in ICUs, or have died, according to the numbers we have. This is nothing like what we saw previously. Most of us in are the base of a pyramid. We might get infected, but very few of us are so sick that we need to see a doctor. If we were testing everybody―symptomatic, asymptomatic, mild symptoms, severe symptoms―the numbers would be very high.
Q/ Do we need to be worried as we don’t see people following Covid-appropriate behaviour?
A/ Covid is not going away. Also, is Covid the only condition we should worry about? Clearly, no. Covid-appropriate behaviour is appropriate for all respiratory diseases, be it TB, influenza or any other disease. So, if I am infectious, it is my responsibility to mask up and not infect others. The bulk of Covid infections right now are in people who have no idea that they are infected.
Q/ Won’t asymptomatic people be a cause for concern?
A/ The only way to limit worry is to make sure that everybody tests every day and if they test positive, they don’t go out. That’s not feasible. In life, there has to be some risk. If you want to protect yourself from an infection, you should mask up, but you can’t place that responsibility on everyone else without a reason. Some people do make the argument that all of us should wear masks forever because we will reduce the risk of getting infections and transmitting those to others. I don’t think that is feasible in the world we live in. You could decide that based on proportions of cases testing positive, or on total number of cases, or on the number of admissions in hospitals.
Q/ What do you think the threshold would be?
A/ I think it depends on the level of countries or the population’s risk. For me, I have been vaccinated, I have had Covid. In general, I am pretty healthy. Unless there is a lot of Covid in the community, I don’t think I will wear a mask. So, it really depends on an individual’s level of risk tolerance and the decisions that people make. I think that within our populations, there are sub-populations that need to protect themselves at levels of risk that are relatively low.People will mingle, people will travel and the viruses will travel with them. Covid is not going anywhere. What we are seeing is a slight uptick in cases because we have a new variant that is causing some symptoms, mostly mild.
Q/ What challenges are we facing while trying to cope with Covid?
A/ The rest of the world has resources where they can worry about Covid endlessly. However, for us, it would be a disservice if we ignore all other health problems that we are facing in the country. We should be thinking about making our health care system stronger, in general, and not worry about just one infectious disease. I never think that we spend enough money on health or research. We can always invest more.When policymakers don’t spend enough on health and research, we ignore the fact that the health and education of our population is the most valuable resource we have. It’s not about the buildings we build. It really is about the people we educate and protect. Investing in people and in their health and wellbeing can never be wrong.