How do we look at the FUTURE?

Who could imagine 3 months ago that a new disease called COVID-19 would become one of the most important cause of death globally? The figures globally stand at 8.5 million today with 451,000 deaths. Indian figures are 400,000 with 13,000 deaths. Mercifully in our UT the figures are significantly lower proportionately at 2500 active cases with 75 deaths and the numbers are steady.

The big question is however what is the future like, are we going to get a progressively larger number of people getting infected or is it going to halt somewhere? The virus causing it is very stable with very little evidence that genetic mutation altering it in our favour is going to happen soon. According to the prediction of Dr Michael Osterholm, an international expert on Infectious diseases from University of Minnesota, it is likely to affect more than 70% of the population and the best scenario would be that the infection stays back in this form. Rather than going back and then coming as a spurt as has happened in some countries. When most of a population is immune to an infectious disease, this provides indirect protection—or herd immunity -to those who are not immune to the disease. The best-case scenario would be, if we maintain current levels of infection—or even reduce these levels—until a vaccine becomes available. This will take concerted effort on the part of the entire population, with some level of continued physical distancing for an extended period, likely a year or longer. The possibility of an effective and widely available vaccine which the world is waiting for has limitations. SAARS and MERS never came out with an effective vaccine in time. The vaccine for which 120 players are working hard at best is going to boost the immunity for a short period of time. In the words of Dr Osterholm “trying to hit a goal but hitting the pole only! “. No model has worked so far in containing the pandemic examples: Sweden, China, Singapore, UK and Japan.

The approach of Herd Immunity for less severe diseases might look reasonable. But the situation for SARS-CoV-2 is very different: COVID-19 carries a much higher risk of severe disease, and even death. The death rate for COVID-19 is unknown, but current data suggest it is 10 times higher than for the flu. Mortality is even higher among vulnerable groups like the elderly and people with weakened immune systems. The role of prevention to avoid an explosion in numbers who tested positive is critical.

The role of perfectly worn masks which is rare is at best reducing the chance of droplet infection marginally especially with complete opening up of cities. So, the general principles of prevention are physical and not social distancing. Not to go in groups and practice all the hygienic measures which have been emphasized regularly. Caging inside homes is not going to work for long periods. In fact, the deaths because of other causes like heart attacks, heart failure, brain strokes and cancers are becoming much more than COVID in all parts of the world because population is avoiding to go to hospitals to prevent getting Corona disease.

We need to look after our elderly population: our parents and grandparents. Healthy life style, going for a walk-in fresh air in parks while maintaining a physical distancing of 6 to 12 feet, eating plenty of fresh fruits and garden vegetables, adequate amount of fluids including juices is very important. All this increases the immunity and brings in confidence and reduces chances of getting mental depression which is of a common occurrence.

We need to remember that the darkest days are still ahead and we need to live in harmony with this Virus.

A Cardiologist, Past President of Cardiological Society of India and SAARC Cardiac Society. Recipient of Dr B C Roy Award and Padmashiri