From India's largest Newsroom. I'm Warren Gorge. And this is the times of India podcast. The number of covid cases has been rising across India, but worryingly. So our cases of seasonal influenza or flu. Three years after the covid-19 pandemic began visiting a fresh spike in cases and a few reported deaths across the country. People with symptoms, like coughing and fever are being advised to mask up in today's episode. Mike illegal. Am I speaking with dr.
Vaishali solo about these two waves of infections, dr. Sewell ow. Is the head of critical care at the Fortis Hospital in, Mumbai. She talks about the cases that they're seen presently and what are the issues of concern. She also talks about how we need to deal with this double wave of infections. They'd be a sing presently. You must be seen that many covid cases are rising since last two weeks, we are seeing the numbers have gone up, especially in Bombay. So being an expert, can you tell
us why? There is a sudden rise? In covid-19 cases, is it H3N2? The influenza is rising or spreading in the in the community or the covid-19. Thank you mother for having me here, first of all. So yes, we are seeing a spike In the number of cases in both the viruses that is the covid-19 virus as well as the H3N2 which is the variant of the influenza virus. Right now. The first part of your question is why are we seeing the rise in the number of cases?
Influenza is usually seasonal and whenever we see the rice, there are usually three factors which come into play. One, is the virus itself and the viral factors. Second is the environmental factors and third is the The host factors. So host, here is US usually anywhere between November to February due to the winter season. The temperature goes down and that makes the virus survive longer and multiply more and
transmit more. So, that's why we see a peak of influenza in the wintertime that is between November and February and then the virus factored. So, the viruses are the most smartest sort of beings on this Earth and Both covid-19 as well as the influenza they mutate, right? So every year, when it comes to influenza every year, you will see a new sort of mutation coming up and this time it is the H3N2 which is a predominant one.
And in covid-19 again, you already know that the mutation of xbb 1.16 is the predominant one. And I think 60% of the cases are now being attributed to this new variant. All the three factors come into play. That is the winter season making the virus survive, longer multiply more the host is more susceptible because usually our immunity goes down in the winter season and of course, the virus factors.
The virus has mutated. We have not developed immunity to. So that is why there is a spike in the covid-19. You just explain about the new variant XP, deep 01 .16. It's being circulated in Maharashtra and Gujarat. So can you tell us about these this new variant? So xdb 1.16 has mutations at two places one in the spike protein and one in the open reading frame, now the water, some mutation is one air, which is in the spike protein and that mutation will make it a little
bit immune evasive. That means you and I, if we have had an infection, or if we have had vaccinations, we should be immune to developing. A new infection with covid-19, but with this variate, which is that xbb 1.16, there are chances that this variant will evade our acquired immunity to covid-19. Now, should we be worried now? That's a question, which is the most important in everyone's mind? No doubt about it because there's so much information
everywhere. So, let us be a clear that as the virus is evolving and mutating the fresh. Screens are weaker, right? So this xbb 1.16, so far, whatever data has come in is not giving rise to very severe. Infections write the rate of hospitalizations are not alarmingly high. They are increasing.
Yes as you said just a week back we didn't have a single admission with the covid-19 and now every hospital has a few but most of them are still in double digits out of those hospitalizations also Oh, those people who are requiring oxygen, the percentage of patients who are required and oxygen is not very high. So the first thing to understand is that it does not cause a very severe illness.
So it is not a cause of panic, but yes, the vulnerable population need to take much more precautions than average healthy individuals. And these vulnerable subset are basically people who have cardiovascular diseases, those who are diabetic elderly, I'm 65 years, old, and obese individuals, if there is immunosuppression for any reasons, suppose, they have undergone some organ transplant in the past and they are on drugs, which suppress their immunity. They are also vulnerable.
And, of course, the biggest vulnerability is, if you are not vaccinated. So, these people need to be extra cautious, they need to take more precautions and those precautions are basically adhering to the covid up. Appropriate behavior. So do not panic, but take adequate precautions because this virus is still evolving and we don't know the entire impacts as such so better to take precautions than to face the effects of it. Are there any long-term risks? You know that come with a
reinfection? So like lab last year? Somebody was having some other variant. Now the another reinfection happened this year also. So what do you think there is any risk of risk comes with a re-infections also? So the long-term effects will only be in patients who have developed a severe covid. That means either they required oxygen or they were in the Intensive Care Unit, no matter. My which variant right if they developed an infection, which affected the lungs, they
required oxygen. And how, how much of those lungs were affected. Yes, then there is a scarring on that lung and that scarring gives rise to long-term effects in terms of requiring oxygen over a few months to a year. You must have seen that in the last few wave. Some people also required to undergo lung transplantation because of very severe. Covid leading there. Lungs, very scarred. That are that is one aspect.
The other aspect in the elderly. For those who are developing repeated infections is that it is a taking a toll on their mental health as well as physical health. See, it is difficult for people more than 65 years to cope with any infection. And for them to come out of those infection. Also, it takes longer so more and more people are reporting cognitive decline. Cognitive decline is in layman's term. It is called as brain fog, if you remember.
You know, there was so much talk about this brain fog. Basically, it was a deficit in their analytical skills and their, their ability to think clearly. Which is what many elderly started reporting after the kögel all. Fatigue, a lot of fatigue, not able to get back to normal level of activity, which they used to do before covet. But mind you, these were all after severe covid, not mild infections. So healthy individuals who develop mild infections.
Usually don't tend to have any long-term effects but elderly those who have had severe infections required oxygen were in the ICU for long duration, same a one week, or sometimes even two to three weeks, they have reported a lot of I'll long-term side effects, as well as respiratory. Also, where they required oxygen for a few months to a year and the lungs did show some scarring. So, yes elderly are vulnerable in that sense. There are, there are two experts.
We've explained that you know, right now what is happening, you know, influenza and covid-19 both are spreading and you know, the viruses are doing the rounds at the same time. Is there any any, any kind of like, you know, doctors experts are saying that it will be, we need to be very She's in terms of whether we have to go for vaccines to the flu vaccine will be more available, you know how to protect yourselves.
So as a critical care specialist which I am, I am more worried about the H3N2 right now as compared to the XP 1.16 billion to the forward because this H3N2 can give rise to a severe respiratory illness in the elderly. And we have seen influence of patients coming to the ICU and getting on The ventilator and taking a week or 10 days to come off it as we have been observing, the severity of the covid-19 is not so much as compared to the last two wave
about this H3N2. Now, this variant is a variant of the influenza A virus. It is known to cause severe infections and especially elderly, when they develop these infections, the chances of Landing up in the Intensive care are higher and they take longer time to come out of the ICU also. So it is a preventable illness normally in India as compared to the West. The influenza vaccination rates are very low, you know, they are in sub, 10% levels and people are not very keen on taking
influenza vaccination. It is advisable that anyone who's above the age of 50 should take. A flu shot every year, right? And that to just before the wave, because it takes around three to four weeks for the antibody levels to sort of build up. So it is scientifically and medically advisable to take the flu shots, especially for the elderly people.
And also the other one. The rebel group is less than five years but we are we need to raise this awareness of influenza vaccination and increase the acceptance of the influenza vaccination, mind you Ear. It has to be once a year every year and preferably in that season, which is November to February is when it Peaks, if we have parents at home, our in-laws at home elderly, we must encourage them to take the flu shots every year.
It's a preventable illness and it cuts down the rate of severity, considerably of the influenza respiratory illness. People have like almost forgotten. The covid-19 appropriate behavior. Are we taking this? These waves to casually. Do you want to say something on this? So, yes, a complacency has set in in the average population about the covid appropriate behavior.
Now, you have to understand that this covid appropriate behavior, not only prevents covert but it will also protect you against the influenza. So both are you know sort of transmitted by the cough and the sneezing. So currently seeing the spike, it will only be wise to mask up. now you and I we may not develop severe infections but we go home and we expose our parents and our elderly Do that, and then they get seriously ill. So it's not just for protecting
us, but it is for protecting. T the elderly at home, we interact with every day. So at an individual level, it is only wise to mask up. Take appropriate precautions, if you are coughing or sneezing, try to do it in the elbow. Keep Your Hands Clean, watch the hands regularly. And if you see somebody whose symptoms Attic around you. It is best to avoid close interaction with such a person till such time that the person is fever free.
We have not reached a stage where the government needs to, you know, sort of start shutting down public places because the financial and the economical impact of all.
Those measures are tremendous and looking at the rate of hospitalizations, it is not even warranted right now, but individuals do need to take precautions because even if you Develop a severe illness, you are exposing your elderlies, back home and even children, you are exposing your children who are less than 5 years to say, h 3 and 2. And they will pay a bigger price because you didn't take enough
precautions. What should people do if they exhibit, you know, symptoms, what is happening right now. People are not going for testing it just taken as a, as a, as a normal viral fever, you know? Do you think it's it is advisable to go for testing and isolate yourselves. So there are 2 pi aspects to this. So say a 30 year old person, develops symptoms, like cough, fever and cold right now. He doesn't have any other comorbidities. He's a healthy individual who
has developed symptoms of flu. Now, such an individual. Once he starts developing fever, should ideally stay at home and not go to work because you might land up exposing others at work and during your commute, and it will be advisable that he stays at Home till the fever lasts. Right now, is it needed that every such individual healthy individual who has these symptoms? Undergo testing.
Know, if you don't have any comorbidities and you have mild illness like just a mild fever cough, and sneezing. You can stay at home, take symptomatic treatment like decongestants or paracetamol for the fever and usually it's a self limiting illness in these individuals. Now individuals who have a long-lasting fever Art developing shortness of breath, right? And the cough is not subsiding. These individuals need to seek medical help, especially elderly.
So when people above 65, start developing symptoms of fever cough, or even the slightest breathlessness, they should seek medical attention. And yes, they should undergo testing because they have a higher likelihood of developing a severe illness, but a young healthy individual Flipping some symptoms can stay at home, isolate himself till the time. The fever is gone, take symptomatic treatment and can get back to work once the fever has subsided.
I just want to add one more question here about the Pediatrics cases. You know, they are going to schools, say something about how to protect your children. So, the children are vulnerable age group for the H3N2. No doubt about it. And the parents need to get over the vaccine hesitancy, as far as the flu vaccine is concerned, especially this year, because it's H3, and to, which is much
more severe. So it is very essential that more and more of Awareness about the flu vaccination is is generated amongst parents and whatever hesitation they have towards giving flu vaccinations to the children. They need to overcome it so that the number of cases amongst the children come down the vaccine hesitancy needs to be, needs to be combated at a community level at a government level and at individual level also, and it is essential to immunize their
children with the flu shots. With the influenza and H3N2 and the covid-19, both both patients simply have the similar symptoms. The first line doctors they are the GPS, they generally, misdiagnosed the patients, is there any other way? In terms of the symptoms, we can identify the patient is suffering from viral influenza or the covid-19. Young healthy individual developing fever, cough, and cold.
You don't need to do the test. It could be either influenza or it could be the new variant of covid-19. The treatment is symptomatic now in the elderly do more than 65 years, depending upon the severity of the symptoms. The testing is advisable because influenza, you can give an antiviral or drugs and it is treatable if given early enough while covid-19 again. Also, if it is severe enough, there are antiviral drugs, which can cut down the severity.
So again, elderly are the one who need to seek medical attention early. And Get themselves tested, but not every young individual who's developed symptoms needs to be tested. Is there any other way of differentiating? Apart from testing? There is no way. The symptoms are the same for both. So unless you test, you would not know which of the two you have.
Again, I am emphasizing that the elderly and the vulnerable group, that is those who have diabetes, those who have cardiovascular illnesses, or those who are obese. Yes, they need to have a lower threshold to seek medical attention and get themselves test. Give and take the appropriate treatment. Today's episode was produced by Gerard sing.
So now I'm arathi and on Vijay Singh for a daily Spotlight on people ideas and stories that matter, subscribe to us, we're available on T. Y+ Spotify, Apple Google podcast and all other platforms of your choice. For any new steps email us at DIY podcast at times, internet dot in