Mumbai: Health experts alarmed after respiratory viruses soar

A rapid antigen test is done at the CSMT on January 3, 2021. File pic

Health experts are concerned about the recent surge in Covid-19 and influenza cases in Maharashtra and India. They fear this is because of an increase in lower respiratory syncytial virus (RSV) circulation in the atmosphere along with other respiratory viruses like influenza A and B (H3N2, referred to as common seasonal flu) and SARS-CoV-2. Vulnerable age groups, which comprise children and elders, have fallen victim to this triple whammy. While there is no vaccine for RSV, the concern is that the public at large has stopped taking precautionary shots for the other two viruses. Health experts have cautioned citizens to mask up in public and follow Covid-appropriate behaviour to prevent transmission of the viruses.

Triple whammy

"The triple viral whammy of respiratory illnesses is projected to put high pressure on healthcare systems. A similar situation is emerging early in Mumbai and several states, possibly due to reduced exposure to these viruses during years of following Covid-appropriate measures. For influenza viruses, India has several local vaccines for individuals over 6 months of age to prevent severe respiratory illnesses," said Dr Subhash Hira, professor of global health at the University of Washington, Seattle, an infectious diseases expert and member of health core groups of G20.

Also Read: Mumbai: Only hospital patients to be tested for H3N2

"Furthermore, the Covid-19 pandemic has not ended. The sudden increase in new cases caused by mutant sub-variants of Omicron, namely XBB and XBB.1, has occurred in most Indian states. New Covid-19 cases in Mumbai increased from a few in early March to 36 on March 14. Cumulative active cases in Mumbai are shown as 256 after the celebration season," said Dr Hira. He added, "Prevention and control of respiratory illnesses include staying home when ill; good hand and respiratory hygiene; appropriate use of face masks; appropriate ventilation of indoor spaces; use of teleworking where possible; and avoiding crowded public spaces, including public transportation, to reduce the spread."

WHO statistics

Dr Wiqar Shaikh, professor of medicine, Grant Medical College and Sir JJ Group of Hospitals, said that he is worried about the recent surge in Covid-19 cases as well as the widespread increase in influenza cases. He added that World Health Organisation statistics reveal that a total of more than 220 crore doses of Covid-19 vaccine have been administered in India till March 11, 2023. However, the number of doses being administered in India is only 8,000 per day. He added that 13.33 billion Covid-19 vaccine doses have been administered worldwide to date while 4.5 lakh people across the globe are getting the jab daily.

Dr Shaikh said that he welcomes the approval granted to the use of nasal Covid-19 vaccines in India but added that they cannot be administered to those who have already taken a booster dose. The Covid working group in India has explained that the nasal vaccine can only be taken as a first booster dose. Dr Shaikh also stated that whether multiple booster doses of the Covid-19 vaccine provide any additional benefit is an unanswered question. He explained that in North America and Europe, despite taking three, four or even five doses, people continue to suffer from Covid-19 infections.

Dr Shaikh said that the expiry date of Covid-19 vaccines is 12 to 18 months from the date of manufacture, depending on their type. He added that there is no data as to how many doses of expired or unused Covid-19 vaccines are lying around in India. He explained that their disposal is a complex process that involves crushing, autoclaving and chemical treatment.

Numbers on rise abroad too

In recent weeks, RSV circulation in the US and 45 countries of the European Union has intensified, with high transmission rates in all population groups and an almost a month-earlier-than-usual start of the respiratory illnesses than in pre-Covid-19 years. RSV infections generally cause mild disease, but severe cases are being reported in children below five years, those aged 65 years and above and individuals with underlying comorbidities. Hospitalisations caused by RSV and other respiratory pathogens are putting pressure on healthcare systems in foreign countries. There are currently no licensed vaccines available to prevent RSV infection. At present, there are no specific treatment options for RSV, and treatment of hospitalised patients is mainly supportive.

Vaccine maker says

A spokesperson at M/s Bharat Biotech, Hyderabad, told mid-day, "Despite the lack of demand for Covid-19 vaccines, we continued product development in intranasal vaccines to be well prepared with platform technologies for future infectious diseases. We have also initiated the development of variant-specific vaccines for Covid to be future-ready for India and worldwide."

"The intranasal vaccine is cost-effective and does not require syringes, needles, alcohol wipes, bandages, etc, saving costs related to procurement distribution, storage and biomedical waste disposal, which are routinely required for injectable vaccines. At present, it is available in Chennai, Delhi, Bengaluru and Hyderabad, only," the spokesperson said.

He added, "iNCOVACC utilises a vector-based platform that can be easily updated with emerging variants leading to large-scale production, within a few months. These rapid response timelines and easy intranasal delivery make it an ideal vaccine to address future infectious diseases. We will develop an antigen bank of 10 million doses, as a stockpile, the capacity for our intranasal vaccine is very large and can be scaled up as required. We have approval for primary and booster doses for adults and not for children, as of now."

8,000
No of Covid vaccinations administered in India daily