On variants in India
The B.1. 617.2 the sub lineage of B.1. 617 is rising faster than B.1.617.1. In some parts of the country, the B.1.117 (Kent variant) is still dominant like in Punjab and Haryana and in many other parts of the country, B.1.617 is rising. In cities, it is a mixture of both. On B.1.617
Only thing that is proven at both epidemiological and molecular level is its likely transmissibility is as high as the B.1.117. It is either keeping up with it, sometimes behind it and sometimes ahead. But it is transmissible enough to call it a variant of concern.
Mortality and severity
Anyone in Delhi would say that families around us are more infected than last year. There are two possible explanations: Percentage of severe cases is same, but denominator is much bigger. The alternate explanation is that the percentage of severe cases has increased and denominator has not increased that much more. Both are possibilities. At the top of it, the total number of deaths are clearly higher, there is no doubt of that. We don’t know the total number of infected. Something we will only know when we do serological surveys which will give a better sense of the scale of severity as well as mortality. These will be done towards the end of the month once people have antibodies. We know school and colleges were open at the time it spread and young people were also the ones socialising in cafeteria, bars , meetings without masks. I would not discount that possibility of more young people getting infected.
On third wave and children
Let us not think of the third wave yet, let us just think that this is not the end. We have seen now that immunity may decline, that the virus can evolve. It is a living organism, as we try to suppress it, it will keep coming back at us. The least protected people will be the one hit hardest. The solution is to get everybody protected. What they are saying probably is that children are difficult to protect because other people will be vaccinated, therefore children will be more involved in the next wave. I am not convinced because the virus has not changed a lot. I cannot honestly believe that those who were least affected by it will suddenly become most affected.
On Vaccines
Mutations will reduce the ability of antibodies to neutralise but not take it away. So, it basically means that the variant is neutralisable, but it may take a higher level of antibodies to neutralise it. So people who get vaccinated get good antibodies and are safe.
Current Trajectory
The outbreaks in New York, Italy, Spain took 2-2.5 months. The UK outbreak came up fast and down fast. Same thing was in US. Rapidly spreading variants usually affect a huge no of people in a short time and then they run out as they can’t find fresh people to infect. So, it is usually compressed with higher peaks and shorter durations. In my assessment, Delhi’s immediate peak is over as long as we maintain reasonable precautions, but we may see smaller bumps on way down.
The city can open up gradually provided we take reasonable precautions.