For nearly two years the COVID pandemic disrupted life around the world. The WHO has confirmed that 117,332,262 cases of COVID-19 were reported globally. Around 2,605,356 deaths were reported as of March 11, 2021. Of all the cases worldwide, about 24.5% were present in the United States, followed by India at 9.6%, Brazil at 9.41%, and the Russian Federation at 3.7%.
Other infectious diseases had temporarily seemed withdrawn for that period. Now that we dismantled the measures to slow the spread of the coronavirus disease, the viral and bacterial nuisances, previously on hiatus, are returning — and misbehaving in unexpected ways.
Flu experts are worrying that when influenza viruses return in a serious way affecting the section of our population who haven’t had a recent infection, the upcoming flu season would be really difficult.
The last two winters were amongst the mildest influenza seasons on record. However, flu has picked up pace in the last few months, not just in Kashmir but, all over the globe.
- Adenovirus type 41, believed to cause moderately harmless bouts of gastrointestinal illness, might be setting off severe hepatitis in healthy young children.
- Respiratory syncytial virus, or RSV, normally causes disease in the winter, but it has been spreading like wildfire among children in the summer now.
- Monkeypox, mostly found in West and Central Africa, is causing an uncalled-for outbreak in many countries in Europe, North America, the Middle East, and Australia.
These viruses are not different than before, but we are.Â
Because of COVID restrictions, we have a lot less recently acquired immunity.
Some studies suggest that after a 1- or 2-year period in which flu transmission is low, there could be ample reduction in the number of people who have flu antibodies at levels high enough to be considered protective. Endemic diseases have a certain pattern of predictability, which in part is seasonal, but is also driven by the size of the immune or non-immune population.
An increase in vulnerable populations isn’t the only way the COVID-19 pandemic might’ve affected patterns of disease transmission. And the disruption of normal patterns of infections might be more noticeable for diseases where children play an important role in dissemination.
Children are germ magnets and amplifiers. Their lives were greatly altered during the COVID pandemic. Most of them went months without attending daycare, or school in person. And many had less exposure to people outside their households. Even when they did meet others, those people may have been wearing masks.
A study that researched antibodies in the blood of young children showed the impact of what is called an infection honeymoon. This means that children have fewer antibodies to a set of common respiratory viruses in the second year of the pandemic because they were less exposed.
The pandemic-induced disruption of normal mixing patterns has other outcomes.
Adults, as well, haven’t been producing the levels of antibodies that would normally be acquired through their regular exposure to the virus, creating even larger groups of susceptible people. And as a consequence, babies delivered during the pandemic may have been born with few antibodies passed on by their mothers in the womb.
While all this could be unsettling over the next couple of years, things are bound to eventually dial down. Once people are infected, herd immunity gains a foothold and the virus goes away. The rules of infectious diseases haven’t fundamentally changed.
In hospitals across the valley, physicians are adjusting protocols. These regulations had, for decades, showcased a predictable cycle of illnesses that would come and go when schools closed or the weather changed.
In this regard, JKPI held a conversation with a prominent physician, Dr. Abdul Hameed, who retired as Principal – Government Medical College, Baramulla. He has served for more than four decades in upholding and restoring healthcare facilities in GMC Srinagar and associated hospitals. Dr. Hameed has an MD in Anesthesia and Critical Care/Pain Medicine. He has been honored as one of the best medical practitioners and administrators during the pandemic.
Q: Is COVID-19 still a highly transmissible respiratory illness or has it calmed down to act like the common flu?
A: COVID has changed from pandemic to epidemic and is declared endemic now. This fifth-largest pandemic in medical history, which claimed approximately seven hundred thousand lives, has been a nightmare for the whole globe. But there is a marked and definite encouraging change in the frequency of cases and the severity of symptom complex which indicates the development of immunity in the community. Endemic nature means that herd immunity has come to safeguard but continuous vigil is needed to identify and manage possible complications.
Q: How are respiratory virus behaving since the pandemic? Should there be a reason for alarm among the general Kashmiri population?
A: Personally, I have noticed that the mode of infection and transmission of COVID is as per the general respiratory viral behavior. But evidence-based observations seem to indicate that the infection takes a longer time to settle, and the frequency of super-infections is higher which could be due essence here.
Q: Does COVID influence other respiratory or enteroviruses?
A: The case count of Influe to the prolonged course of the viral syndrome. Kashmir is part of the globe and all medical rules that apply to people abroad hold the samenza and Respiratory syncytial viral illnesses were seen to be very low. It was attributed to Non Pharmacological Interventions like social distancing, masking, restrictions on travel, avoiding gatherings, teleconsultations, abstaining from socializing, etc. The season of peak activity of these viruses also showed a drift and cases occurred beyond expected time-lines. However, relaxation in NPIs marked a resurgence. This was not seen in the cases of Rhinovirus and Respiratory enterovirus where the incidence as such was not altered much. It was also seen that the episodes of viral infections showed alterations in severity and duration which could be due to changes in immunological profiles during relative non-exposure during NPI implementation. All issues need further scientific clearance.
Q: What, in your opinion and as per your clinical investigation, should people in Kashmir do to prevent infections?
A: As I mentioned the medical rules are the same and need to be followed with commitment. Cleanliness and hygiene are important in communities and hospitals. Observing barrier nursing in health service centers is very important.
Common colds seem a bit virulent and tenacious now, however…
How and when they may revert to normal depends on modification in our own behavior during the pandemic and the interplay between SARS-CoV-2 and other viruses, known as viral interference. Humans have evolved alongside pathogens, and regular contacts usually allow our immune systems to upgrade the response without making us really sick.
The moment a population stops seeing a virus on this regular rhythm, that natural balance is disturbed. Those extraordinary measures we took to limit exposure to COVID-19, also limited the influence of other viruses. Hence, when we do get exposed to a virus again, and too much time has passed, we may not be able to protect ourselves significantly. This leads to out-of-season waves across the population and unexpectedly virulent infections for individuals. However, the coronavirus and other haywire viruses will, like other respiratory viruses, fall into a pattern of seasonal circulation once population immunity increases, thus decreasing the force of infection. All those shifts will be further affected by other environmental factors as climate change alters seasonal weather patterns.
However, maintaining a healthy environment is imperative at all costs. It is possible when all communities, both at national and international levels, strictly abide by the guidelines prescribed by authorities to combat the spread of viruses.
COVID-19 led to several advancements across many scientific fronts, including vaccine development.Â
Scientists are now proficient at rapidly developing vaccines. This is due to a more streamlined clinical testing strategy that does not trim down on safety analysis, and mRNA technology that permits rapid vaccine product development.
Surprisingly, COVID vaccine development took just 11 months. A major factor in this was the work previously done with mRNA vaccines. Researchers and developers are now in a much better position to develop vaccines more rapidly and respond to future epidemics and pandemics in a better way.
We can now easily categorize the world as pre- and post-COVID just like we did after the world wars. Such is the degree of shift witnessed by our planet during the pandemic.
References
https://www.frontiersin.org/articles/10.3389/fpubh.2022.723229/full
https://www.washingtonpost.com/health/2022/06/13/covid-flu-rsv-viruses/
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