At the end of the year, social networks announced the end of Covid-19. New cases had dropped dramatically across the country since peaks in mid-September.
In March 2021 came the second wave. Not everyone who had Covid in the first wave will be immune to re-infection with Covid, as immunity develops in only 83% of patients and likely lasts for six months. We are dealing with patients with residual damage already induced by the first wave, suffering again from Covid. In medical terms, we call sequelae of residual damage; a condition that develops as a result of something, or a medical condition that results from a previous illness.
People with severe sequelae are most likely to be affected, but even young, otherwise healthy people can feel unwell for weeks or even months if infected through neglect. The most common signs and symptoms that persist over time are fatigue, shortness of breath, cough, joint pain and chest pain.
In terms of the disease profile, India is a country where diabetes, high blood pressure and obesity will continue to be problems. It is not only geriatric people, but also a part of the younger population, many of whom suffer from obesity as well as undiagnosed diabetes and high blood pressure, who could contract a severe form of Covid because most are not not diagnosed and treated for pre-existing conditions. . There is also evidence that neurological complications are on the rise. All of these could lead to a new disease profile in India.
There will also be a marked change in the country’s heart health profile, long term problems are likely to manifest in organs such as
1. LUNGS: The type of pneumonia that is normally seen in Covid-19 can cause irreparable damage to the tiny air sacs (alveoli) of the lungs. The resulting scar tissue can lead to long-term breathing problems. In the case of smokers, the negative impact of smoking will be felt even more.
2. HEART: Those who have recovered from Covid-19 may continue to have lasting damage to the heart muscle, even if they have experienced only mild symptoms. This can increase the risk of heart failure or other heart complications in the future. At the population level, on the one hand, there will be higher cardiac incidences. On the other hand, the severity of the cases themselves will be greater.
3. COAGULATION: Covid-19 can make blood cells more likely to form clots. While large clots can cause heart attacks and strokes, much of the heart damage caused by Covid-19 is believed to be from very small clots that block tiny blood vessels (capillaries) in the heart muscle. This may impact a higher percentage of sudden deaths in the home, especially among those whose pre-existing blocks have not been diagnosed.
4. KIDNEY: Covid-19 can weaken blood vessels and cause leakage, which can lead to long-lasting kidney problems.
5. PANCREAS: Empirical evidence suggests that Covid leads to inflammation of the pancreas. The incidence of abdominal pain and temporary or permanent diabetes will increase due to the same. Diabetes, in turn, is a risk factor for heart disease.
6. MENTAL HEALTH: People with severe symptoms of Covid-19 often need to be treated in the intensive care unit of a hospital, with mechanical assistance such as ventilators. Just surviving this experience can make a person more likely to later develop post-traumatic stress disorder, depression, and anxiety. There will be a sharp increase in the need for mental health management after Covid.
The resurgent strain from March 2021 – a virus that mutated into a faster spreading (no more fatal) strain – hit us at a time when we are tired of Covid and have become complacent about preventative behaviors such as wearing a mask and maintaining a physical distance. And that is what we must beware of.
A strain that spreads faster is even more bad news when we are casual and do not follow precautions. Even after vaccination, there is no protection for a week and partial protection for 4-8 weeks (depending on the type of vaccine). People should follow the same precautions.
As mentioned earlier, being infected once only protects 83% of those infected and most likely only six months after. Which means that we can re-infect ourselves. Now this re-infection can be more dangerous, especially for those who have already compromised immunity.
(The author is Vice President and General Manager, Asian Heart Institute, Mumbai. Opinions are personal)