In the second Covid wave, no more need for oxygen, death rate almost the same

A key government task force on Covid on Monday picked out important elements of the ongoing second wave over the first surge at the end of last year: a higher need for supplemental oxygen, no difference in the percentage of deaths and only slightly higher proportions of younger patients.

With several states reporting an increase in demand for medical oxygen, the task force highlighted national hospital data, which showed 54.5% of admissions in Wave 2 required supplemental oxygen during treatment. . This is an increase of 13.4 percentage points from the peak reached in September and November last year, according to data from 40 centers across the country.

With 2.73,810 new cases and 1,619 Covid-related deaths recorded in the past 24 hours, and a total active workload of 19,29,329, Prime Minister Narendra Modi on Monday held a meeting with leading doctors and major pharmaceutical companies.

During the meeting, Modi pointed out that the second wave is spreading rapidly to Tier 2 and Tier 3 cities and urged medics to connect with their colleagues there and provide an online consultation to ensure that all protocols are followed correctly.

Shortness of breath is the most common clinical feature in symptomatic patients of Wave 2, according to the National Covid Data Clinical Registry. It shows that 47.5% of symptomatic hospitalized patients reported shortness of breath in the second wave, compared to 41.7% in the first.

“The breathlessness was slightly higher in the second wave. The deaths showed no difference: it was 9.6% (first wave) against 9.7% (second wave) of hospitalized patients. Oxygen requirements were higher in the second wave, at 54.5%, compared to 41.1% in the first. It was important, ”said Balram Bhargava, Director General of ICMR.

Data show that over 70% of patients were over 40 in both waves. “The older population continues to be vulnerable due to co-morbidities and other risk factors,” Bhargava said.

He said that only a slightly higher proportion of the younger age group was affected despite the opening of various activities: the 0-19 age group made up 5.8% in the second wave against 4, 2% in the first; the 20 to 39 age group represented 25.5% in the second wave against 23.7% in the first.

The data show that in the first wave, 54.9% had at least one comorbidity compared to 48.6% in the second. “The policy implications are that the asymptomatic can be managed at home. Moderately ill patients, if managed according to guidelines, may be discharged earlier. The oxygen supply for health care needs to be increased, ”Bhargava said.

Dr VK Paul, who leads the working group, said Integrated Disease Surveillance Program (IDSP) data collected from states reiterates that there is no change in the prevalence of age in the second wave.

“The data on positive PIDP cases also clearly shows that in last year’s pandemic wave, those under 30 contributed 31% of cases compared to 31% in that wave. Essentially, there is no difference in the proportion. In the 30 to 40 age group, it is 21% (in both waves). This demonstrates that there is no overall undue risk for young people to become Covid positive. We don’t see a change in the prevalence of age in general, ”said Paul.

Data from the registry also show that the need for mechanical ventilation declined during the second wave: 27.8% of admitted patients required mechanical ventilation compared to 37.3% in the first wave.

Significantly, 74.5 percent of patients were symptomatic at hospitalization in the second wave, compared with 87.4 percent in the first.

In addition, there was a significant decrease in clinical features in symptomatic hospitalized patients in the first and second waves: dry cough (5.6% vs. 1.5%); loss of odor (7.7% vs. 2.2%); fatigue (24.2% versus 11.5%); sore throat (16 percent vs. 7.5 percent); muscle pain (14.8% vs. 6.3%).