Recent rise in Covid-19 and influenza cases in Maharashtra is a concern for the health experts. There is an increase in the 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. Children and elders can fall prey to these viruses sooner than others. Currently there are no vaccines for RSV and the majority of the population are not taking the precautionary shots for the other two viruses. The health care professionals have requested to use masks in public and follow the necessary Covid-appropriate steps for further transmissions of these viruses.
Dr. Subash Hira, professor of global health at the University of Washington, Seattle, an infectious diseases expert and member of health core groups of G20 said ““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”.
According to him, the Covid-19 pandemic has still not ended as a sudden increase in new cases has occurred by mutant sub-variants of Omicron, namely XBB and XBB.1, in most of the Indian states.
After the celebration season Mumbai has shown around 256 cases, a cumulative rise in the active cases. Respiratory illness can be prevented and controlled by staying home when ill, good hygiene, use of masks, appropriate ventilation of indoor spaces, and avoiding public places as much as possible.
Dr Wiqar Shaikh, professor of medicine, Grant Medical College and Sir JJ Group of Hospitals is also concerned about the increase in Covid-19 cases and influenza cases. According to World Health Organization statistics though India has administered more than 220 crores doses of Covid-19 vaccine till March 11, 2023 but the number of doses is only 8000 per day. Dr. Sheikh added that till date worldwide 13.33 billion people have taken the Covid-19 vaccine doses while 4.5 lakh people across the globe are getting it daily.
Dr. Sheikh welcomed the use of nasal Covid-19 vaccines in India but they cannot be administered to those who have already taken a booster dose. It can only be taken as a first booster dose. He also added whether the number of Covid-19 vaccines or jabs will have any additional benefit is still not answered as in North America and Europe people continue to suffer from Covid-19 infections despite taking three, four and even five vaccine doses.
Dr. Sheikh mentioned that depending on the type of vaccine the expiry date of Covid-19 vaccines varies from 12-18 months from the date of manufacturing. There is no data of the number of the expired or unused vaccines lying in India. Their disposal involves a complex process of crushing, autoclaving and chemical treatment.
Increase in the numbers abroad as well
RSV has shown an intense rise in US and 45 countries of the European Union in recent weeks 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 start from mild symptoms but there are severe cases in children below 5 years and adults above 65 years & above, and individuals having chronic symptoms. There is pressure in health care systems of foreign countries because of hospitalization caused by RSV and other respiratory pathogens. Present RSV infection currently does not have any available vaccines and no specific treatment and hospitalization treatment against RSV is mainly supportive.
A spokesperson at M/s Bharat Biotech mentioned that “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 spokesperson also said that the intranasal vaccines are cost effective as it does not require syringes, needles, alcohol wipes, bandages, etc., and thus, saves costs related to procurement distribution, storage and biomedical waste disposal, which are mandatory for injectable vaccines.
At present the vaccine is available only in Chennai, Delhi, Bengaluru and Hyderabad.
He added, “iNCOVACC utilizes 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.”