Top 8 Emerging Questions on COVID19:

Q.1 Do we still need to fear about having future waves of COVID in India?

A.1 Pandemic phase is over for India; actual true seropositivity expected is around 95% against COVID in our population (which is much more than required).
We have already passed through delta variants, for which the western world is still feared.
We were able to get rid of the pandemic phase without much help from vaccination (at the cost of lives we lost), but vaccination could play a crucial role in preventing any future waves if they occur.
At least till the last quarter of 2022, no such fear should be there; after that, we need to watch how things move further.
What is required now is to remain vigilant, i.e., keeping surveillance of variants on esp if any varient is found to have significant vaccine immunity evading potential; and continue vaccinating those who are still unvaccinated (esp children).

Q.2 Do you think that vaccination of children at this stage is required?

A.2 Yes, children must be vaccinated.
Although children have milder disease, there is data to say; children could act as reservoirs of infection if they remain unprotected, giving rise to variants in the future. To keep the disease under control during the endemic phase, vaccination should be offered to them.
Once authorities clear, we should begin with the 12-18 years age group and collect safety data.
If safer, focus on 6-12 years, and then below 6 years.
Schools could be used for the vaccination of these kids like done in the MR campaign.
Gradually, the COVID vaccine becomes another vaccine for children as part of routine immunization (UIP).

Q.3 Will there be a need for annual vaccination for COVID like influenza?

A.3 Unlikely. Maximum we might need 1-2 additional doses for long protection (first after 6-12 months of completing schedule), specially for immunocompromised.
COVID incubation period is longer than influenza so for prevention it doesn’t require to have high antibody titers in blood; immune memory is good enough to take care of repeated infections.

Q.4 Do we need to fear when festival season is reaching India when there will be overcrowding?

A.4 Probably not, since most people are already immune. Some of them might develop a breakthrough infection, but that will be mild like the common cold (>95% are infections in the already immune community, such reinfections should not cause any worry). Open everything but continue using masks is the advice for now.

Q.5 Should schools continue to remain close, or is opening of school the right decision?

A.5 Closing schools was the right decision during the pandemic.
But now, we have entered into an endemic phase; no school should be closed now.
Let children attend schools regularly (except when they have cough/cold/fever).
Promote using masks for children above 5 years at least till they get vaccinated.
Schools should not be closed, even if there is some increase in the number of cases, as most of them will be mild.
Vaccination of kids should not be a prerequisite for opening schools.

Q.6 Do you think testing every patient before admission is needed now, or simply a waste of resources.

A.6 Screening for COVID before admission is being practiced in many hospitals including PGI. I believe that should continue at least for 6 more months, and then it could be done as we do for influenza or RSV, whenever required.

Q.7 Is eradication of COVID possible?

A.7 Yes, this is the best time for that, as no animal reservoirs have known till now.
Once it starts infecting animals, it will be an impossible task.
There is also a paper regarding developing a pan-coronavirus vaccine that sounds very interesting.

Q.8 How long do we need to use masks?

A.8 Actually, using a mask in a hospital is a very good practice, it protects from so many other illnesses.
I wish, it never goes in hospitals.
But for the public, at least for 6 more months, keep wearing, then gradually it will go.
Masks should not cover beautiful faces in public, this has to go finally.

(These FAQ’s are made based on a recent talk by Prof T Jacob John; Compiled by Prof Sanjay Verma, PGI, Chandigarh)

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