Amid Covid-19 Third Wave Scare, AIIMS Chief Says India's 'R-Value' Increase Is Cause Of Concern

The Chief of the All India Institute Of Medical Science, Dr Randeep Guleria, has issued a warning about the rising 'R-Value' as India battles the threat of the third Covid-19 wave. He emphasised the importance of vigorous containment tactics in areas where new SARS-CoV-2 infections are on the rise.

R-value, also known as R0-Value or R Factor, is the effective reproductive number of a virus. That is the number of people to whom an infected person will spread the virus. During the second wave of the pandemic in India, when the novel coronavirus was spreading rapidly across the country, scientists estimated that the overall R-value was 1.37 between 9 March and 21 April. From 24 April and 1 May, it fell to 1.18 and then to 1.1 between 29 April and 7 May.

Guleria expressed his concerns about the R-value of coronavirus increasing in the latest interview with NDTV while stressing the importance of the "test, track, and treat" strategy to stop the virus from spreading.

He said: "Starting from .96, and going all the way up to 1, the rise in R-Value is a cause of concern. Simply put, this means that the chances of infection spreading from a person, who has Covid-19, to others have gone up."

According to Guleria, "The areas which are witnessing this surge should bring in restrictions and employ "test, track, and treat" strategy to break the chain of transmission."

India registered 44,230 new Covid-19 cases on 30 July, which is the largest daily increase in three weeks. Kerala and some northeastern states have been concerned about the recent increase in instances. According to the government, 46 districts in the country have a positivity rate of more than 10 per cent.

The AIIMS Chief noted that Kerala had set a good example for other states in the beginning by handling the pandemic well, and they also conducted a vigorous vaccination campaign. "Yet despite that, are witnessing a spike in a way that's different from other parts of the country. This needs to be evaluated. Also, is there a variant behind the surge? Are containment strategies being aggressively followed - all this needs to be evaluated," he added.

Guleria suggested that to break the transmission chain, neighbouring states such as Karnataka and Tamil Nadu must also implement vigorous testing strategies. According to a recent serosurvey by the Indian Council of Medical Research (ICMR), seroprevalence was found to be 69.8 per cent in Karnataka and 69.2 per cent in Tamil Nadu.

Even though the serosurveys showed promising signs in India, Guleria said these are not an indicator of herd immunity. He took the reference of Brazil, where a comparable poll found that 70 per cent of the population possessed antibodies. But still, there was a massive outbreak, said Guleria and added that "we really don't know what's the cut-off in such cases, and also the antibodies gradually decrease over a period of time".

Furthermore, the expert said: "It, however, shows that the chances of serious infections are lesser. For instance in Kerala, and the United Kingdom, people are getting infected, they may be spreading to others but they are not getting a serious infection."

The Delta variant of the coronavirus, according to the American health authority, the Centers for Disease Control and Prevention (CDC), may cause more severe sickness than any previous known versions of the virus and spread as easily as chickenpox. This variant was first detected in India and played a key role in the second wave of the pandemic in the South Asian country.

Guleria said that Measles or chickenpox used to have an R-factor of 8 or more, which meant that one individual could infect up to eight additional people. According to him, this indicates that coronavirus is extremely contagious, and it was pretty evident during the second wave of Covid-19 when all family members were getting infected.

"This happens with chickenpox also. In a similar manner, when one person has Delta variant, the whole family is vulnerable," the AIIMS chief added.

Last week, the World Health Organization (WHO) stated that the "highly transmissible" Delta variant is driving a majority of the increase in cases across the world and has now been detected in at least 132 countries.

However, according to researchers led by Mathukumalli Vidyasagar and Manindra Agrawal of the Indian Institute of Technology (IIT) in Hyderabad and Kanpur, respectively, India might experience a surge in Covid-19 cases as early as August 2021, with the third wave peaking at less than 100,000 infections per day in the best-case scenario and roughly 150,000 in the worst-case scenario. They also said that the spike in Covid-19 infection would push the Covid-19 pandemic into its third wave, which might peak in October 2021.