Overcoming the pandemic: Do we need a far-reaching plan?

The Spanish flu infected about 500 million people in 26 months. Its four-phased outbreaks killed at least 50 million people in the world. Looking at the COVID-19 pandemic, it is not possible to estimate exactly how many waves we have and the total number of deaths. The thing is that standing on the beach, we are counting the waves crashing at our feet.

The SARS-CoV-2 has a proofreading mechanism, which results in a low mutation rate compared to influenza. Recently, it has been reported that the SARS-CoV-2 has been mutating at a rate of about 1-2 mutations per month. Some recent emerging variants, however, have accumulated significantly more mutations in short periods, causing concern around the globe.

Multiple mutations that spread persistently give rise to a new 'variant' of the virus are called 'lineages'. Scientists predict that these mutant lineages of the SARS-CoV-2 strain will not be the only concerning variants that emerge, as the continued uncontrolled transmission of this virus in many parts of the world and selective pressures, such as vaccines, are creating ideal conditions for additional, significant virus evolution.

Multiple variants have recently made headlines, including a UK variant known as 501Y.V1, VOC 202012/01, or B.1.1.7 lineage, a South African variant known as 501Y.V2 or B.1.351 lineage, a Brazilian variant known as 501Y.V3 or P.1 lineage and many others. Some emerging variants are believed to be more transmissible and therefore have the potential to increase hospitalisations and deaths, especially in areas with already at-capacity healthcare systems.

The Indian experts have theorised that the new wave of infections is driven by the 'double mutant' variant discovered in the country, the B.1.617. Some of the SARS-CoV-2 variants carry mutations that can escape detection by the immune system and neutralising antibodies, or spread faster, or infect more, causing severe disease, or a combination of these three behaviours.

The B.1.1.7 and B.1.351 variants have been associated with higher viral loads compared with existing variants in preliminary analyses, resulting in lower cycle threshold (CT) values for polymerase chain reaction (PCR) testing. Detection rates with antigen tests may increase due to an increase in the concentration of antigen in the samples. Some variants have been associated with higher transmission rates compared with others and existing variants. Furthermore, shared mutations with some variants may increase the transmissibility of this virus.

The type of coronavirus is such that the more movement a COVID-19 patient has, the worse the physical condition will be and the greater the prevalence of the infection. Meanwhile, the fact that the strict lockdown approach does not apply to Bangladesh at all is already understood. None of the COVID-19 vaccines discovered so far have been 100% successful. In other words, it is not known when our waiting hours will end for a successful COVID-19 treatment modality.

Due to lax management, the infection has increased again in many countries. It carries a message that the pandemic is not leaving us easily. At present, COVID-19 patients as well as their families are suffering a lot.

When someone in the family is COVID-19 positive, the sky seems to be falling on everyone's head. People are fighting to arrange a bed or isolated care unit in the hospital routinely. In that case, it should be our main concern now to deal with the current situation and successfully deal with the upcoming wave of the pandemic.

Dr Muhammad Torequl Islam is an Assistant Professor of Pharmacy at the Bangabandhu Sheikh Mujibur Rahman Science and Technology University. E-mail: dmt.islam@gmail.com