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Table of Contents
Year : 2020  |  Volume : 6  |  Issue : 2  |  Page : 81-83

Living with COVID-19: Herd immunity to appropriate behavior to vaccine

1 Executive Director, All India Institute of Medcial Sciences, Bibinagar, Yadadri Bhuvanagiri District, Telangana, India
2 Department of Community and Family Medicine, All India Institute of Medical Sciences, Yadadri Bhuvanagiri, Telangana, India

Date of Submission05-Nov-2020
Date of Decision18-Nov-2020
Date of Acceptance22-Nov-2020
Date of Web Publication24-Dec-2020

Correspondence Address:
Dr. Kishore Yadav Jothula
Department of Community and Family medicine, All India Institute of Medical Sciences, Bibinagar, Yadadri Bhuvanagiri, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJCFM.IJCFM_131_20

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How to cite this article:
Bhatia V, Jothula KY. Living with COVID-19: Herd immunity to appropriate behavior to vaccine. Indian J Community Fam Med 2020;6:81-3

How to cite this URL:
Bhatia V, Jothula KY. Living with COVID-19: Herd immunity to appropriate behavior to vaccine. Indian J Community Fam Med [serial online] 2020 [cited 2021 Jun 25];6:81-3. Available from: https://www.ijcfm.org/text.asp?2020/6/2/81/304788

The Ministry of Health and Family Welfare, Government of India, has reported 8.3 million COVID-19 cases and 0.12 million deaths as of November 05, 2020. Since the past 7 weeks, India is showing a decreasing trend in daily cases. Compared to the peak of 97,894 cases on September 17, India has reported 50,210 cases on November 05 (a decrease of around 50%).[1] India's 7-Day Moving Average daily test positivity rate is 4.6%.[2] India continues to occupy the top position globally in terms of COVID-19 recoveries while the total number of active cases has witnessed a sustained downward trend, with its percentage having reduced more than thrice in just 2 months as per the statement given by the Union Health Ministry.[3] Public health experts have opined that India is at the verge of the flattening COVID curve. Although India's COVID-19 trajectory shows a downward trend, there is no scope of complacency. Jan Andolan campaign must be executed in true spirit.

The challenge for the nation is to find a balance between reviving the economy and protecting people's health as the Government of India has been lifting the lockdown in a phased manner since June 2020. The onus of containing the spread of the virus now lies majorly on every individual of the country along with the government and the health-care team. The tools for the humankind to fight with the virus include developing vaccine, achieving herd immunity, developing effective treatment protocols, adopting COVID-appropriate behavior, and to wait till the virus stops naturally.

There is little evidence to suggest that the spread of SARS-CoV-2 might stop naturally before at least 50% of the population has become immune. For COVID-19, which has an estimated infection fatality ratio of 0.3%–1.3%, the cost of reaching herd immunity through natural infection would be very high, especially in the absence of improved patient management and optimal shielding of individuals at risk of severe complications. Allowing the virus to effectively run its course and infect such huge percentages could only increase the casualty risk and mass suffering. As the long-term complications of COVID-19 are still unclear, the concept of herd immunity is debatable. The safest way to reach herd immunity is again developing an effective vaccine.[4]

The big question now is when a vaccine will be available? According to the WHO, there are currently more than 100 COVID-19 vaccine candidates under development, with a number of these in the human trial phase.[5] India currently has three COVID-19 vaccines, including two indigenously developed candidates, that are being tested across the country. Covishield, jointly developed by the Oxford University and AstraZeneca, has advanced the farthest in clinical studies in India. The Oxford COVID-19 vaccine candidate, which is being handled by the Serum Institute of India, has entered the Phase 3 trials in the country. The other two candidates, COVAXIN being developed by the Bharat Biotech in partnership with the ICMR and Zy-CoV-D developed by Zydus Caldia, are undergoing Phase 2 human trials. Recently, the Drugs Controller General of India has granted permission to Dr. Reddy's Laboratories to conduct the Phase 2/3 clinical trials of the Russian Sputnik-V, the world's first registered vaccine against COVID-19, in the country. The vaccine is expected in the late December or January if the trials are proven successful.[6] The vaccine against COVID-19 is likely to be anywhere between 50% and 100% effective as per the ICMR. The Government of India had already started groundwork to vaccinate its people against coronavirus. In an advisory to states on setting up coordination committees for distribution of the COVID-19 vaccine, the health ministry has said that the introduction of the shots will span over a year with multiple groups being included sequentially, starting from health-care workers, while also asking governments to be vigilant about disinformation on social media.[7] It may take a couple of years to know whether the vaccines are robust or not.

Some of the European countries and also few states in India such as Kerala, West Bengal, Karnataka, Andhra Pradesh, Tamil Nadu, and Delhi have reported a spurt in cases, which can be attributed to the opening of public places, transport, and also laxity on the part of people who are now shunning distancing and mask rules due to pandemic fatigue.[8] According to the statement given by the Centre for Cellular and Molecular Biology Hyderabad, there is a possibility of a second or a third or even further waves in the near future which are severe than the first one. We have to be extremely watchful and need to delay or reduce the amplitude of further waves by practicing appropriate COVID-19 behavior.[9]

The overwhelming message is that the evil is still out there and here to stay, which means we have to learn to live with it and it is the only immediate option we have right now.

Living with corona demands three important practices – wearing a mask, maintaining social distancing, and timely hand washing or sanitization. Never before have we wanted to change behaviors in such a compressed time and at such a large scale. The need of the hour is to bring behavioral change among the people and to address the challenges in the way of promoting healthy behavior.

Although COVID-appropriate behavioral practices look like simple measures, the extent to which people adopt and implement these practices is questionable in a country like India. At times, it becomes difficult to maintain social distance in the public places and transport as the density of the population is high. People who are more stressed about their financial situation may compromise with the protective measures. Social and religious gatherings are the other areas where the preventive measures are at times compromised. People who feel a false sense of security due to the relaxation of restrictions, are less likely to wear masks and avoid large gatherings.

There is an urgent need to address the hurdles in adopting and practicing preventive measures and make the people to realize that it is every individual's responsibility to follow COVID-appropriate behavior in order to protect their health, their family health, neighborhood, and community as well. People should be sensitized to be cautious about the virus and to take preventive measures as much as possible. When people cannot afford to buy masks, they can use clean cloth as a mask.

As festivals and the winter season are approaching and the economy is also being unlocked, our honorable Prime Minister Sri. Narendra Modi launched Jan Andolan campaign on October 8, 2020, to encourage people's participation in following COVID-appropriate behavior. “Wear mask, follow physical distancing, maintain hand hygiene” is the key message of the campaign. The campaign will focus on awareness raising through all media such as television, hoardings, wall paintings, audio messages, pamphlets, brochures, mobile vans, and social media which is a strong communication channel.

The world is thrown into a tricky situation, where every individual has to think about the risk of corona in every step they take. The ability to co-exist with SARS-CoV-2, as the virus is known, will increasingly ride on how individuals assess risks and make decisions. Currently, the humankind is left with two options – living with corona and living for corona. With the relaxation of restrictions, knowingly or unknowingly, most of the people are living for corona by not following the preventive measures out of carelessness and ignorance. The health-care team at all levels, nongovernmental organizations, teachers, and leaders should take an active role to promote COVID-19-appropriate behavior intensively through various information, education and communication activities to turn the people living for corona into the people living with corona.

The war is not over and the future is unpredictable. It requires efforts by every single citizen to win this war. The humankind's existence depends on adopting to the change. It is time to accept and adopt the new normal way of living as a responsible citizen and live with corona till the dream of an effective vaccine is fulfilled.

  References Top

Ministry of Health and Family Welfare, Government of India. COVID-19 Statewise Status. Available from: https://www.mohfw.gov.in/. [Last accessed on 2020 Nov 05].  Back to cited text no. 1
World Health Organization. COVID-19 Quick Links. Situation Reports. India Situation Rport-39. Available from: https://www.who.int/docs/default-source/wrindia/situation-report/india-situation-report-39.pdf?sfvrsn=be72116a_2. [Last accessed on 2020 Nov 05].  Back to cited text no. 2
Staff. India in Pole Position Globally in COVID-19 Recoveries; active Cases Witness Steady Downward Trend. The Tribune; 2020. Available from: https://www.tribuneindia.com/news/nation/india-in-pole-position-globally-in-covid-19-recoveries-active-cases-witness-steady-downward-trend-164896. [Last accessed on 2020 Nov 05].  Back to cited text no. 3
Fontanet A, Cauchemez S. COVID-19 herd immunity: Where are we? Nat Rev Immunol 2020;20:583-4.  Back to cited text no. 4
World Health Organization. COVID-19 Quick Links. COVID-19 Vaccine. The Push for a. COVID-19 Vaccine. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines. [Last acessed on 2020 Nov 05].  Back to cited text no. 5
Staff. Can India Expect a COVID-19 Vaccine by Year-end? Times Now; 2020. Available from: https://www.timesnownews.com/health/article/can-india-expect-a-covid-19-vaccine-by- year-end/671024. [Last accessed on 2020 Nov 05].  Back to cited text no. 6
Pandit A. COVID-19: India's Vaccination Drive May Span Over a Year, Group-Wise. The Times of India; 31 October, 2020. Available from: https://timesofindia.indiatimes.com/india/covid-vaccination-drive-may-span-over-a-year-group-wise/articleshow/78961827.cms. [Last accessed on 2020 Nov 05].  Back to cited text no. 7
Pandey V. Delhi Reels Under Second wave of Coronavirus as Cases Jump. Deccan Chronicle; 29 October, 2020. Available from: https://www.deccanchronicle.com/nation/current-affairs/291020/delhi-reels-under-second-wave-of-coronavirus-as-cases-jump.html. [Last accessed on 2020 Nov 01].  Back to cited text no. 8
Didyala A. CCMB Lens on Reinfections, Warns of 2nd wave of COVID. Times of India; 04 November, 2020. Available from: https://timesofindia.indiatimes.com/city/hyderabad/ccmb-lens-on-reinfections-warns-of- 2nd-wave-of-covid/articleshow/79028744.cms. [Last accessed on 2020 Nov 04; Last accessed on 2020 Nov 01].  Back to cited text no. 9


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