Abstract
Background: – This time last year in 2020 India was under lockdown phase, many theories about India’s surprisingly low rates of Sars-CoV-2 infection included variety of factors including hot weather, natural immunity, heard immunity, robust health system, highly qualified doctors and the country’s high proportion of young people; some also attributed it to the country’s harsh lockdown. India was doing so well that in megacities like Mumbai and Delhi, officials had begun dismantling temporary COVID-19 facilities. Comparing it to current scenario in April 2021, cases and deaths are soaring. The shortage of beds and space is so acute that people are dying in car parks and other places while waiting to be admitted in hospitals. Daily rates are currently over 300,000, the world’s highest-ever daily infection rate.11https://www.gavi.org/vaccineswork/why-indias-covid-19-pandemic-skyrocketing
The SARS-CoV-2/ Covid -19 pandemic is still going on and globally as well as in India particularly healthcare system is overstressed with this new burden added with previous NCD(non communicable diseases) & CD(communicable diseases). The First human case of this global pandemic was reported from Wuhan city of China in December 2019.22https://apps.who.int/iris/bitstream/handle/10665/332197/WHO-2019-nCoV-FAQ-Virus_origin-2020.1-eng.pdf The first case of covid-19 in India was found in January 2020. Today India is having more than 3 lakh cases per day and thousands of deaths daily due to this pandemic. The situation is very worse as compared to previous year and is worsening day by day due to several factors.
Objective: – The main objective of this study is to illustrate the key features of Covid -19 virus, host human beings factors, irresponsibility’s and environmental factors responsible for continuation and recurrence of this pandemic as well as worsening of pandemic day by day. Setting and design: – Different aspects of Covid -19 structural variations, mutations, host factors, environmental factors (internal & external) and its effect will be analysed. Brief details about epidemiological triad will be outlined.Methodology : – The explanation will be given to title through analysis of several factors responsible for increase in cases. The cause of perpetuation of Covid -19 can be understood by the way of infections and other related factors. Result : - Several factors are responsible for the continuation and worsening of pandemic situation in India of the pandemic. Of great concern today is a new ‘double mutant’ B1617 variant, identified in India last year, that is spreading across the country as well as triple variants discovered recently and studies are going on to know more. Although scientists are still investigating whether or not the variant is more deadly & more infectious, it does contain the L452R mutation that affects the virus’ spike protein. This protein is very significant because through this the virus hooks on to our cells receptor. Early research suggests that this mutation makes the virus more infectious. This doesn’t necessarily mean that the variant will be any more deadly, but it means that more people are at risk.33https://www.gavi.org/vaccineswork/why-indias-covid-19-pandemic-skyrocketing
Conclusion : – In the epidemiological triad we have agent/host/environment. The clinical approach is based on individuals & standard treatment guidelines-protocols and public health approach is based on population strategy to control this pandemic. Various strategies and approaches are required to prevent epidemic through assessment of important parameters and indicators (see figure 1) to control the ongoing disaster and hazards of pandemic
Keywords: – SARS-Cov-2, Covid-19, Pandemic, Strain,
Background – This time last year in 2020 India was under lockdown phase, many theories about India’s astonishingly low rates of COVID 19  infection included variety of factors including hot weather, natural immunity, heard immunity, robust health system, highly qualified doctors and the country’s high proportion of young people; some also attributed it to the country’s harsh lockdown. India was doing so well that in megacities like Mumbai and Delhi, officials had begun dismantling temporary COVID-19 facilities. Comparing it to current scenario in April 2021, cases and deaths are soaring, leaving hospitals running out of oxygen & beds with other medicines and required facilities. The shortage of beds and space is so acute that people are dying in car parks and other places while waiting to be admitted in hospitals. Daily rates are currently over 300,000, the world’s highest-ever daily infection rate
The SARS-CoV-2/ Covid -19 pandemic is still going on and globally healthcare system is overstressed with this new burden added with previous NCD & CD in existence. The First human case of this global pandemic was reported from Wuhan city of China in December 2019. The first case of covid-19 in India was found in January 2020. Today India is having more than 3 lakh cases per day and thousands of deaths daily due to this pandemic. The situation is very worse as compared to previous year and is worsening day by day due to several factors.
The SARS-CoV-2/ Covid -19 coronavirus belongs to a large family of coronavirus. Usually they cause respiratory infection in humans like other respiratory viruses such as rhinoviruses/ human respiratory syncytial virus/ parainfluenza viruses/ adenoviruses/influenza A & B viruses / enteroviruses / herpes simplex viruses/ human metapneumoviruses etc.44Harrisons Principles of Internal Medicine-18th edition volume 1 If we look at the history SARS-2002/2003 – south china outbreak begin with 8096 recognised cases in 28 countries & added to this 90 % of cases occurred in china and hongkong. Now the world is moving very fast or we can say the host factors related spread have exaggerated the pandemic added with various climatic changes. That time the natural reservoir of SARS-CoV appeared to be horseshoe bat. The 2002-2003 outbreaks thought to be originated due to human contacts with infected domestic animals. The striking fact is that in 2002-2003 as well as 2019-2020-2021 most cases spread from human to human and there are multiple ways of spread particularly respiratory droplets. The 2002 outbreak ceased in 2003 but 2019 outbreak is going on and global fast movement is one of the most important factors. The super spreaders may remain symptomless while spreading the virus.
WHO (world health organisation) have notified and actually its alarming and alerting that globally new covid-19 cases are rising again or we can say alternatively that incidence rate is increasing. In the last week of March 2021 the new cases reported globally are more than 3.8 million. At the same time the number of deaths also increased consecutively for the second consecutive week. The deaths increased by 5 % compared to previous week. The total number of death for above mentioned period was over 64000 new deaths. The more alarming fact is that all regions have reported an increase in incidence rate in last week of March 2021. If we talk about deaths then except African region all regions reported an increase in the number of deaths due to covid-19. Added to above facts still the European region with region of Americas are on the top accounting for 80 % of all cumulative cases and deaths.55https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19—31-march-2021 There is sharp rise in south East Asia region or actually it’s the largest increase on global basis that is 21 % increase in deaths with continued increasing trends in the 3rd consecutive week.
The south East Asian region is also having a huge population as well as many nations are in developing stage with stressed and overburdened health system. The health system administration and management in India is such that the topmost positions are acquired by people who are not from the medical, clinical or public health backgrounds. All the important decision is taken by these non technical persons as well as India is always having problems of corrupt practices and haphazard system failures in critical circumstances. Added to this there is lack of human resources, infrastructure, and capacity building, to cater the huge population which is growing day by day. The number of beds and medical resources are not enough and not sufficient as per international norms and this pandemic have added an extra demand on the system which is already overburdened.
Objective - The main objective of this study is to illustrate the key features of Covid -19 virus and mutations as well as strains added with host and environmental factors responsible for continuation, recurrence & increase in number of death and cases in India. The global scenario of covid-19 pandemic see table 1- Newly reported and cumulative COVID-19 confirmed cases and deaths, by WHO Region, as of 28 March 2021- source – WHO & table-2- Overview of variants of interest (VOIs), as of 30 March 2021 – source – WHO
The whole group of coronavirus is very peculiar. They are pleomorphic, single stranded RNA viruses measuring about 100-160 nm in diameter. There are several factors responsible for the continuation of covid-19 pandemic. Broadly we can look at the epidemiological triad i.e. agent, host and environmental factors.
Setting and design – Different aspects of Covid -19 structural variations (see table 2) and its effect will be analysed. Brief details about epidemiological triad will be outlined. All the triad of epidemiology is detailed (see figure 1) to tackle the pandemic in proper way.
Agent coronavirus is having continuous variations one of the factors responsible for the ongoing covid-19 pandemic. These viruses have crown like appearance produced by club shaped projections that studs the viral envelope. The coronavirus group actually infects a wide variety of animals of different species. These are divided into three antigenic and genetic groups.
Methodology – Beside host and environmental factors the cause of perpetuation and increase in number of Covid -19 cases and deaths can be understood by the way SARS (SARS – CoV) CORONAVIRUSES is causing human infections. They fall in group 1 and 2. The old human isolates were HCoV-229E and HCoV-OC43. SARS-CoV-2 was earlier considered to be a novel group of viruses (novel coronavirus, n covid-19) but now they are placed in group 2 (SARS-CoV-2). The covid-19 virus has shown variations. There are variations and mutations see table-2 which is taken into consideration added with host factors and environmental factors.
Result- Several factors are responsible for the continuation of the pandemic. Of great concern today is a new ‘double mutant’ B1617 variant, identified in India last year, that is spreading across the country as well as triple variants discovered recently and studies are going on to know more. Although scientists are still investigating whether or not the variant is more deadly & more infectious, it does contain the L452R mutation that affects the virus’ spike protein. This protein is very significant because through this the virus hooks on to our cells receptor. Early research suggests that this mutation makes the virus more infectious. This doesn’t necessarily mean that the variant will be any more deadly, but it means that more people are at risk.