To the Editor,
The possible use of vaccination certificates to mitigate subsequent waves of coronavirus disease 2019 (COVID-19) in India has been described earlier.1 The third wave has been predicted to hit India within the next few months; hence the Government of India needs to take immediate and stringent public health measures to regulate and possibly avert the predicted third wave of COVID-19. The four-point strategy that needs to be implemented has been delineated below:
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Lockdown and restrictions: As many states in the nation have already given green signals to open public places, it is imperative to notice the appropriate behavior of the public during the unlocking as per the standard operating procedure (SOP) of COVID-19 protocols, which need to be revamped and ethically enforced at the level of the state as well as district administration. Public leniency was one of the primary reasons behind the second wave of coronavirus spread in India. People took it very casually in the month of January 2021, when nationwide daily cases came down to 15,144 only and became reluctant in following the COVID appropriate behaviour (CAB) such as hand hygiene, facial masks, and social distancing.
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Faster vaccine roll-out: A high vaccine coverage is essential before the predicted hit of the third COVID-19 wave so that the target of immunizing the whole nation may be achieved, possibly by the end of this year. Until 18th June 2021, 218.8 million (approximately 15.7 percent of the total population) and 5.0 million (approximately 3.59 percent of the total population) people have been vaccinated with the first and second doses (fully vaccinated), respectively, in India.2 Although a universal vaccine with the concept of “one size fits all” is not yet available across different risk groups, such as pregnant women and children,3 efforts should be made to cover all such groups in field-based efficacy trials and include them in the vaccination programme as soon as possible. In spite of being the largest manufacturer of COVID-19 vaccines, India is currently facing a shortage. To overcome the deficit, the government underwent an amendment in foreign vaccine manufacturer rules, paving the way for other foreign vaccines in the Indian market soon to upgrade the pace of mass vaccination.4
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Mass gatherings restriction: Mass election rallies and religious gatherings can also act as a possible foreseen reason behind the predicted third wave of COVID-19 in India, as they had played a significant role as super spreading events in the second COVID-19 wave. To avoid a further resurgence of the mutated and lethal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, the Government of India should take some strict initiatives to avoid such mass gatherings. Moreover, many religious festivals (Onam, Muharram, Durga puja, Dussehra, Diwali etc.) are lined up in the coming months throughout the nation in which mass gatherings may resurge the COVID-19 in India; hence solitary celebrations should be ensured instead of mass gatherings.
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Enhanced genomic surveillance: The fourth strategic requirement is to enhance surveillance, including sequencing enough viral genomes to identify potential threats from new variants of concern (new variants of the potentially more infectious and/or pathogenic virus) and executing an immediate mitigation plan based on this knowledge. B.1.617.2 or Delta, the SARS-CoV-2 variant (a variant of concern), has been a possible reason behind the second wave of COVID-19 in India. Early identification of such variants by genome sequencing is necessary for the nationwide control of the predicted third wave.5
In conclusion, this four-point strategy may help to mitigate the predicted third wave of COVID-19 in India by implementing lockdown in the hotspot areas, upgrading the pace and coverage of the mass vaccination drive, imposing restrictions on political rallies/festivities/weddings, or other crowd-gathering events. In addition, there is also a need to put some strict COVID-19 appropriate protocols in action and enhance the surveillance to better track the coronavirus strains. Finally, the success of any strategic plan can only be achieved through the collective and coordinated efforts of the public and the administration.
CRediT authorship contribution statement
Om Prakash Choudhary: Conceptualization, Data Curation, Visualization, Writing - Original Draft, Writing - review & editing. Priyanka: Conceptualization, Supervision, Writing - Original Draft, Writing - review & editing. Indraj Singh: Supervision, Writing - Original Draft, Writing - review & editing.
Ethical approval
This article does not require any human/animal subjects to acquire such approval.
Funding
This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Declaration of competing interest
The authors have no conflicts of interest relevant to this article.
References
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