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Year : 2021  |  Volume : 2  |  Issue : 3  |  Page : 62-65

India in second Coronavirus Disease-2019 pandemic emergency: A brief review

Department of Oral Medicine and Radiology, R. R. Dental College and Hospital, Udaipur, Rajasthan, India

Date of Submission25-May-2021
Date of Decision16-Jun-2021
Date of Acceptance26-Jun-2021
Date of Web Publication25-Aug-2021

Correspondence Address:
Tarun Vyas
Department of Oral Medicine and Radiology, R. R. Dental College and Hospital, Udaipur, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpcdoh.jpcdoh_20_21

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In a number of countries, coronavirus disease-2019 is a second pandemic that is progressing fast. When it comes to diseases in India, the rate of spread is incredibly high. There has been a slowdown in the use of multifaceted strategies to some extent. Sadly, the disease is advancing rapidly in India despite all efforts. The objective of this review is to evaluate critically the strategies adopted by the Indian Government to address this second pandemic and to propose appropriate strategies for the current context mainly through the 5 T approach (Trace, Track, Test, Treat, and Technology). Local governments have begun to implement disease containment measures, but to explain the need for a mask, a social divergence, stop mass meetings, voluntary quarantines, and testing, the federal government has an essential role to play.

Keywords: Coronovirus, second pandemic, testing, tracking and treating

How to cite this article:
Vyas T. India in second Coronavirus Disease-2019 pandemic emergency: A brief review. J Prim Care Dent Oral Health 2021;2:62-5

How to cite this URL:
Vyas T. India in second Coronavirus Disease-2019 pandemic emergency: A brief review. J Prim Care Dent Oral Health [serial online] 2021 [cited 2022 Jun 29];2:62-5. Available from: http://www.jpcdoh.org/text.asp?2021/2/3/62/324538

  Introduction Top

According to the World Health Organization (WHO), just over 94 million coronavirus cases were recorded with just over 2 million deaths in the world when they were reported. New, more virulent coronavirus strains that have contributed to a very serious second wave of infections in many countries have emerged as an important concern around the world.[1] India fights the second wave of coronavirus disease-2019 (COVID-19), with its number of new cases and deaths per day quickly exceeding its first wave in 2020. Today, India has the second-highest COVID-19 cases worldwide after the United States.[2] By May 4, there were over 20.2 million reports of COVID-19, with an average of 378,000 daily, plus over 222,000 deaths, which experts think are likely to be considerably underestimated. Hospitals are overwhelmed with the exhaustion and infection of health workers. Social media are full of people desperately seeking medical oxygen, hospital beds, and many other needs (doctors and the public). Yet, before COVID-19's second wave of cases started to rise, Harsh Vardhan, Indian Health Minister, declared that the epidemic was ending in India. The Government's impression was that, despite repeated warnings of the risks of a second wave and the emergence of new strains, India was beating COVID-19 after several months of low cash numbers. Modeling falsely suggested Indian immunity, encouraging complacency, and insufficient preparation, but a January serosurvey suggested that only 21% of population have severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies. Odisha, in this second wave, was better prepared and could produce enough oxygen to export it to other countries.[3]

ASPHER suggests that the second wave may be defined as an incidence rate resurgence during pandemic, cumulatively increasing the number of disease cases over a given time period and a certain territorial area. The second wave could be defined as: this exponential increase is due to the disappearance or nearly disappearance of disease cases and could be influenced by a new behavioral characteristic or modified feature of a newly known infectious agent (Middleton et al. 2020). Vaccines and antiviral therapies are available.[4]

Following different success levels with the spread of severe ART 2 (SARS-CoV-2) or COVID-19, governments worldwide are now seeking public health policy that will enable residence orders to be lifted while infection continues. In previous pandemics, waves of infection and communities were at risk, several weeks later, as we can see around the planet and at home in the states which have reopened in early days, that restrictions are prematurely loosened before effectively flattening the curve of the infection.[5] Since the virus has caused over 119,000 domestic deaths, containment remains an urgent problem.[6]

State governments are examined in other countries' experiences, particularly those that contained the first wave of COVID-19 cases more successfully, and in past cases of infectious diseases, to develop containment strategies to mitigate the second wave of cases involving COVID-19 and deaths. Continued hand hygiene, social dissociation practices, the use of personal protective equipment, and robust contact tracing programs, together with policies at hospital level needed to test critically ill patients for triage and protect staff and patients from infection are certainly the main focus of the recommendations. Policies and programs to curb the spread of diseases spread will require ongoing analysis and review as technologies progress, the surge abates, and the pandemic evolves.

  Testing and Contact Tracing Top

SARS-COV-2 testing started with China's first sequence of the virus in early January 2020. Since then, COVID-19 testing has changed and improved quality rapidly and makes it essential for policymakers to keep up to date with state-of-the-art technologies.

In March 2020, cohort studies estimated that 50%–90% of patients with positive COVID-19 diagnostic tests were asymptomatic when they were tested.[7],[8] It is now estimated that up to 45% of people remain completely asymptomatic during their illness.[9] Researchers are still looking at how much asymptomatic people are releasing the virus and whether they can transmit diseases easily or not.

Molecular tests

The presence of the disease pathogen is indicated by molecular testing (also called “diagnostic” or “antigenic” testing) either through identification of its genetic material or by identifying the pathogen's unique markers (ribonucleic acid or RNA). COVID-19 molecular tests usually require a nasopharyngeal or throat swab that samples the respiratory tract when the virus infects one individual for the first time.[10] The reverse polymerase chain reaction transcription (RT-PCR or PCR) tests detect, detect and amplify specific RNA sequences of SARS-CoV-2 to quantify the presence of a virus in the sample. Both qualitative and quantitative results are possible, and further interpretation is required to determine the viral charge and suspected level of infectivity. The best option to detect COVID-19 during the first 2 weeks of exposure is molecular testing.

However, the body begins to develop antibodies against the diseasing system approximately 11–12 days after onset of symptoms (or 16–17 days after asymptomatic case exposure), and PCR tests make it harder to detect this virus. PCR testing in the most highly infectious, symptomatic, and early symptoms of infection is recommended and is most commonly positive.

Serologic tests

The antibody production is evaluated in serologic tests (also known as “antibody” tests or “blood-based tests” tests) and it is used to determine whether individuals are exposed to the disease. By about 12 Days after the onset of COVID-19, the body began to develop an immune response to three types of antibody: IgA and IgM followed soon thereafter by IgG, or day 16 following the exposure of asymptomatic people. Serology tests of large population will help us understand prevalence, patterns of spread, and risk factors for infected people, in particular the high level of asymptomatic infection, the percentage of people who have been infected with SARS-CoV-2. Serosurveys must focus on vulnerable and marginalized communities to understand better how and why the disease burden is disproportionate.[11]

  Contact Tracing Top

Molecular COVID-19 tests are carried out on a scale that can help governments to curtail their transmission by detecting infections in symptomatic and asymptomatic persons. This is a long-standing public-health process through which a health-care worker helps an infected individual to identify their contacts and then explains to contacts that they have been exposed to an active case of COVID-19 that they also get contagious and ill.[12] Public health personnel work directly with patients in the traditional or manual contact tracing to aid them in recalling their contacts and reach them directly.[13] Contact tracking proved extremely helpful when fear and stigma can lead infected persons to refrain from being exposed to infection.

Symptom screenings

COVID-19 screening staff has become common for symptoms including fever, cough, anxiety, shortness of breath, loss of taste or smell, and nasal or runny nose. While this type of screening helps employers to identify symptomatic cases, however, it does not protect worksites of exposure, as we know that for the majority of cases, they are highly infectious for several days before they become symptomatic. Therefore, temperature checks alone are not protective, as they only screen out those who have this one symptom (more than half of cases do not have a fever during the early, most contagious phase of infection).[14]

Successful containment of COVID-19 may rely on the capability of rapidly identify individuals at risk of COVID-19 through robust contact tracing and adequate as well timely testing. Traditional screening methods that only evaluate symptoms are inadequate, thus a novel approach to track the spread of the virus. New tracking methods should include identification of asymptomatic COVID-19 patients, as noted in the revised guideline of Centre for Diseases Control and WHO. Countries have implemented a digital solution to enhance the traditional contrast-tracing method in combination with novel testing strategies to combat SARC-CoV-2, with variable levels of success. The current diagnosis of active COVID-19 infection relies on RT-PCR and rapid antigen tests. With mass testing, technology may provide an opportunity to strengthen the fight against the virus and return normalcy. Treatment for COVID-19 involves optimal supportive care for symptomatic patients. Oxygen therapy for severely ill patients and advanced respiratory support such as ventilation for critically ill patients are indicated. Home isolation is an option for asymptomatic patients who have very mild symptoms or are pre-symptomatic if they have the necessary self-isolation facilities at their home.[15]

Herd immunity is an extremely serious health-care system prevention and control measure against mortality and morbidity in the context of the COVID19 pandemic. If the herd's immunity should naturally be obtained by exposure to SARS-Cov-2 infection of at least 60% over 5–65 years (84.5% of the population), preparedness for health facilities of economic consequences is essential. Research should be focused on appropriate strategies, challenges identification, and herd-immunity approaches as well as vaccine development. Testing, treatment, tracking, teamwork, and monitoring are the tools for measuring the time it takes to get herds.[16]

Herd immunity can be achieved either through natural or vaccine infections or both at times. The immune threshold of COVID-19 is estimated at around 55% and 82% and vaccine waste above 10% is significantly affected. Vaccine hesitation and rejection of new pandemic vaccines are the main barriers to the use of vaccines. COVID-19 development from the vaccine itself is a challenge with inadequate health and a less educational focus on the efficacy of the vaccine.

Once a safe and efficient vaccine is on the market, primary care doctors play an essential role in implementing a successful vaccination program. As the vaccine becomes available, the community, family, friends, and relatives ask general practitioners for advice on the benefits and risks of vaccination. To get a vaccine as accessible and effective as possible for their patients as soon as the medical centers are reached, they must structure their practices. In addition, primary care professionals should play a major role in educating and reducing the fears of the general public about the vaccine.

For this purpose, primary care doctors must have up-to-date information about vaccines COVID-19, and the rationale behind all immunization campaigns before they start, to maintain confidence and clear communication between providers of primary care and their patients.[17]

As many as possible during the vaccine roll-out, India must reduce transmission of SARS-CoV-2. As cases continue, the government must publish precise information on what is happening and what is needed to bend the epidemic curve, including the potential for federal lockdown, promptly and immediately. The sequencing of genomes needs to be expanded to track, understand, and control emerging SARS-CoV-2 variants. Local governments have begun measures to control the disease, but the federal government has a key role to play in explaining the need to mask, distance society, stop mass gathering, voluntary quarantine, and trials.[3],[18] The second wave spreads much quicker than the first wave. Fast and effective administrative action is therefore required to stop the rapid growth of the epidemic.[19] By 2021, the peak during this period puts students at risk because of uncertainty, with many examinations being delayed for endless periods. At the same time, paradoxically, mass gatherings in religious locations have been reported, festivals encouraging mass participation, political rallies, and even uncontrolled demonstrations are taking place. It shows clearly that there are no or inefficient politics for rationalizing matters to control the rise of COVID-19 cases. In resources-exhausted countries, such as India, it is high time to take drastic action to curb the rapid growth in cases of COVID 19. In a pandemic situation like this, we recommend that a nodal COVID management agency, which oversees the national efforts to fight the COVID-19 crisis, be clearly divided between the central and state governments.[20] As regards the COVID pandemic, the overall health-care system must strengthen in India and no other NCCP – the elimination of COVID by 2050, a single disease committing all national resources. India urgently needs to move from selective primary health care to a comprehensive health model. We only need a national resolution, we have capacity and resources! The time has come for national interest to be protected. We cannot artificially keep ourselves forever vulnerable.[21]


As India is developing country in second pandemic and this environment is best suited for pandemic as mass gatherings in religious places, festivals that encourage mass participation, and political rallies, people have forgotten social distancing and mask wearing. This spread of wave, i.e. the second wave spread more faster than the first wave. Hence, there is a huge problem in the second pandemic and now if we are not following social distancing, wearing mask, and go for vaccination, we will be now facing thread toward the third wave.

Ethical approval

This research did not need any informed consent because we did library research. References and quotations were written based on the journal guideline.

  Conclusion Top

Once the number of cases has decreased, the governments have relaxed and the public have forgotten the health care, the mask, and the social distancing (SMS) they have had to follow and now there is a second wave of corona. People remain determined to abide by the rules. In this way, fines are levied not to wear masks, not to keep safe distances, and to the excessive congregation. People should change their behavior and take the safeguards. Without a change of attitude, there will be no epidemic or pandemic.

Can the government not, in the interest of the Nation, make vaccine compulsory? Can media change its negative attitude and encourage positive vaccine effects? And hammer over and over the COVID safeguards rather than the deaths? These questions are currently unanswered but must be answered. How are you expected to end this pandemic? Or the herd immunity, which is likely to lead to increasing deaths, or the immunity induced by the vaccine in the spread of the chain, should exist. In the meantime, the public must follow the SMS scrupulously and be vaccinated early to save itself and others. The change of attitude of the public is the biggest thing that should happen early; otherwise, no salvage is seen in the near future.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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