 Last week, the highest number of COVID-19 cases were reported so far in the pandemic, said the chief of the World Health Organization regarding the first week of the new year. In the same period, India witnessed a six-fold rise in the COVID-19 cases compared to the previous week. The steep rise in cases was primarily due to the case surge in urban centres. Chennai recorded more than 17,000 infections in one week. It is a 350% increase compared to the previous week. The city recorded more than 6,000 fresh cases on January 9. The number was only around 850 a week ago on January 3. This 50% of what Tamil Nadu loved. In the same period, the fresh case count shot up from over 1,700 to nearly 12,900 in the state. Simultaneously, the active cases in the state rose from more than 10,300 to over 51,300. While the test positivity rate rose from 1.4 to 7.9 in a matter of 7 days. The R0 or the average number of people every COVID positive person infects is 4 in India. Experts say that for the daily infections and fresh cases to come down, the effective R must go below 1. All this data points to only one thing, an enormous speed in the spread of COVID-19 infection. Former Tamil Nadu Director of Public Health, Dr. Kolandya Swami, explained about the spread of the disease at the present stage. During the first wave and during the second wave, we have seen the time duration. There is a gap between the waves in one country and another country. So it all happened in China, then subsequently we have seen in Europe, UK and America. So then followed by it happened in Maharashtra, Delhi and Tamil Nadu, Kerala. Then the same way, the second wave. So now also the same wave. So what is happening in America in Europe for the past one or two months is now happening in India. So the epidemic, the third wave is in different phases in different parts of the world. And even if we take India, it is in different phases. In Tamil Nadu, usually the Chennai and then other major cities like Coimbatore, Madurai, Tirumalveli. This way the pandemic progresses from one place to other places. So now here the current reason for the third wave. So the Omicron which is a variant of these SARS-CoV-2, that is the COVID-19 virus. The infectivity of this particular variant is very high, 5 to 10 times higher than the other variants of the COVID-19. So the reason is it multiplies more in the upper respiratory tract and including the throat. So the viral load and the virus which is usually in cough or talking or speaking. So the virus, the quantity of virus which is spreading through the air and all reason why the amplitude is very high. So and also the infection, the people who had been infected by COVID-19 earlier and those people who had been vaccinated with the two doses. So the reinfection and breakthrough infection occurs in these people. But among these people, the Omicron is very, it appears to be very, very mild. And at the same time, the people who have not been immunized or partially immunized, they received the first dose, not received the second dose, received, not at all immunized with at least one dose. So these category of the people and particularly 50 plus and with the comorbid conditions, severe comorbid conditions, they are at a particular risk. Such people will be the most affected people during the third wave when compared to the other category of the people. The numbers we can divide into two categories. So one is the severe category and mild category. As we have already explained, the milder form will be among the vaccinated people and the COVID-19 recovered people. The severe form will be 50 plus comorbid conditions. So the hospital will be full of such kind of people. So that proportion of the people will be suffering more. That is the main thing. So then recovery rate also will be because of their comorbid conditions at age. Recovery rate also may be the mortality rate from 1%. So now it may, if we include those category of the people, then mortality rate may go up when compared to the first wave and second wave. So that is the real challenge that we will be facing during the third wave. There is much discussion about the Omicron variant being a mild one with limited symptoms. But is it mild for everyone? Can we afford to be wary of its spread? Moreover, amidst the third wave, what does that take for the much spoken about booster dose? In Singapore, people did a study analysis about the immunity status of the people who had been infected with SARS-CoV-1. But earlier it got to be known as SARS. Now it is being named as SARS-CoV-1 and this COVID-19 is named as SARS-CoV-2. Even after almost nearly about two decades after the infection with the SARS-CoV-1 in 2002, these people are still having the cell-mediated immunity. They are having robust immunity against the SARS-CoV-1. Here in the case of the COVID-19, the immunity developed by the natural infection and the immunity developed by the vaccines is long-lasting. Antibodies are not the only tool to measure the immunity level. So there is another component of the cell-mediated immunity where the cells remember the foreign antigen. So the moment a new infection occurs with the same virus, the body responds in a better way to overcome the infection. So that is why the Omicron is mild among the people who had been infected by the Omicron variant. But it is already people are seeing it is very severe among the people who are unvaccinated and partially vaccinated. Immunologist Satyajit Rath further explains the repercussions of an unvaccinated or partially vaccinated population while simultaneously having a population that is highly immune to the virus. Whether we have the drive or not is almost rendered irrelevant by the apparent fact that we don't seem to have a special focused set of policies to address the problem of the unvaccinated. All of us should remember that the unvaccinated are not simply random individuals distributed in communities. The unvaccinated tend to cluster as communities, as communities of the marginalized, as communities of the underprivileged in places like the United States, the communities of the irrational conservatives, the irrational conservative radicals, whatever you call them. All of these are communities in which the, in which virus populations can grow enormously, both in terms of rapidity, as well as in terms of generating potential virus variants for future selection, and so on and so forth. So focusing on the unvaccinated and completing their second dose vaccination and where necessary first and second dose vaccination is going to take specifically design policies. Whether we have the drive or not, we don't seem to have developed policies or at least they're not heard of in the public domain. This is one major issue that I think across the world and particularly in India we are deficient. The second issue connects to this point about communities remaining unvaccinated. And when communities remain unvaccinated, what we are doing by allowing communities on the one hand to remain unvaccinated and on the other hand creating hyper immune communities. These living cheek by job with booster doses is allowing a growing virus population with all the potential variants included in it to be repeatedly tested against the hyper immune population so that future true immune escape variants. acquire the likelihood of emerging in all these, however, in all these terms therefore inclusive approaches are absolutely essential. And what that means in vaccine terms is that we should not be in a situation where we are thinking about vaccinating on the ratings, vaccinating with additional doses, those at high risk such as healthcare professionals, and completing the basic vaccination should not be either or situations, our vaccine manufacture, our vaccine supply, our vaccine distribution and our vaccination implementation systems need to be geared to deliver all of these simultaneously. This is a context where it's important to underline Cuba. Everybody talks about not having enough vaccines, not having enough resources, not having this not having that. Cuba has fully vaccinated more than 80% of its population, including children with homegrown vaccines and the major major distinction is not that vaccines were invented or designed in public sector research organizations that is true the world over. The major differences that Cuba provided public sector manufacturing seamlessly connected to vaccine development to make deliver and implement vaccination campaigns on scale.