Men wear protective masks as they ride a motorcycle amid the coronavirus outbreak in Karachi on Nov 16. — Reuters/File

'Has the virus mutated? When is a vaccine expected in Pakistan?': Your questions about the second wave answered reached out to Dr Faisal Mahmood, head of the Infectious Diseases Department at Aga Khan University.
Published November 24, 2020

With the second wave of the coronavirus intensifying in the country and an increasing Covid-19 positivity rate being witnessed, federal and provincial governments have stepped up restrictions to try and control the spread of the infection, including imposing smart lockdowns and shutting down educational institutions from Nov 26.

Earlier this month, a group of researchers in Khyber Pakhtunkhwa recorded the first case of Covid-19 re-infection in the country while a pulmonologist suggested that there is a "new Covid-19 strain which does not show up in tests, is very severe and lasts longer than in the previous wave".

In this backdrop, reached out to Dr Faisal Mahmood, head of infectious diseases at the Aga Khan University Hospital, for some clarification and advice regarding the coronavirus. Here's what he had to say:

Are we going through a second wave?

Dr Mahmood: At this point, it seems we are entering the second wave of Covid-19 in Pakistan. This means that after our rates came down, they have started to go up again and we are probably in the second wave.

We expect that this wave will be slightly different from the previous one. Since it is winter, and we see a lot of cold and cough viruses, it will be difficult to distinguish between Covid-19 and normal respiratory tract infections. It would mean we may need to do a lot of tests.

Our hospitals are already full of non-Covid-19 patients. Previously, our healthcare system had almost ground to a halt allowing us to divert resources to the treatment of Covid-19 patients and this time it may not be possible. However, the good news is that we are much better at treating it and people are more aware and we hope we may be able to manage the patients that do make it into the hospital in time for care.

How are patients different this time compared to the previous wave?

Dr Mahmood: We are seeing the same kind of patients as last time — mostly the elderly and people with other medical problems who are coming into the hospital with severe illness. However, we're also seeing the infection in the entire age range as expected.

We do not feel the virus has mutated or changed. The behaviour of the virus is pretty much the same as it was before.

However, the question arises: why did this virus come back? There are many reasons. When the weather gets cooler, viruses that spread through the respiratory tract tend to spread much more easily. At the same time, we know that people have become very complacent, mask-wearing is at an all-time low, people are now gathering in weddings and other public places which really helps this virus to spread. And when this virus takes a foothold, it really spreads exponentially until something is done.

Is it necessary to quarantine if I have mild symptoms?

Dr Mahmood: Unfortunately, because we cannot really tell [the difference] between a normal cough (the common cold virus) and the Covid-19 virus, if you have mild symptoms it's better to get tested and go into isolation because the treatment for both is different and we need to know if you're contagious and can spread the virus to other people.

Similarly, if you have Covid-19, the duration of isolation is also slightly different than someone who may have a normal cold virus for which not much isolation is required.

So, if you feel you have the infection, if you have fever, body aches, cough, loss of smell and loss of taste, then get yourself tested and go into isolation until your results come.

Have there been cases of re-infection?

Dr Mahmood: Unfortunately, we have seen a number of patients who had Covid-19 in the previous wave and are now coming again with the symptoms and when we test them, they have a very high virus level indicating that they have gotten infected again.

This is a good warning for us that even if you had the infection in the past, keep taking precautions because we don't know how many people who were infected in the past will get infected again.

Read: KP researchers record first case of Covid re-infection

How soon can we expect a vaccine?

Dr Mahmood: We are currently undergoing one vaccine trial in Pakistan and we expect more to come. There are a number of vaccine trials going on around the world. Pakistan is just one of the many countries where the trial of this vaccine is being run. Regardless, even once the vaccine trial ends and we know whether it works or not, we [still] do not expect the vaccine to come to Pakistan for distribution until mid of next year.

I want to emphasise that we need to follow precautions until a vaccine arrives. Even once a vaccine arrives, it will not alone be enough to halt the virus and we will still need to take some precautions to stop the spread of the virus.

Editor's note: The answers above have been edited for clarity.