India has witnessed three Covid-19 waves so far. The first wave, which began in March 2020 and lasted till November 2020, was caused by the Alpha variant of SARS-CoV-2, the second wave, which began in March 2021 and lasted till the end of May 2021, was caused by the Delta variant, and the third wave, which began in January 2022 and lasted till March 2022, was driven by the Omicron sub-lineage BA.1. Since February 2023, Covid-19 cases in India have been rising. The Omicron subvariant XBB.1.16 is believed to be responsible for the surge. 


Will Covid-19 surges keep happening in the future from time to time?


On April 8, 2023, India witnessed the highest number of Covid-19 cases in six months. Due to the rising Covid-19 cases, people are worried if a fourth wave may affect India, and whether such surges will keep happening from time to time in the future, even if the entire population is vaccinated. 


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According to experts, there could still be occasional outbreaks, even if the entire population is vaccinated. This is because vaccines do not provide 100 per cent protection against infection or transmission of the virus. SARS-CoV-2 will keep mutating as a result of which new variants will emerge. These variants could have higher transmission rates than previous variants, and might breach the immunity conferred by Covid-19 vaccines. Also, a large majority of the population does not follow Covid-appropriate behaviour.


“It is possible that even if the entire population is vaccinated, there will still be occasional rises in Covid-19 cases. Vaccines are highly effective in preventing severe disease and death, but they do not provide 100% protection against infection or transmission of the virus. Additionally, new variants of the virus may emerge that are not well covered by the existing vaccines, leading to breakthrough infections. Moreover, the behaviour of individuals and communities can also affect the spread of the virus, such as failure to follow recommended precautions, travelling, or attending mass gatherings. Therefore, it is crucial to continue monitoring the situation and implementing public health measures to minimise the spread of the virus, even after vaccination campaigns,” Dr Anurag Saxena, HOD, Internal Medicine, Primus Super Speciality Hospital, New Delhi, told ABP Live.


Experts have highlighted the importance of adhering to public health measures to reduce the frequency and severity of future surges. The peak of future waves will be determined by the collective efforts of the entire population.


“Even with the entire population vaccinated, occasional Covid-19 surges may still occur due to vaccine limitations and emerging variants. However, widespread vaccination and adherence to public health measures can significantly reduce the frequency and severity of surges and our collective efforts in this regard will decide the peak of the future waves,” Dr Dipu TS, Associate Professor, Division of Infectious Diseases, Amrita Hospital, told ABP Live.


According to an expert, Covid-19 is likely to be a part of everyone’s lives for quite some time. However, “regularly updated vaccines” which target new antigens or variants can reduce the impact of SARS-CoV-2 on public health. The development of antivirals will also help reduce the effect SARS-CoV-2. The expert also highlighted the importance of a sustained and integrated system in India for managing acute respiratory diseases.


“It is premature to declare a definitive ‘endgame’ for the Covid-19 pandemic as there are multiple potential scenarios for how it could unfold and how the acute phase could come to a close. While it is true that Covid-19 will likely be a part of our lives for the foreseeable future, we will need to establish a sustained and integrated system for managing acute respiratory diseases. However, the impact of future coronavirus transmission on public health will likely be less severe due to factors such as broad previous exposure to the virus, regularly updated vaccines that can target new antigens or variants, the development of antivirals, and increased knowledge about how vulnerable individuals can protect themselves during future waves through the use of high-quality masks and physical distancing. Ultimately, Covid-19 will likely become a recurrent disease that health systems and societies will need to manage,” Dr Babina NM, Chief Medical officer, Jindal Naturecure Institute, Bangalore, told ABP Live.


What precautions should people maintain?


While experts have said that there is no need to worry about the recent surge in cases because XBB.1.16 causes mild disease, people must not forget to maintain necessary precautions. 


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Everyone in the country must wash their hands regularly, practise ‘social distancing’ when outdoors, and wear masks, and people who are not vaccinated should get their shots immediately.


“People should keep up with routine hand washing and other public health recommendations like wearing masks outdoors and keeping a distance from others to prevent the spread of Covid-19. Additionally, people who are not vaccinated should think about getting vaccinated because research has shown that it greatly lowers the risk of developing a serious illness and requiring hospitalisation. People should keep an eye on their own health and get help if they experience Covid-19 symptoms or come into touch with someone who has the virus,” Dr Saxena said.


People with comorbidities such as diabetes, heart disease and hypertension must give utmost importance to their health. 


“All the precautions which we were taking when Covid-19 was at its peak must be followed. These include avoiding crowded places and washing hands regularly. It is important for people with diabetes, hypertension and heart disease to take good care of their health. They must follow their doctor's advice very strictly. The new variant is not dangerous, but it spreads really fast,” Dr Sanjay Dhall, Director, Internal Medicine, Max Super Speciality Hospital, Shalimar Bagh, told ABP Live.


It is important for fully vaccinated individuals to get their booster shot, if they have not received it yet. Also, people should be cautious and avoid contact with individuals who show symptoms of Covid-19, which include cough, cold and fever. According to Dr NM, performing yoga and consuming natural herbs can help boost immunity. 


“While there is no need to panic about the latest variant, it is important to remain vigilant. It is recommended that individuals practise good personal hygiene and receive the Covid-19 vaccine, including a booster shot. Wearing a mask and regularly washing hands are also crucial in preventing the spread of the virus. Furthermore, if someone exhibits symptoms such as cough, cold, or fever, it is important to avoid contact with that person. Another way to protect oneself is to boost immunity by indulging in regular yoga practice and consuming herbs like Moringa, Tulsi, Neem, Triphala and Ashwagandha on a daily basis,” Dr NM said. 


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Not only should vulnerable individuals take care of themselves, but also every person must consume a balanced diet and drink plenty of fluids to ensure they have a strong immune system. If every individual maintains precautions and follows the recommended public health measures diligently, the threat of rising Covid-19 cases can be evaded successfully.