Introduction 

Towards the beginning of 2022, India has steadily been increasing the number of vaccinations it is deploying, with around 70% of the population having received at least 1 dose. As time goes by, we have heard time and again that the virus (like all viruses) will evolve and lead to possible new variants.

During the pandemic, countries around the world have seen surges in cases and deaths during certain periods, these are typically called waves. Omicron was the cause of the third wave in India and overtook most previous variants to become the dominant strain. Now the question remains, when is the fourth wave coming?

A wave can also be referred to in some cases as a surge or outbreak. Covid has many waves due to mutations in virus which is evolving at a faster rate than any other virus seen before. Waves can improve dramatically by reaching levels of immunity in human populations with immunisation. Unlikely there will be a 4th wave.

Dr. M.G. Kartheeka, MBBS, MD

What experts say about the fourth wave?

There isn’t a clear consensus on when or how the fourth wave of Covid-19 is likely to play out in India. We have seen that although Omicron was much more contagious than previous variants, the peak numbers of positive cases during the third wave have not been drastically higher than the second wave. This may be due to several factors such as increased vaccination and fewer people getting tested (since Omicron may only show mild symptoms in most people). 

But some experts think that just because we have been lucky with the Omicron variant, we cannot rely on luck going forward. There may be future coronavirus variants that evolve from the Alpha or Delta lineages, resulting in a deadlier and more contagious variant down the line. This could easily become the dominant strain and overtake Omicron, should it occur. 

Others believe it is impossible to say with any accuracy what the effect will be since there are many factors to consider. The transmission rate and fatality rate are two important factors that will need to be analysed before we’re able to see how a new variant will spread and affect the population. 

The role of vaccines in the fourth wave 

More and more evidence is mounting that vaccinations (whether 1st dose, 2nd or booster) have been able to suppress the fatality and hospitalisation rate in the general populations. It remains our key defensive measure on the largest scales, as well as our hope of exiting the pandemic. 

During the first and second waves in India, virtually nobody was vaccinated. While during the third wave, the country was still undergoing its massive effort to vaccinate its huge population. As it stands in the first few months of 2022, India has given at least 1 dose to 70% of its population, with around 58% getting at least 2 doses. These factors may affect how the fourth wave unfolds. It also needs to be accounted for whenever statisticians and epidemiologists are trying to model what a potential fourth wave looks like in the future. 

Vaccinations and booster shots may or may not help to curb a rapid spread of a new variant, this is yet to be seen.

Is a fourth wave inevitable?

While a fourth wave is not inevitable, new variants of the coronavirus are inevitable. The WHO and many medical bodies around the world have repeatedly stated that Omicron is not the final variant, nor will it be the most contagious. Viruses are naturally evolving organisms, every time they spread there is a chance of a new variant evolving. But not all variants evolve to become deadlier, not all evolve to become more contagious. 

There is a possibility of a deadlier variant evolving, but there is also a possibility that this won’t happen. Regardless of this, we need to be more vigilant and ensure that we use whatever tools and protocols we have to halt the progress of the virus. 

Some experts have suggested that the fourth wave (if it occurs) could happen as early as June 2022 and peak during August. Until we know the details of the new variant, it’s hard to accurately say whether this prediction will come true.

Conclusion

Newer variants are almost a sure thing when dealing with viruses, but a fourth wave is something we cannot predict. We can’t really know the scale of a fourth wave spread, nor its effects on the population. All we can do for now is remain calm, follow the protocols and keep vaccinating as many people as possible. If you are eligible for a booster shot, go ahead and book your slot. Till then, let’s hope for the best and follow the usual precautions like mask-wearing and regular hand washing.

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