With a fresh Covid-19 spurt in China, Japan and the US ringing global alarm bells, India too has got into a fighting mode. China is grappling with a massive surge in Covid cases after letting go its zero-Covid strategy. The current surge in Covid-19 infections in China is believed to be driven by the BF.7 sub-variant of Omicron. Infections have risen in many other countries including Japan, South Korea, Brazil and the United States.
While the new variant has been found to be highly transmissible, it is reportedly not very infectious. The image of Union Health Minister Mansukh Mandaviya chairing a high-level meeting of officials – all seated with masks –brings back memories of the days when masks had become mandatory. For the last couple of months, all the Covid protocols like social distancing and mandatory masks have been eclipsed. The number of cases dipped, may be because the testing took a back seat. The disease is apparently no longer dreaded. The infection curve in India became almost flat.
A fresh wave?
The three scenarios that could drive a new wave are highly infectious new variants; free movement and crowding of people with existing variants or strains of virus; and large number of unvaccinated people. A new wave can be precipitated by waning immunity among people, emergence of a more transmissible variant and relaxations in Covid appropriate behaviour. The virus has mutated and evolved ever since the first wave of the pandemic. The new variants are less virulent than the earlier ones. However, the fact that the original formula of existing vaccines may not be matched for the new circulating variants, could pose an even greater danger to the seniors and those with a weakened immune system.
Four cases of Omicron sub-variant BF7, apparently the strain that is driving the current surge of cases in China, has already been detected in India. There is a need to monitor in real-time the dynamics of the transmission of this variant in China and the proportion of its various sub-lineages and new strains with potentially altered biological characteristics, including their clinical manifestations, transmissibility and pathogenicity.
Way Forward
Vaccination is key to controlling the epidemic. The hybrid immunity developed by vaccination actually helped the Indian population minimise the spread. But the current concern is that the vaccination programme has significantly slowed down. Vaccine development in India has done reasonably well especially on the technology transfer needed for making vaccines – both viral vectors and protein-based. But a lot more needs to be done. India must now update its vaccines for the new variants. For this India must spruce up its research and build a more robust infrastructure for vaccine development.
The immunity booster programme with additional dose in the country wasn't very successful because of a very low penetration. The availability of boosters should be broadened to all hospitals in the rural areas. The vaccination drive should be taken closer to the people at the community level by creating satellite vaccination centres near rural villages.
India should also initiate another precaution dose after the booster dose especially for the vulnerable population to tackle the new set of variants. A strategy needs to be outlined to check the incoming cases at the international and domestic airports. There should be new guidelines for the travellers from abroad.
We need a multi-pronged approach of surveillance including sampling at the point of entries into the country. Genetic sequencing must be used on a large scale to examine the spectrum of variants. The government should gear up the whole genome sequencing of positive case samples. This will help in tracking the new variants.
The strategy should be a blend of scaled up public health infrastructure, clinical and genomic surveillance, Covid appropriate behaviour, keeping the people updated on the evolution of the virus, expansion of testing, agility in policy building and communication management. It will take some time before the pandemic is tamed. The main lesson learned from the pandemic is that the country should be always prepared for any kind of health emergency. For this, there is a need to spruce up the infrastructure of our health ecosystem. The earlier, the better.
— The author Dr Vanita Srivastava is an independent science and health writer
Read her previous articles here
(Edited by : CH Unnikrishnan)
First Published: Dec 22, 2022 2:00 PM IST
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