India is seeing a surge in Covid-19 cases, with nearly 6,500 active cases. Consequently, the Indian Medical Association has advised the public to be cautious, but not panic. Anvitii Rai examines the variants on the rise, the steps to be taken by citizens, and why the virus makes a comeback every year
What is the current situation regarding active Covid-19 cases?
As of Monday morning (June 9), India had 6,491 active cases, with 358 fresh cases of the virus being reported in the last 24 hours, according to the Ministry of Health and Family Welfare (MoHFW). Kerala is still the most affected state, with its active cases tally reaching 1,957. It is followed by Gujarat, West Bengal, and Delhi according to the MoHFW data, with the city reporting about 42 fresh Covid-19 cases in the last 24 hours, taking the tally to 728. Since January, 65 deaths have been reported; however, all of these patients had underlying respiratory issues or other comorbidities and health conditions. The current surge of cases in India is driven by new Omicron sub-variants such as JN.1, NB.1.8.1, LF.7, XFC and XFG, known to have shown increased transmissibility. They have been declared by the World Health Organisation (WHO) as ‘variants under monitoring’. The NB.1.8.1 has been behind a recent surge in cases in China, Singapore and Thailand, and has been detected in some parts of Europe and Canada also.
How does the WHO monitor variants?
The WHO classifies variants into three categories—variants under monitoring (VUM), variants of interest (VOI), and variants of concern (VOC). This classification is based on several factors, including transmissibility, severity, vaccine effectiveness, mortality rate, and more, and it decides the response of public health authorities. When a variant appears in one or more Countries, understood as an uptick of cases in the region, it is classified as a VUM. As the name suggests, once a VUM is recognised, it is actively tracked to understand its impact. VOIs are strains that may have a heightened impact on public health, calling for more precautionary measures. VOCs are identified by their assigned greek letter suffix and significant impact on public health and morbidity.
Why is there a resurgence?
Before answering this question, two factors must be kept in mind. One, viruses naturally mutate over time, picking up new strains to evade our immune systems. Two, the spread of such viruses depends on factors such as environmental conditions, immune responses, and human behaviours. For example, there’s an uptick in influenza cases in the winters as, along with the drop in temperature, the air is dry and people tend to spend more time indoors, which is less ventilated. This makes the respiratory tract more susceptible. The SARS-CoV-2 is unique, as it does not have a defined seasonality and tends to mutate quicker than other influenza viruses. The dominant variant in India is JN.1, which is highly transmissible but generally mild. Its impact is not as severe as populations have now been vaccinated and health authorities are better prepared to address outbreaks. Eventually, it will become a part of the normal cycle of diseases such as flu and common cold.
Is there any cause for concern?
Public concern should now be informed not by fear, but by sound understanding. Even major health organisations now advocate responses to the virus being determined by the severity of the strain, which is now better tracked as genome sequencing of the virus has become easier. The current strains have been classified as VUMs and are characterised by increased transmissibility; however, the majority of the population does not need to be concerned beyond basic precautions such as hygiene. That being said, susceptible groups include people with existing respiratory issues, the elderly with comorbidities, and others with vulnerability to infections (such as people who have recently undergone surgeries). The Indian Medical Association has not issued any advisory on booster doses just yet and has emphasised basic precautions such as hand hygiene, avoiding large gatherings, wearing masks in healthcare facilities, and isolating if symptoms like a fever, fatigue, or cough are experienced.
What can governments & citizens do?
Response to covid-19 spikes have improved drastically as compared to its first emergence, with more research data being available. However, seeing that the SARS-CoV-2 virus is unique, it warrants a slightly different approach. Public health authorities must maintain their response systems to the virus, including infrastructure and vaccine stocks, apart from actively monitoring variants and reporting them to the WHO and the Global Initiative on Sharing All Influenza Data (GISAID) on time. Last week, the central government had conducted facility-level mock drills to assess hospital preparedness. Researchers must continue to study the virus and its variants to understand its mutation patterns, which should subsequently be used to update vaccines. Finally, groups more susceptible to respiratory illnesses as well as those with comorbidities should keep up with their medical appointments and vaccinations to ensure that they are not as vulnerable to the virus.
