After a long Covid-induced hiatus, as many in India were finally getting to draw up plans for a festive season that runs high on its social mixing and mingling component, Maharashtra reported new variants of Omicron. What emerged were all the algebraic and alphanumeric descriptors – XBB, BQ.1, BA.2.3.20 and a statistic on more number of cases – about 17 per cent. What now?
The obvious questions: How sick is it going to make people? How easily will it spread? And will the vaccines protect against them? Finally, will this mean a return back to the dreadful days of isolation yet again?
Financial Express Online reached out to the Dr Gagandeep Kang, the lodestar to many in the virus tracking arena though professionally known to most as the virologist and professor at the Christian Medical College, Vellore. Her most telling comment and perhaps crucial for many is that “India needs to stop the hype on COVID though it needs to maintain vigilance, especially enforce the well-articulated guidance it has on testing, implement completely, correctly and in a timely fashion its surveillance programme.” Since most in India have either have had the infection or have been vaccinated so chances of them developing severe disease is limited. The only caveat, Dr Kang, is very particular about is protecting vulnerable people – especially the very elderly or those who are on special medication say on cancer therapy, people with low immunity should all avoid crowds and the caution for them continues while the rest could get back to normalcy, which, as is evident, has already happened and could stay so.
It is therefore perhaps with good reason that she says, “It is now time to pay less attention to COVID-19 among the public and let the government figure out and implement its strategy and stay vigilant about variants.” While the risks of developing severe ailments may be low for many, it is not as if there is no need to keep track of the virus. To measure severity, she
says, it typically involves tracking all the severe respiratory disease cases coming into hospitals and figuring out what proportion of these are due to COVID-19 and the proportion that is on account of flu and then from those that figure in the COVID-19 basket “look at the proportion of cases due to the new variant over others and all of this needs to be done consistently overtime so that data are not misinterpreted.”
As for the new variants, she explains, “for any new variant you need to understand the severity of the disease and specific to that variant and we do not have that information as yet. We may get it at some point and perhaps may also come from other countries. Mere mention that there are X number of more cases does not convey anything and it could well be a factor of how much of testing is being done.” What is crucial, she says, is an understanding of the severity and the first step in this is to understand what is contributing to that increase in cases. Then, looking for severity. On what to make of the new variant and their multiplicity, Dr Kang says, “there is no evidence so far that any omicron variant causes more severe disease. So far, of all the variants that we have seen, delta has been the worst in terms of severity.”
As for the numerous variants, she says, “it is like some bushes have lot of branches and some have less branches. The omicron family seems to be putting out lots of little branches that make sense because it is only trying to evade the immune response.”
One learning from the past experience, she says is that the old vaccines do protect reasonably well and those who have been previously infected by omicron tend to have a slightly better hybrid immunity (a combination of natural immunity and vaccine-triggered immunity). In fact, she points to details that have emerged in the last couple of months and a publication in the New England Journal of Medicine which says that if you have had an omicron infection then you have better protection than if you were infected with older types of virus.
As for the newer updated vaccines made available abroad by Moderna and Pfizer and if people now need to get a booster shot with these. In medical jargon, described as ‘bivalent’ mRNA vaccines, these are meant to provide protection against the older strain and the omicron. These, she says, provide only marginal benefit but it is not as if the whole population needs to take them. Those who can afford and want that extra protection could go for it. And perhaps it could be considered for the really vulnerable sections of the population.