Omicron BF7, a SARS CoV-2 sub-variant, is the dominant strain in China, which is seeing an unprecedented Covid-surge after it ended its hardline ‘zero Covid’ policy. Nature reports that some modelling exercises predict over a million deaths from the disease in the next few months in China—with the likelihood of such a large fatality count coming down with Covid-appropriate behaviour and moderate movement-restriction measures. China, experts say, is seeing a surge primarily because of low coverage of vaccination, including booster doses, among its elderly (a class especially vulnerable to severe morbidity and mortality from the virus), the low efficacy of China’s vaccines, and high susceptibility at the population level due to lack of exposure to the virus, thanks to the zero Covid policy. The paradox is that though BF7 has been reported by 91 countries over the last two years—as per an Insacog expert citing data from the Scripps Research Institute—scientists say it has so far presented little reason for concern outside China. Despite its high infectivity, it has been reported for a very small number of cases, suggesting that there could be several factors retarding its spread potential. Virulence of the main Omicron strain, of course, remains low compared to the Alpha and Delta strains.
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This backdrop, read with the fact that Omicron XBB remains the dominant strain in India where the number of active and new infections is still low, should offer us some comfort. That said, given how population-level vaccine protection is certain to be lower than, say, earlier this year when the Omicron wave hit, and the fact that the possibility of the virus mutating into a highly infective and virulent variant can’t be completely eliminated, we need to stay watchful and pre-empt any ‘spillover’ from China, however low the probability of this is. Moreover, with surges in South Korea, Japan, and the US, where vaccine coverage and previous exposure limiting susceptibility have both been high, India must not get complacent. Thus, the Centre sounding caution in advance is the right step forward. Prime minister Narendra Modi has urged states to increase booster coverage, and enforce mask usage and other Covid-appropriate behaviour. CoWin data shows only 220 million precaution doses have been administered so far, indicating a large chunk of the population eligible for boosters under the national guidelines is yet to receive this. States will need to encourage people through booster drives, even as they ready the necessary treatment infrastructure, from hospital beds to oxygen supply to pre-empt shortages. Even if there is lower virulence this time, a high absolute number of infections, and proportional severe morbidity, could put pressure on the capacity.
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The health ministry has asked the civil aviation ministry to conduct random testing of at least 2% of those arriving from international destinations. If there is a spurt in cases in the coming days, states will perhaps need to do this for domestic arrivals as well. It’s a good sign that the Drugs Controller General of India has approved the country’s first intra-nasal Covid-19 vaccine — iNCOVACC — for restricted emergency use in those aged above 18 years. It’s only the second such vaccine in the world, after CanSino Biologics’ vaccine in China, to get regulatory approval. The government should also work on releasing relevant data on the vaccine which are still under wraps.