The death toll is 55 in the current surge which started January this year, primarily among individuals with pre-existing illnesses, according to the Union Health ministry.”People with pre-existing illnesses and those older than 65 should follow standard precautions, as they would against any other respiratory infection — not just for COVID-19,” explained Lahariya, a consultant physician and former staff member of WHO.Kerala is the most affected with over 1,600 cases, followed by Gujarat, West Bengal, Delhi and Maharashtra, ministry data shows.The case surge in India is part of a wider wave impacting parts of Southeast Asia, including Singapore, Malaysia, Thailand and Hong Kong, which have been seeing a rise in infections over the past months.Wastewater surveillance by the Council of Scientific and Industrial Research-National Chemical Laboratory (NCL) has detected presence of SARS-CoV-2 — which causes COVID-19 — in samples from 10 sewage treatment plants in Pune, the Times of India reported.Patterns are similar to those seen in the weeks preceding earlier surges, NCL scientists were quoted as saying.Genome sequencing of samples from India’s west and south have shown links to the subvariants of Omicron — LF.7, XFG, JN.1 and NB.1.8.1.The cases are not severe and there is no need to worry, Director General of Indian Council of Medical Research (ICMR) Rajiv Behl said earlier this week.LF.7 and NB.1.8.1.have been classified as ‘variants under monitoring’ (VUM) by the WHO to alert public health authorities that a variant of SARS-CoV-2 requires prioritised attention and monitoring.JN.1 has been circulating in India since November 2023. The current situation, Behl stressed, is being monitored.Immunologist Satyajit Rath explained that the subvariants driving up case numbers indicate that they are probably better at binding themselves to human cells, despite pre-existing antibodies created in response to a prior infection or vaccination — or ‘infectivity’.”However, the important issue here is not their infectivity, but their tendency to cause severe disease, or ‘virulence’,” Rath, former scientist at New Delhi’s National Institute of Immunology, told PTI.”Since selection pressure among the virus strains depends on infectivity and transmissibility — and not on virulence — there is no reason to expect a steady increase in the virulence of the emerging virus strains, which, in fact, has not at all been seen either,” he added.Moreover, given that the COVID-19-causing virus is now endemic and constantly ‘mutating’ or evolving, ups and downs in infections in the population are expected, the health experts said.”People need not worry themselves until they are informed of a new ‘variant of concern’.VUM is not relevant to the public, but only to public health authorities,” Agarwal said.Lahariya advised the public to gather information from reliable sources and not to forward unverified messages, while Rath suggested that citizens keep a watch for the virulence of newly emerging strains.The experts also stressed on the role of authorities.”National and state governments in India should keep a watch on cases, monitor the trends in new cases and share data widely.The linkage between infections and clinical outcomes should be explored to understand the clinical features of the variants in circulation,” Lahariya said.Rath drew attention to systemic issues that remain regarding preparedness of public health systems and availability of healthcare facilities across sections of the society should a virulent variant emerge.”The catch is, how efficiently, systematically and rigorously are our public health systems tracking virus strains, their infectivity and their virulence, not only for SARS-CoV-2 but for any other infection?” he asked.”Are we making next generation Covid vaccines at all? Are we making them available widely and affordably? Are we even carefully tracking evidence to see how well or poorly the current vaccine-induced immunity functions against emerging strains?” he added.The poor and vulnerable would need special protection “but are masks being made widely and freely available? And if not, we are throwing poor communities onto their own resources even for taking such simple precautions, and that is a systemic problem,” Rath said.
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