The rising cases of Covid-19 in the country—359 cases were added between Wednesday and Thursday morning, with 300 in Kerala alone—should be treated with caution. Even though experts believe there is no cause for alarm just yet, four Covid deaths have already been reported in Kerala and one in Karnataka, giving enough reasons to be on guard once again. JN.1, an Omicron sub-variant circulating elsewhere in the globe since August, is now the dominant strain in a clutch of developed nations, including Singapore and the US, which have reported a surge in new cases. India has managed to detect this in just 21 positive samples so far, against 2,669 active cases reported on Thursday by the health ministry. Given how JN.1 has prevailed over the last highly infective sub-variant reported (BA.2.86) in other jurisdictions, the Centre and the states need to fire up the Insacog mechanism for genome sequencing again, to track strains and connected morbidity/mortality.
Omicron and its sub-variants have exhibited far lower virulence, or propensity to cause a severe form of the disease, compared with earlier variants, though they have all been highly infective. Indeed, the World Health Organization (WHO) hasn’t yet elevated JN.1 to the level of Variant of Concern, from its current Variant of Interest classification. However, whether JN.1 is is connected to the recent deaths must be nailed immediately, and health conditions that played a role assessed. While Omicron sub-variants have shown greater immune evasive capabilities than other variants, there is no evidence of complete immune escape from prior immunity. Indeed, the WHO Technical Advisory Group on Covid-19 Vaccine Composition found that JN.1 was neutralised by antibodies present in those who had received vaccines, irrespective of whether they had had a prior infection or not.
The upcoming holidays and seasonal factors that help the spread of respiratory illnesses need to be kept in mind as India mounts a pre-emptive response to Covid. The Centre has done well to start a stock-taking process to map states’ preparedness to face a worse situation than what is projected at present, involving assessment of oxygen availability, hospital beds, ventilators, support drugs, diagnostics, etc. While the Centre has advised states to ensure the requisite public health measures and adhere to the detailed operational guidelines on the revised surveillance strategy, the latter can perhaps a take a leaf from Karnataka’s book, which has directed senior citizens and those with co-morbidities to mask up. Some onus also lies on the rest of the population—voluntary masking and Covid-appropriate behaviour such as hand-hygiene and maintaining distance can help contain spread, no matter how mild the strain. Covid is endemic and the need is to treat it as such. It is often better to err on the side of caution.
