COVID case rise concerning but no reason to panic: NTAGI's NK Arora

We have seen a consistent growth in COVID numbers in India, what do you think is the problem?

In the last week of February and first week of March, the number of COVID cases was less than 1,000. Then we saw the Delhi and NCR region cases rise in April. In May, we saw cases across India going past 8,000. We saw that case clustering is taking place in big cities — in Maharashtra, it’s in Mumbai; in Kerala, it’s in Kochi, Ernakulam and nearby areas. Even in Tamil Nadu, Telangana and Karnataka, a rise in cases can be seen. In fact, in the last 4 to 6 days, a rise has been witnessed in other parts of the country.

Is it concerning to see the case rise after enhanced vaccination coverage? Is some new variant responsible? 

In the last four to six weeks, we have seen new Omicron variants getting detected in India. BA4, BA5 and some sub-variants of BA2 are also circulating. These sub-variants of Omicron have a higher infection rate than the original Omicron variant. The case rise may also be there because of this new sub-lineage of Omicron. For a country like India, cases are being monitored minutely and the genotype of the variant prevailing in the population is being checked aggressively. The rise is concerning but people must not panic due to this.

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We have seen the DGCA and several state governments bringing the mandatory mask rule back. Is there a reason to worry?

Wearing a mask has to be seen as a tool of protection even after you are vaccinated. Schools have reopened and migration has taken place to bigger cities — people are travelling. As a result, you can see cases rising in the metropolitan areas. It clearly shows that the COVID virus is in the surroundings and masks should still be mandatorily worn when we go to a crowded place.

We see cases rising at an increased pace compared to the last three months. What is the hospitalisation status of patients?

We have over 99.5% of beds empty. When the case rise got to over 8000, we saw only 10 deaths — though every death is unfortunate, you can see a significant decline in mortality. The disease is not causing serious illness but if we lower our guard, it can wreak havoc. A cautious approach of COVID-appropriate behaviour has to be a part of our habit for another four to six months.

INSACOG has been monitoring genomic surveillance. What will the consortium do, as far as this case rise is concerned? 

It’s only through INSACOG that we have got to know BA4, BA5 and some sub-variants of BA2 are also circulating, through surveillance. We are doing sewage sampling in 40 to 50 cities. We meet weekly to review the genomic situation, and we will do so this week also, to assess the situation.

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In China's capital Beijing, officials have reversed the relaxation because of the outbreak. In fact, in the commercial hub, Shanghai, mass testing is being done to contain a jump in cases. How do you see this?

China’s policy is different from ours. China's infection rate is low by global standards, but it maintains a zero-Covid policy. As far as COVID cases are concerned, from the examples seen worldwide, it’s now clear that local epidemiology is far more important. On the issues of China, I don’t have clarity, so I won’t comment.

Any mathematical modelling or projections for a case rise… how high can it go and when can we see the numbers coming down?

Most cases that are getting detected now are mildly symptomatic in nature and most don’t report infection in the lower respiratory tract. People are not getting admitted in hospitals due to COVID. From a public health perspective, you need to look at three issues: patients getting serious disease, the rate of hospitalisation and deaths being reported. Fortunately, all three are in control right now. The case rise is being closely monitored and analysis is being done.