Rising COVID-19 cases and new Omicron subvariants put government on alert 

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A steep increase in COVID-19 cases in many parts of the world and an uptick in infections in some Indian states has prompted the Centre to step up disease surveillance and experts to issue cautionary advisories to the public.

Some Omicron subvariants that are said to be behind the fresh rise in coronavirus cases in Europe, the US, Australia, and Bangladesh, China and Singapore in India’s neighbourhood include BQ.1.1, BF.7 or XBB and BA.2.75.2 with immune escape properties.

Sources in INSACOG, India’s COVID-19 genomic surveillance programme, told Moneycontrol that all of these have also been detected in India over the past several days.

“However, it is not yet ascertained whether the spike in cases is due to the new subvariants,” said a senior INSACOG scientist. “Also, what matters primarily now is the trend in hospitalisation patterns which needs to be monitored centrally.”

Union health minister Mansukh Mandaviya chaired a meeting on October 18 to review the COVID-19 situation in the country and directed officials to focus on effective implementation of a surveillance strategy and strengthening genome sequencing for early detection of variants.

In the meeting, he also asked states to accelerate implementation of COVID-19 precautionary measures  and administer booster vaccine doses to all people above 18 years of age.

Administration of boosters has remained abysmally low—only about 21 percent—to those who had taken two jabs of the primary vaccine earlier.

Independent experts like Dr Praveen Khilnani, academic director with the Rainbow Group of hospitals, likened forecasting whether the new variants may cause a fresh wave of infections to predicting the future. Precautions such as wearing a mask, social distancing and mass vaccination need to continue, they said .

Overall, India has been reporting around 2,000 new cases daily over the last several days, but on some days, such as October 14, this figure went past the 2,500 mark.

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Concern among states

The states that have shown a rising trend in daily cases include Kerala, Karnataka, Gujarat, Maharashtra and Delhi. In these states, there has been an uptick in daily infections along with a slight rise in the test positivity rate even though nationally, the rolling average of the weekly test positivity rate remains under 1 percent.

Two of these states, Kerala and Maharashtra, have issued public warnings for people to follow COVID-appropriate behaviour, saying Omicron’s XBB variant had a growth advantage over its parent lineage, the BA.2.75, and had a far greater immune-evasive nature.

Whether it is more severe than existing Omicron variants in circulation is not yet known, the two states have said.

The Omicron BQ.1 and BQ.1.1 strains, which have been dubbed as “dangerous” for their fast doubling time in the US, have also now been identified in India,INSACOG authorities said.

The highly transmissible BF.7 subvariant, which triggered a fresh lockdown in some parts of China last week, on the other hand, has been detected in Gujarat.

Need for caution

Dr Akshay Budhraja, chief pulmonologist at the Aakash Super Specialty Hospital in the national capital, said overcrowding and not wearing a good mask ahead of festivities like Diwali can lead to a generalised spike in cases of respiratory viral infections; a mixed bag of different viruses are circulating at present.

Dr Lancelot Mark Pinto, pulmonologist and epidemiologist with P D Hinduja Hospital in Mumbai, pointed out that periodic surges are to be expected, as are newer variants but what is important is to keep a close track of the pace at which cases spread and the severity of the disease in the people who are infected.

A rise in COVID-19 cases during the festive season, coupled with changes in the weather that facilitate influenza, has led d to many people falling sick.

According to Dr Subramanian Swaminathan, director of infectious diseases at Gleneagles Global Health City in Chennai.

“All of this makes for a lot of viral respiratory illness in the community, but let’s hope that a majority of those who fall ill experience only mild sickness,” he said.