India reports 10,158 new cases in 24 hours, experts say no reason to worry

India has registered a single-day rise of 10,158 Covid-19 cases, the highest in nearly eight months, according to data released by the Union Health Ministry. The daily positivity rate has reached 4.42 per cent. However, virologists have maintained that the surge does not indicate a wave because the pandemic has reached the endemic stage.

Epidemiologists indicated that the cases are likely to rise for the next two weeks, but thereafter it will subside. Even with rising cases, the hospitalisation has remained low and is expected to remain that way.

The number of active cases has increased to 44,998, as on April 13, 2023 and the country had reported 7,830 coronavirus infections on April 12. The daily positivity rate was recorded at 4.42 per cent while the weekly positivity rate was 4.02 per cent. The active cases now constitute 0.10 per cent of the total infections. The case fatality rate was recorded at 1.19%.

Omicron and its sub lineages continue to be the dominant variants and the prevalence of XBB.1.16 (sub-variant of the Omicron strain) increased from 21.6 per cent in February this year to 35.8 per cent in March. XBB.1.16 is driving the current Covid-19 surge across the country, with at least 50 per cent of the genome sequenced samples testing positive for it.

XBB.1.16 is a recombinant of BA.2.10.1 and BA.2.75 and has three additional mutations in the SARS-CoV-2 spike protein (E180V, F486P and K478R) compared to its parent lineage XBB. The F486P mutation is shared with XBB.1.5.

“We are still in endemic phase and it is not outside what we would call endemic. We do not expect a surge. We are not an island population and keep adding 65,000 additional members per day into our population. They are unvaccinated and are eligible to get Covid-19. This also adds to the cases,” explained Dr T Jacob John, retired Professor and Head, departments of clinical virology and microbiology, Christian Medical College (Vellore).

In July 2022, there were 20,000 cases per day, pointed out John, and it was because Omicron variant is highly infectious. A surge or seasonal outbreak is quite on the cards. “Then, it came down. We are not worried because it is a slow and steady rise. If you look at the spikes, the rise was rapid, unlike now. There is no indication that we are moving into an epidemic phase,” added John, who was also the director of ICMR’s Centre of Advanced Research in Virology.

“During early 2023, we had only 100 cases per day. In the endemic phase, everyone will get infected.

As per our population, we are expecting 20 lakh cases per month and this is within the endemic phase variation. It is akin to seasonal outbreak of influenza and it evens out at the end of the year. If we had a huge susceptible base population then we would had a major outbreak or wave,” explained John.

He pointed out that we will have to keep watching for how long it would take to saturate the entire population. “If it crosses the number of 20,000 cases per month, only then will we have a cause for worry. This is a variant that has been known for almost six months.” He advocated for caution, watchfulness and asserted that it would be good to wear masks in crowded areas.

“People with co-morbidities should complete their vaccine course and we have one of the safest vaccines (Covaxin). Those in authority should ensure that such policies are made and followed,” added John.

According to preliminary results from studies being conducted at the Indian Council of Medical Research (ICMR)- National Institute of Virology in Pune, this strain does not exhibit higher clinical severity. According to the World Health Organisation, global laboratory studies on the sub-variant also do not show increase in disease severity.

WHO’s latest epidemiological update stated, “...till March, 712 XBB.1.16 sequences were reported from 21 countries. However, so far reports do not indicate a rise in hospitalizations, ICU admissions, or deaths due to XBB.1.16. Further, there are currently no reported laboratory studies on markers of disease severity for XBB.1.16.”

Amidst rising Covid-19 cases, the All India Institute of Medical Sciences (AIIMS)-Delhi has issued an advisory for its staff to follow appropriate Covid-19 protocols after several of them tested positive.

The AIIMS advisory stated, “Must use reusable cloth face cover/surgical mask in the workplace. Ensure proper cleaning and frequent sanitation of the workplace, particularly of the frequently touched surfaces. Cover your nose and mouth with elbow/handkerchief/tissue while sneezing and coughing. Maintain personal hygiene and physical distancing.”

"Gathering especially in canteens must be avoided, a gathering of five or more persons at any place in the office should be avoided. If feeling unwell then should leave the workplace immediately after informing their reporting officers. Such employees should also home quarantine themselves,” read the advisory.

Serum Institute of India CEO Adar Poonawalla said that they had begun re-production of the vaccine in response to the rising cases.

“The company also has six million doses of Covovax vaccine which are available at private hospitals depending on the demand and can be used as heterologous booster doses. The company has taken this

step to ensure that people have the option of Covishield if they so choose,” said Poonawalla.