India must act early to escape Omicron threat; utmost caution needed right now

Though the third wave of COVID-19 in India is delayed and experts say its severity would be much reduced compared to the first and second, if at all it strikes, we cannot afford any slackness in guarding ourselves. Scientists have just discovered a new more infectious and virulent variant in South Africa which they have named as ‘Omicron’, and the World Health Organisation (WHO) has put countries across the world on alert. Omicron has crossed the boundary of South Africa to Botswana, Belgium and Israel, and we will know more when findings from other less transparent countries are disclosed.

Though we do not know the exact level of threat Omicron presents right now, there is a fear that the key (32 mutations on its spike protein) it uses to unlock human body’s cells may render antibodies from previous infections or vaccinations too weak to counter the progress of this new variant. The interaction of this variant with other aspects of the immune system, such as T-cells, or its severity on health or even its impact on our present course of treatments, is under investigations, the findings of which would be known in the coming weeks.

Omicron was first reported to WHO on November 24, 2021 from South Africa, where the epidemiological situation has been characterized by three distinct peaks in reported cases, the latest of which was predominantly the Delta variant. In recent weeks, infections have increased steeply, coinciding with the detection of Omicron, the first known confirmed infection was from a specimen collected on November 9. The Technical Advisory Group on SARS-CoV -2 Virus Evolution (TAG-VE) was convened on November 26 for further assessment.

The preliminary evidence suggests an increased risk of infection with emergence of the new variant as compared to other strains, such as Delta that had ravaged India during the second wave of the pandemic. Moreover, the peaks of Omicron have seemingly something to do with the Delta variant, and it should be a major concern for India at a time when almost all sectors of the economy are opening, and people have just begun enjoying an early return of normalcy. Therefore, India needs to guard against Omicron, and take action now rather wait for further details, more than that is already known.

Though the current PCR diagnostics continue to detect this variant, several labs have indicated that for one widely used PCR test, one of the three target genes is not detected (called S gene dropout or S gene target failure) and this test can therefore be used as marker for this variant, pending sequencing confirmations. Using this approach, this variant has been detected at faster rates than previous surges of infection, suggesting Omicron having growth advantage, the WHO has said. Currently the number of cases in South Africa is increasing fast in almost all provinces. Therefore, countries across the world have been asked to enhance surveillance and genome sequencing efforts to better understand Omicron, which has largely affected young people with low vaccination rate.

Information about Omicron is, however, limited at present, as the WHO’s COVID-19 technical lead, Dr Maria Van Kerkhove, has said. Yet, we do know this variant has a large number of mutations, and the concern is that when you have so many mutations it can have an impact on how the virus behaves, she added. It will take a few weeks for us to understand what impact this variant has, since researchers are currently trying to determine where the mutations are and what they potentially mean for diagnostics, therapeutics, and vaccines.

In the meantime, the WHO has urged all countries to adopt a risk-based and scientific approach to travel bans. This advisory has come after Britain, France, and Israel had already cancelled direct flights from South Africa and surrounding nations.

There are two levels of advisories from WHO – first for individuals, and second for the countries. Individuals are reminded to take measures to reduce their risk of COVID-19, including proven public health and social measures such as wearing well-fitting masks, hand hygiene, physical distancing, improving ventilation of indoor spaces, avoiding crowded spaces, and getting vaccinated. Individuals must make sure to take steps to reduce exposure of the self and prevention from passing that virus to someone else.

At the governance level, the advisory of the countries include four basic steps for the time being.

• Enhance surveillance and sequencing efforts to better understand circulating SARS-CoV-2 variants.

• Submit complete genome sequences and associated metadata to a publicly available database, such as GISAID.

• Report initial cases/clusters associated with VOC infection to WHO through the IHR mechanism.

• Where capacity exists and in coordination with the international community, perform field investigations and laboratory assessments to improve understanding of the potential impacts of the VOC on COVID-19 epidemiology, severity, effectiveness of public health and social measures, diagnostic methods, immune responses, antibody neutralization, or other relevant characteristics.

Under these circumstances, India should speed up vaccination, and ramp up technical facilities. Appropriate precautionary measures must be scaled up now because it is easier than the handling of the crisis once occurred.

(IPA Service)

(Views are personal)