BENGALURU: With the emergence of the Omicron variant of the Covid-19, eminent virologist and nodal officer the INSACOG lab at NIMHANS, Dr V Ravi, who also heads the genome sequencing committee, says that the answer to whether the Indian SARS-CoV-2 Genomics Consortium (INSACOG) is doing its job, is a resounding ‘Yes’. It is important that sequencing is done to pick up the variant quickly and the labs are doing just that, he stressed.
What does the finding of the Omicron variant mean to India?
It means three things — a) Reminder that Covid is still around and everybody has to follow Covid-appropriate behaviour; b) It’s nature’s way of reminding you to take two doses of vaccine; c) Nobody is safe until everybody is safe. We live in a global village. Vaccine access to countries that do not have access should definitely be given.
What makes Omicron different from Delta?
It is different from all other variants for the simple reason that it carries mutations from Alpha, Beta, Gamma and Delta in one bag. In fact, here’s a candidate for the first time in the last nine month’s that’s challenging the Delta variant. Omicron is like Usain Bolt amongst all the SARS-COV2 variants which can spread faster than the others, primarily because it took advantage of all the other variants.
How concerned should we be about this variant’s mutations?
Credible data within Africa showed that from early November, cases from single digit percentage jumped 60-80% in all genomes. Delta is considered seven times more infectious than its predecessor but even that did not rise in such fashion. The virus will be isolated in the next one week.
Once we have it, then cell culture experiments comparing infectivity of variants will be done and then we will know how much more infectious this is.
Secondly, the other way of establishing infectivity is by determining the R-naught value (how many people get infected from one person).
Also, this variant has 50 to 52 mutations, of which about 28-32 are in the spike protein and 10 to 12 are in the region where the virus binds to the human cell. Omicron is the best key that we have today.
What will be the severity of illness?
An honest answer is nobody knows, as there are no published scientific reports yet. Overall, it all looks like the illness spectrum is like Covid caused by any other variant.
A majority are mildly symptomatic, a few have mild to moderate symptoms. No deaths have been reported so far among those with severe symptoms.
Fingers are being pointed at INSACOG for not sampling enough?
In this pandemic, whenever there is an outbreak, the first to be blamed is the virus and the next is the virologist. Alpha was declared as a variant of concern in late November or early December.
The Centre set up INSACOG on December 25, the NIMHANS lab in Bengaluru identified the Alpha variant for the first time on December 26. INSACOG identified the Delta variant for the world. Two days after Omicron was declared as a VoC, Karnataka picked it up.
Wasn’t that fast enough? Has it missed a variant? Why should every sample be sequenced? Wearing masks and taking vaccines is the answer.
The Bengaluru doctor had no travel history. Is Omicron already in the community?
I can only tell you that it is very reminiscent of the first wave — the Nanjangud case with no travel history. There was a missing link.
Here too, there is a missing link. We will have situations like this. If this missing link had entered India, or Bengaluru or Karnataka sometime late October or early November, we should have seen hundreds of clusters.
A single swallow doesn’t herald the summer. If, in multiple cities or districts you see it with a similar background, then I would say it’s in the community.
What steps governments should immediately take?
Government should continue to be aggressive in pushing the vaccines. There are challenges. If you take any immunisation program, the first 70-80% is easy because people come forward and take the vaccine. The last mile is always difficult to walk. you have to make the vaccine available to them. They neither have the inclination nor the time nor resources to come to a health care centre and face the challenges digitally of registering and then getting the vaccine. We have to really put our heads together and find ways of getting the vaccine.
More importantly, for those who have taken the first dose, the second dose should be given. One dose is easy second is very difficult but we need to do it.
Government should go on appealing to people that covid is not gone and they should also lead by example of not having events where crowding takes place.
What's the urgency for the vaccine booster dose?
What does one expect from a vaccine? If you look at the history of viral vaccines then it should prevent death and serious illness. Irrespective of which covid vaccine we are talking about, they are all doing this. Ideally, it should prevent infection. Show me evidence that those who have had breakthrough vaccination, is there any compelling evidence to show that they are having a more serious illness and they are dying. The answer is No. Who told you only antibodies are a marker of protection. There is something called cell immunised protection. Why are we forgetting that one of the fundamental duties of the human defence system is memory?
I understand elderly, healthcare workers, immune-compromised are important. But you have to wait in this situation. I am told the govt of India is still looking into it. we have to wait. Let's not ape what the west does. They have resources they will go on immunising. This debate will continue. It should continue. I think let's wait. Let's look at whether giving booster is a solution to manage omicron? Let us wait. We all know for one year, the immunity lasts. None of this in this country have finished one year of the first dose.
Remember, this is not the end of the world. This is the beginning of a long journey with several road humps. we should learn to live with it and manage it. It is not in nature's hands. We have to wear masks, get vaccinated, avoid crowding in closed spaces, follow all COVID norms.