Hysteria must not overtake empathy and common sense, said CSIR-IGIB director Anurag Agarwal in an interview with The New Indian Express' Sumi Sukanya Dutta even as the detection of the Omicron variant of Covid-19 has sparked fears of a fresh wave of deadly infections globally.
CSIR Institute of Genomics and Integrative Biology is a key institute under INSACOG, a consortium of several institutions under the National Centre for Disease Control for carrying out extensive genomic and epidemiological surveillance of SARS CoV 2 virus in India. Excerpts from the interview
Q. In your view, why is there so much worry about the detection of the Omicron (B. 1.1.529) variant of SARS CoV 2 virus among scientists and administration around the world?
The Omicron variant is the most highly mutated version of the SARS-CoV virus to date, with 30 amino acid changes, three small deletions and one small insertion in the spike protein. Many of these mutations are at antibody binding sites and are expected to reduce the effectiveness of neutralizing antibodies. Some mutations have also been associated with increased transmissibility in previous variants.
Its rapid emergence and spread has occurred in a population expected to have a high natural immunity, due to a preceding large Delta wave. Also, we have seen examples of transmission between fully vaccinated international travellers. Thus, the limited clinical data so far is consistent with molecular predictions about immune escape potential being high.
I do note here that many calculations about transmissibility being six times higher than Delta have an underlying flaw. Growth advantage against Delta, measured during its falling transmission, is not the correct way to estimate transmissibility because there is likely to be immunity to Delta but not Omicron in the population. Just immune escape can explain much of what we have seen so far.
Q. How prepared is our SARS CoV 2 genetic surveillance programme to detect the variant in India and how do you think it will help the containment measures?
First, our colleagues in South Africa must be praised for rapidly finding and informing about Omicron. I believe there is much to learn from their excellent work, but we are well prepared. Timely sequencing will help in determining seeding of a community and guiding public health measures.
However, I would recommend that we try to screen for Omicron in the initial diagnostic test itself. S-gene target failure of RT-PCR has been used by South Africa to detect its spread, without waiting for sequencing. While those types of three gene kits, containing S-gene, are not readily available to us, we are fully capable of producing them.
Alternate CRISPR based methods are also possible. We should explore all options. I would add here that while there is a need to more strictly follow existing protocols for travellers from higher risk regions, we should not overreact by banning all flights or creating undue hardship beyond what is necessary.
We too have been through the spread of a new VOC and the old proverb of “do unto others as you would that they do unto you’ is a good one to remember. We are all in this together as a global community.
Very bad variants cannot be stopped long-term by simply shutting flights to the few countries that report its presence. Hysteria must not overtake empathy and common sense.
Q. Given the information on the variant we have so far, does a third COVID-19 wave in India look imminent?
If you are asking whether I see something like the second wave happening again, with surges in hospitalization and deaths - no, I don’t see any firm data yet that leads to that conclusion, especially since there is no sign yet of higher severity.
If you are asking whether we will see an increase in new cases in coming months, yes that does seem likely. How much, how fast, how bad will depend upon our choices and willingness to follow reasonable precautions.
Overall, it is a time to be cautious and prepared. We don't need to panic. This is however a good time to consider boosters for people like health care workers and elderly. In my opinion, if we prepare well, we will be fine, with an increase in cases, but not what most people have in mind when they think of the third wave
Q. Can you please explain why the mutation in the virus--which in its earlier forms has already infected a substantial chunk of the global population--still continuing and what does it mean for the course of the pandemic?
RNA viruses do mutate. The large reservoir of infected hosts has allowed SARS CoV2 to evolve further, becoming more infectious. Some of it is a matter of chance but truthfully, the global action to reduce infections in a concerted manner everywhere has been inadequate.
Unfortunately, while the global production of vaccines is enough to vaccinate everyone in the world, a large fraction remains unvaccinated.