Former director of the Institute of Genomics and Integrative Biology and ex-chair of the WHO technical advisory group for viral evolution, Dr Anurag Agarwal, says that India will be able to ride the current
Covid-19 surge without increased hospitalisation or deaths. Currently the Dean of BioSciences and Health Research at the Trivedi School of Biosciences, Ashoka University, and head of the Koita Centre for Digital Health, he spoke with Kavita Bajeli-Datt about the evolution and surveillance of Covid. Excerpts:
India is again experiencing a surge in Covid-19 cases. How do you view the latest surge, coming after a brief pause?
Globally, there have been many such surges since the initial Omicron wave. These have all been with descendants of Omicron, and no new variant of concern has emerged. The risk to public health has been low due to the change in the virus and, more importantly, sufficient immunity to protect against severe disease. I expect this surge to follow the same pattern as the rise in infections, with little change in hospitalisations or deaths. So, we should ride this wave, too.
Do we need to start wearing masks, especially those living in Kerala, Maharashtra and Delhi, which are the top contributors?
It is always good to avoid infections, and wearing masks in crowded places with poor ventilation is always a good idea, especially for high-risk individuals, such as the elderly. Whichever place tests more seems to be the highest contributor.
Do you think Covid-19 is now just like a cold and cough and a seasonal virus?
No, it is not seasonal. We see surges at odd times. It continues to evolve and requires more surveillance than a common cold virus.
This time, Omicron sub-variants LF.7, XFG, JN.1, and NB.1.8.1 are leading the surge. How potent are they?
These variants are similar to previous Omicrons, with no significant change in risk.
The WHO has classified NB.1.8.1 as a “variant under monitoring”. Does this variant pose a new challenge globally?
This requires monitoring.
No global challenge is anticipated. Otherwise, the label would have been VOC (a variant of concern).
Do you think the current vaccines and treatments are effective against the new variants? Or do we need to make another vaccine?
These variants are lower-risk but do have more immune evasion against current vaccines. The time it takes to develop a new vaccine is often longer than the time it takes for the virus to mutate further. Only mRNA technology is fast enough, but it has other limitations, including cost. A multi-antigen nasal vaccine would be interesting. Some people are trying.
Hong Kong, which has reported a six-month high in Covid-19 cases, has asked its citizens, especially those at high risk such as the elderly and those with comorbidities, to receive a booster dose. Should India follow suit?
No, India is mostly a young country, and practically, our best solution remains precautions, with very few at risk of severe disease and a low likelihood of public health stress.
Kerala again leads the surge and remains the worst-affected state. Why? Do you think Kerala’s surveillance system and testing strategies effectively manage and control Covid-19?
Those who test more appear to lead the surge in infections. Sewage surveillance in Bengaluru revealed a rise in infections as early as May. I am quite sure that sewage surveillance in much of India would have shown the same if it had happened.
You headed Indian SARS-CoV-2 Genomics Consortium (INSACOG). How vital is genome sequencing for fighting the spread of the virus?
I was a senior member of the team. Genomic surveillance helps understand the threat and take appropriate action earlier. The action fights the spread.
Does India have a robust public health strategy to combat Covid-19?
We have made good efforts for early recognition and preparation. It is enough.