BA.2 variety has entire globe on edge, but India need not panic just yet

Western Europe is seeing a boom. China secures Shenzen and prepares health-care infrastructure. Hospitalizations in Hong Kong are on the rise. Is this the calm before the storm for India? The events of the previous several days have caused alarm, and many people are wondering if it will be our time next.
Former US President Barack Obama tested positive for Covid-19 on Monday. The news brought Covid back into the limelight. In India, the hashtag #COVIDISBACK trended on Twitter for a few hours, with the hashtag linking to news reports of China placing the 17-million-person Shenzen metropolis under heavy lockdown.
On Monday, China recorded about 5,300 new coronavirus cases nationally, up from nearly 3,400 the day before, the highest daily amount in two years.

Despite the fact that the comparatively mild Omicron form is driving the spike, Beijing has remained steadfast in its zero tolerance approach regarding Covid. Caixin Media, a Chinese media firm, complained about China implementing stringent limitations. “China Tightens Covid Controls,” shouted the headlines. “Local governments have declared lockdown areas to prevent the virus from spreading in the severely impacted provinces of Yunnan, Jilin, and Guangdong,” it stated. Covid-19 outbreaks have been reported in more than 20 Chinese locations since the beginning of the year.”

According to Chinese health officials, the increase is being driven by the Omicron BA.2 “stealth” subvariant, the most virulent lineage of the SARS-Cov-2 virus to date.

WHAT IS BA.2 LINEAGE?

BA.2 is a sublineage of the fifth variety, Omicron, which was discovered in South Africa last November.

According to the World Health Organization, the increase is not restricted to China and Western Europe.

Why are several European nations seeing a resurgence of infections? Global health specialist Eric Topol attributes this to inadequate mitigating efforts, increased transmission of BA.2, and diminishing immunity.

He, however, ruled out a new variant at this stage, tweeting, “There’s no clear or consistent pattern to determine which (or all) of these factors are driving it; no new variants have been implicated.”

Former Biden White House Sr Advisor, past head of Medicare/Medicaid for Obama, Andy Slavitt tweeted saying the US is next. “Based on European case increases, the US could see a new rise in Covid cases over the spring,” he said.

WHAT IS GOING ON?

According to experts, the coronavirus is constantly evolving, introducing beneficial mutations and removing harmful ones – even within particular sublineages of the Omicron type.

“This is almost like a tree branch that is always developing,” said Dr Rajeev Jayadevan, Head of Research Cell at the IMA-Kochi.

WHY IS INDIA NOT WITNESSING A SURGE?

“In China, the situation is that they have very little hybrid immunity – unlike India. This means that even though they are vaccinated to a large extent, we know that vaccine protection against infection only lasts for a few months, even though protection from severe disease lasts long term,” Dr Jayadevan said.

In contrast to China, India had a fatal second wave in the summer of 2021, and infection acquired immunity combined with increased vaccination numbers provided us with the benefit of hybrid immunity.
Dr Narendra Kumar Arora, head of the Covid-19 task group under NTAGI, told India Today that a rise owing to BA.2 in India is improbable. “A new variation will fuel the rush,” he predicted.

Arora went on to say that the sublineage BA.2 was responsible for 75% of the cases in India during the third wave. As a result, he feels the IIT-Kanpur study forecasting the fourth wave by June 22 is erroneous.

Dr. Rajeev Jayadevan further claims that China is experiencing an increase since the nation has had difficulty vaccinating its elderly residents owing to widespread disinformation that has spurred vaccine aversion in that age group.

“The situation in India and South Africa is that in addition to ongoing vaccination process, there is a parallel process of natural infection, reinfection and breakthrough infection, each of which is increasing the collective immune memory to the virus in the community. Thus, there was a rapid and sustained drop off in cases after the recent Omicron surge in these countries,” he explained.

IS ZERO-COVID POLICY COUNTERPRODUCTIVE?

Yes, said experts.

“Places like China, Hong Kong and New Zealand that pursued a zero-Covid strategy from the beginning do not have this advantage [of immunity acquired by natural infection],” said Dr Jayadevan. “Thus, they’re relying almost exclusively on vaccine derived immunity, which will not be adequate to cover large sections of the population over an extended period of time.”

Lifting of Covid-19 restrictions in Europe has led to a surge in cases, experts said.

“The slow rise of admissions and hospitalisation, mainly from the BA.2 sub-lineage in Europe, is due to a combination of lax restrictions as well as waning immunity after their most recent vaccine dose. The rise of BA.2 is not exponential because there is still some residual immunity in Europe from BA.1 Omicron wave,” added Dr Jayadevan.

WHAT ABOUT BOOSTERS?

Dr Jayadevan emphasised the principle of diminishing returns in the context of boosters.

“The additional protection gained with every subsequent dose (after the second dose) is weaker than the previous dose. By about 10 weeks of a booster, only about 37 per cent protection is expected from infection,” he said.

It is also for this reason that India is not yet rolling out boosters. Dr Arora says that the available vaccines “do not cover Omicron” and that two doses are good enough to prevent severe disease.

“We are studying data to see if precautionary doses need to be rolled out to the entire adult population” he added.

IS BA.2 MORE DANGEROUS, TRANSMISSIBLE?

According to the WHO, BA.2 has a growth advantage over BA.1, the first of Omicron’s four lineages, but does not produce more severe illness.

WHICH COUNTRIES ARE SEEING A RISE IN CASES?

Denmark abolished all Covid-19 limitations, resulting in an increase in cases. Dr. Giridhara Babu, a well-known epidemiologist, stated on Twitter, “China (data not available), Hong Kong, South Korea, and Europe are at the cusp of the next wave. This time, no excuses.”

He also cautioned against talking about the infection reaching the endemic stage in India. “The narratives of endemicity should stop. Surveillance (both genomic and epidemiological) should be strengthened.”

India has also strengthened its surveillance efforts, with the government now looking at studying sewage for new variants. “The study will start in a week’s time,” Dr Arora.

TRACKING OTHER SUBLINEAGES AND DELTACRON

According to the WHO, multiple sublineages of Covid variant Omicron are being tracked, including BA.1, BA.1.1, BA.2, BA.3, and BA.2.2. Meanwhile, Deltracron, a Delta/Omicron recombinant, has been seen in Israel, France, and Cyprus.

“Pls also see here where we talk about the possibility of recombinants of #SARSCoV2. This is to be expected, especially w intense circulation of #omicron & delta. @WHO TagVE is tracking & discussing.” said Dr Maria Van Kherkhove, Infectious Disease Epidemiologist and Covid-19. The WHO’s Technical Lead stated on Twitter that nothing can be ruled out.