The Financial Times insight into the situation of the coronavirus in India
The disconcerting speed with which the coronavirus has engulfed India’s health systems has triggered a global alarm on the viral variant that has emerged in the subcontinent.
Variant B.1.617 has been blamed by some for India’s wave of infections, which recorded more than 350,000 confirmed cases on Monday alone, a world record for a country in a single day. Health experts believe the true figure is likely to be much higher.
But scientists have urged not to jump to conclusions about the extent to which the variant alone is responsible for the soaring cases in recent weeks, which caused 2,800 confirmed deaths in India on Monday alone. They said there is little hard evidence on the virulence and transmissibility of the Indian variant and point to other possible factors – writes the FT.
“Despite the alarming spike in new cases with the second wave in India, there simply isn’t enough evidence to blame the variants,” said Nancy Jaser, an infectious disease analyst at GlobalData, an analytics company that tracks of mutations. When did the “Indian variant” evolve and how widespread it is
Variant B.1.617 was first registered in a global database of viral genomes in early October, just two weeks after variant B.1.1.7 was originally identified in the UK. B.1.617 has since circulated in India and spread internationally. About 20 countries have reported cases, mainly in travelers from India.
The problem is that, in relation to the size of its population, India has done very little of the whole genome sequencing which is the only reliable way to trace the evolution of variants. The extent of the involvement of variant B.1.617 in the outbreak of India is therefore unknown, although it accounts for about two-thirds of the country’s genomes reported to the global GISAID database.
Jeffrey Barrett, director of the Covid-19 Genomics Initiative at Cambridge’s Wellcome Sanger Institute, pointed out that a number of variants were present in India, including one that originated in Britain.
B.1.1.7, which scientists concluded to be more transmissible, was the dominant variant in the wave of Covid-19 in the UK in late 2020, and subsequently spread to mainland Europe.
“There is some evidence of multiple outbreaks that overlap in India rather than a single monolithic outbreak,” Barrett said. “Which makes sense since it’s a huge and heterogeneous country.” B.1.617 and particularly virulent or transmissible
The original variant B.1.617 has 13 genetic mutations that lead to changes in the virus. These include two in the spike protein that has been linked in other variants (such as those identified in South Africa and Brazil) to increased transmissibility and the ability to escape immunity conferred by previous vaccination or infection. But there is insufficient evidence from either epidemiological studies or laboratory experiments to confirm that this is also the case with B.1.617.
“You have to look at these things without panicking,” Barrett said. “The fact that [the variant that originated in India] has not yet spread [widely] in the UK, even though it has been around since February, suggests that it is not likely to be transmissible as B.1.1.7.”
Adding to the uncertainty, B.1.617 is itself “evolving and diverging over time,” according to Sharon Peacock, director of the Covid-19 UK Genomics Consortium. Scientists have already identified three descendants – named B.1.617.1, B.1.617.2 and B.1.617.3 – with slightly different mutations. The practical implications of these strains are unknown.
References in the media and online to “double mutations” in variant B.1.617 are “imprecise, have no specific meaning and should be avoided,” added Peacock. Vaccines will be less effective against B.1.617 than against other variants
Again, it’s not clear. Vaccines developed to combat the original coronavirus that emerged in Wuhan in 2019 appear to work equally well against the variant B.1.1.7 that emerged in the UK, although they appear to be less effective against strains that originated in South Africa and Brazil.
“Whether they will maintain effectiveness against the new variants popping up in India is not yet clear, but it is. . . they are likely to have at least some effectiveness, ”said Peter English, a retired UK-based communicable disease control consultant.
Since only about 10% of the Indian population has been vaccinated, “the variants are not yet under great pressure from the vaccine immunity, so there is not a lot of pressure for mutants that escape the vaccine,” he added. If the new variant isn’t the root cause of India’s Covid-19 crisis, what else could be responsible
The evolution of India’s coronavirus crisis has also been driven by other factors, including its low vaccination rate and limited hospital capacity, as well as decisions made by leaders such as Prime Minister Narendra Modi, and the tolerance of large political and religious gatherings.
“There has been a lot of attention on variant B.1.617,” said Michael Head, senior researcher in global health at Southampton University in the UK. “But it is the mixing of susceptible populations that ultimately causes the transmission of infectious respiratory diseases.”
He pointed to mass gatherings in India in March and April associated with political campaigns, international cricket matches between India and England “with full stadiums and few wearing masks”, and several large religious festivals, such as the Kumbh Mela, an event frequented by millions of people.
The Hajj pilgrimage to Saudi Arabia and traditional New Year celebrations in China have been curtailed to a much greater extent than the Kumbh Mela, Head pointed out.
“India may have downsized its celebrations a bit, but millions of people gathered for the Kumbh Mela at different sites, and thousands of new coronavirus cases were confirmed in the attendees.”
(Extract from the foreign press review by Epr)
