New Variant BF.7: No need to worry
As several countries are witnessing a massive coronavirus infection surge, many are worried about the fact whether India is likely to see the fourth Covid wave in the coming months.
The issue became more concerning as Omicron BF.7, which is behind the surge in China, has also been detected in India. But India has no need to worry at this point…
By Abhigyan/Abhinav
As per Ministry of Health and Family Welfare sources, the next few weeks will be crucial as India may see a Covid surge in January. Even if there is a wave, deaths and hospitalization will be very low, the Health Ministry sources said. The government made random corona virus testing mandatory for two per cent of passengers arriving in each international flight.
Prime Minister Narendra Modi and Health Minister Mansukh Mandaviya have held meetings to assess the country’s preparedness to deal with a fresh surge in cases.
The government is not considering banning international flights, said sources. As per experts, next month is going to be very crucial. For international passengers, Air Suvidha portal is likely to be re-introduced for flyers coming in from Japan, China, South Korea, Thailand, and Singapore from next week.
The government had intensified the screening of all passengers who arrived at the four airports in the state immediately after the sudden surge in corona virus cases in China and other countries. Those coming from China, Japan, Hong Kong, Taiwan and South Korea are mandatorily screened for the virus. The government has already activated a mass fever screening system at the Chennai, Madurai, Tiruchirappalli and Coimbatore airports for early detection of the virus.
Mansukh Mandviya, Health Minister, Ministry of Health and Family Welfare, Govt of India, assured that the government is fully prepared to tackle a potential outbreak. Several countries are administering a third and even fourth Covid-19 booster shot but India, where many fully vaccinated individuals have not taken even one, is not there yet, say experts while stressing on the need for a structured and systematic response.
According to Manindra Agrawal, Professor, IIT Kanpur and also part of the IIT sutra Covid-19 model, the ‘short-term future does not look good but there is no cause for alarm in India. The percentage of the naturally immune (immunity acquired via the previous infection) population in China was less than 5% in October-end and less than 20% in November-end. At present, less than 60% of the population has natural immunity.
Dr A K Agarwal, Medical Advisior(Clinical Research), Apollo Hospital and Former Dean, Maulana Azad Medical College, New Delhi, said, “The rising cases of Covid-19 may stop only when nearly entire population acquires natural immunity. Our analysis of Omicron wave across countries had shown that natural immunity provides strong protection against infection by any variant. It has been observed that the countries with a high level of natural immunity have not seen a significant rise in case numbers. In China, due to its zero-Covid-19 policy, as we observe, natural immunity did not develop at all.”
According to Dr Suneela Garg, Chair, advisory Committee, National Institute of Health and Family Welfare, Member, Lancet Commission and Former Director Professor, Department of Community Medicine, Maulana Azad Medical College, New Delhi, if we talk about especially for China, Japan, America etc… this is the worst time for them — little natural immunity and little restrictions on movements. More than 2 years since cases were first reported, the COVID-19 pandemic remains an acute global emergency. Many governments face uncertainties about how to prioritize at a time when the pandemic appears to be in transition but when the risk of emergence of new variants and future surges remains real.
“To assist national and global efforts to end the COVID-19 emergency worldwide, WHO updated the COVID-19 Global Preparedness, Readiness and Response plan in 2022 and outlined two strategic objectives. First, reduce the circulation of the virus by protecting individuals, especially vulnerable individuals at risk of severe disease or occupational exposure to the virus. Second, prevent, diagnose and treat COVID-19 to reduce deaths, disease and long-term consequences. These combined strategies can save lives and livelihoods,” Dr Suneela Garg, said.
To provide actionable approaches to meeting these objectives, WHO has produced six short policy briefs that are based on previously published technical guidance? They outline essential actions that national and sub-national policy makers can implement for Covid-19 testing, clinical management of Covid-19, reaching Covid-19 vaccination targets, maintaining infection prevention and control measures for Covid-19 in health care facilities, building trust through risk communication and community engagement and managing the Covid-19 infodemic.
WHO Member States are in different situations with regard to Covid-19due to a number of factors such as population-level immunity, public trust and access to vaccines and therapeutics. These policy briefs will provide the basis for an agile response as countries continue to confront the pandemic while consolidating the foundation for a stronger public health infrastructure and strengthening the global architecture for health emergency preparedness, response and resilience.
Amid a spike in COVID-19 cases in some countries, including China and South Korea, the government has sounded an alert and asked states and Union territories to prepare for any eventuality. India has stepped its surveillance and genome sequencing of Covid positive samples. With only 27 per cent of the eligible adult population having taken the precaution dose, government officials have appealed to those due for it to take it.
Mansukh Mandviya, Health Minister, Ministry of Health and Family Welfare, Govt of India, assured that the government is fully prepared to tackle a potential outbreak. Several countries are administering a third and even fourth Covid-19 booster shot but India, where many fully vaccinated individuals have not taken even one, is not there yet, say experts while stressing on the need for a structured and systematic response.
Dr Girdhar gyani, Director General, Association of Healthcare Providers India, said, “As Covid-19 gets back on the radar with a surge in China and people worry about another wave in India and whether the government should now allow a second booster shot to add to the two-jab protection, some scientists call for a reality check. A fourth shot of a Covid-19 preventive is unwarranted at the moment as most people in the country are yet to receive a third dose and there is no data available on the utility of a second booster for the currently used vaccines.”
“Undoubtedly situation in India where a large number of people have been exposed to the virus and also been vaccinated is quite different. There is no reason to expect that the Chinese situation, which is specifically shaped by the zero-Covid policies that the country implemented for almost three years, will predict anything in India.” Dr Girdhar Gyani, added.
Dr Vinay Aggarwal, Past National President, Indian Medical association, said, “China has been witnessing thousands of cases daily in the last few weeks. The Indian situation, with widespread actual infection in addition to vaccination, is quite different. Countries such as the US and UK are administering third and fourth booster doses to fully vaccinated individuals as well as extra shots to the immune compromised who did not have a strong immune response from their initial doses. We have urged Union Health Minister Mansukh Mandaviya to consider the fourth dose for healthcare workers and frontline workers. Because healthcare professionals are more exposed to a larger number of corona virus infected patients resulting in cumulative accumulation of larger volume of viral load and repeated exposure to the virus.” 
According to government data, about 22.35 crore boosters or precaution doses have been administered, which is 27 per cent of the total population eligible for boosters. That leaves the vast majority still without boosters. Besides, Pfizer-BioNTech and Moderna, the manufacturers of two of the most widely used Covid vaccinations, have developed updated vaccines that more effectively protect against the newer Omicron variant.
In India, the currently used vaccines, including Covishield, Covaxin and the recently launched nasal vaccine, iNCOVACC, are designed from Wuhan strain of the SARS-CoV-2 vaccine and do not have Omicron-specific virus components in them. According to experts, the number of daily cases should be monitored; people landing at the airport should be initially tested randomly and routinely tested if cases increase. Getting sequencing done on a subset of RT-PCR positive samples at the very least is essential since the variant prevalent in China, BF.7, is rarely identified in India.
There is no evidence yet to indicate any major nationwide ‘wave’ of severe Covid-19 illness. Both the government and society have failed in continuing to recognize that the pandemic is still ongoing and needs a long-term systematic public health-oriented and structured response. So there is need of focus on to provide enough infrastructure and money to carry out surveillance and set up a robust routine surveillance machinery for the country to monitor any and every infectious disease.
India’s move to vaccinate children against Covid-19 is “unscientific”
The current trend of Covid-19, in terms of speculation over rise and fall in cases from time to time, is a common phenomenon when an infectious disease transitions from pandemic to endemic phase.
According to Dr Sanjay K Rai, Senior epidemiologist, Department of Community Medicine, AIIMS, New Delhi, India already witnessed a very devastating second wave of Covid infections which was very unfortunate. The global evidence shows that natural infection provides better and longer protection against COVID-19. Also, there has been high vaccination coverage. Hence, a severe wave in the future is unlikely until a new mutant variant is capable of invading the existing natural immunity and causing severe disease.
I am a great fan of PM Modi for his selfless service to nation and taking right decisions at right time. But I am completely disappointed with his unscientific decision on children vaccination,”
Dr Sanjay K Rai, said, “In view to Govt of India’s move to vaccinate children against Covid-19 is “unscientific” and not yield any additional benefit. My claim on above statement is based on data from countries that have already implemented vaccination for children should be analyzed before executing the plan in India.”
Dr Sanjay Rai, becomes very popular over social media by reacting over Prime Minister Narendra Modi’s concern over vaccination against Covid-19 for children in the 15 to 18 age group. In his words, “I am a great fan of PM Modi for his selfless service to nation and taking right decisions at right time. But I am completely disappointed with his unscientific decision on children vaccination,”
According to Dr Sanjay Rai, there should be a clear-cut objective of any intervention. The objective is to either prevent corona virus infection or severity or death. But according to whatever knowledge we have about vaccines, they are unable to make a significant dent in the infection. In some countries, people are getting infected even after taking booster shots. In the case of children the severity of infection is very low and according to data available in the public domain, only two deaths per million populations have been reported. Few countries, including the US, started vaccinating children four-five months ago. The data of these countries should be analyzed before initiating Covid vaccination for children.
Profile
Dr. Sanjay K Rai is currently Professor at Centre for Community Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India. He is also Editor of prestigious WHO-South East Asia Journal of Public Health.
Dr. Rai has played a vital role in promoting public health leadership during COVID-19 pandemic. As President of the Indian Public Health Association; he founded a joint COVID-19 taskforce with eminent public health experts belonging to various public health associations of India e.g., Indian Association of Preventive of Social Medicine (IAPSM), Indian Association of Epidemiologist (IAE) and IPHA. The main objective of the joint taskforce was to advise the Government of India regarding the containment of COVID-19 in India. In this regard, four consecutive statements were produced and sent to the government including the honorable Prime Minister of India. The statements were vital in creating awareness regarding the epidemiology, control measures; use of vaccines, etc. to contain covid-19 in India.
He also provided inputs during an interaction with the Prime Minister of India. Awareness generation and educating both lay people as well as health professionals through print and electronic media was his special forte. In fact, he is one of the most recognizable faces in the digital media. He also played a very important role in development of vaccine against COVID-19 in India. His contribution as Principal Investigator of vaccine safety (phase 1 & 2), and effectiveness (Phase 3) trial at AIIMS, New Delhi, helped timely release of COVAXINTM vaccine nationally as well as globally.
Dr. Rai has played a vital role in promoting public health leadership during COVID-19 pandemic. As President of the Indian Public Health Association; he founded a joint COVID-19 taskforce with eminent public health experts belonging to various public health associations of India e.g., Indian Association of Preventive of Social Medicine
Prof. Rai has to his credit over 175 publications and is a regular reviewer of many major national and international journals. He has been involved in more than 40 research projects. Prof. Rai has many awards and honours to his name including “Dr J. E. Park Memorial Oration” of Indian Public Health Association (IPHA), and has also been conferred “Fellowship” of IPHA.
He is member of many technical/expert groups constituted by Government of India, Indian Counsil of Medical Research (ICMR), and International Clinical Epidemiology Network (INCLEN) and has contributed in many national health programmes e.g., National AIDS Control Programme, National Health Mission, Revised National Tuberculosis Control Progrmme etc.
Prof. Rai is also working in the area of HIV / AIDS and has been providing technical support to National AIDS Control Organization (NACO), Ministry of Health & Family Welfare. He is member of many technical resource groups of NACO. Prof. Rai is also focal person for NACO designated National Institute for HIV Surveillance at AIIMS, New Delhi, to monitor and support, HIV Sentinel Surveillance in India.
He was involved in research on human influenza disease burden in India, and also one of the largest influenza vaccine effectiveness trial studies in collaboration with Centre for Disease Control, Atlanta, and University of Alabama, USA. He is the current (2019-23) National President of Indian Public Health Association (IPHA).