COVID-19: As New Variants Emerge Unabated Across the World, How Much Should India Worry?

New Delhi: The pandemic is still on and SARS-CoV-2, the coronavirus that drives it manifests in newer forms or variants. Several of these variants are also in circulation in India. Earlier, India went through a few waves driven by several variants, among which the Delta appeared to be the most dangerous in the country. Apart from it, the Omicron variant also caused widespread outbreaks throughout the country.

Remember, variants of a virus differ from each other by small changes in their gene sequences, occurring through a process called a mutation. The genetic material, either the DNA or the RNA is denoted by four letters of the alphabet, that are A, T, C, G (in the case of DNA) or A, U, C, G (in the case of RNA). These letters represent the bases present in the DNA and RNA and their sequence determines the genetics. In the process of mutation, the sequences of the bases change. Mutation naturally gives rise to random changes in these sequences and thus different variants. All the changes are not worrying or of not many concerns. But some mutations in some variants can be dangerous. These variants may acquire the ability to evade prior immunity (the body’s defence against invading objects) provided by vaccines or they can become more transmissible or they can become
more virulent (can cause more severe disease among those infected). These variants are of greater concern.

The Omicron variant was considered one of the most contagious variants of the coronavirus. However, at this moment there are other sub-variants of Omicron along with other variants that are present across the world. For example, the BF.7 variant caused a recent surge in China. Despite the identification of it in India also, we have not yet seen any worrying situation of either wave of outbreaks or severe disease. Along with it, a recent government survey report says that all the Omicron variants are circulating in India. The sub-variants of Omicron that are found in India, according to the government survey report are the BQ.1.1, XBB and BF7.4.1.

Notably, these variants are also found in different places of the world. For example, the XBB.1.5 has been found to be globally
dominant. This variant makes up 28% of the cases in the United States of America (USA) now.

With the emergence and circulation of new variants worldwide and also in India, the questions that arise are how much should we worry about it and what will be the possible outcome? NewsClick approached Professor Satyajit Rath, an eminent immunologist associated with the Indian Institute of Science Education and Research (IISER), Pune on various aspects regarding the variants.

On being asked whether these new variants have more transmissibility coupled with more virulence and more vaccine-evading power and any evidence regarding this, Prof. Rath told NewsClick, “Many of the new variants do seem to have somewhat more transmissibility. Some of them, such as XBB1.5, also seem to manage greater vaccine evasion. However, it is important to note that there is no evidence so far that any of these variants have more virulence.”

One interesting observation is that these variants are also found in different parts of the world, but with varying degrees of threat. From this, another question raises, which is- can a variant manifest differential transmissibility and virulence in different geographical locations and if so, what explanations can virology offer? On it, Professor Rath remarked, “That is an interesting formal possibility, but so far, there is no evidence for such differences in different parts of the world and in different ethnic groups.”

India has not put a strict restriction or ban on international travellers, especially those who land in India from different
countries. Is this alright or does it require some strictness? Professor Rath opined that travel restrictions may not be fruitful.
“Although our monitoring, both of infections and of variants, is much less careful and poor than it ought to be, the fact remains that covid infections are now endemic in all parts of the world, including in India. This is also true of most variants. Therefore, attempting to prevent travel no longer provides even as much utility as it did in the early months of the pandemic,” he commented.

India is not showing any worrying conditions as of now, despite the presence of several variants. Is it due to vaccination or herd
immunity or any particular context of the variants in India? On this, Prof. Rath said, “In most places around the world, a combination of vaccination and actual infection has led to so-called hybrid immunity, reducing the frequency of serious covid illness (though not so much of infection). This is likely to be true of India as well. China, with its strict and effective zero-covid policies for the first couple of years of the pandemic, is an exception in this respect, which is the likely reason for the sudden surge of infections there.”