Omicron's threat

New variant should shake up Indian vaccine complacency

Little is known for certain about the new variant of the Covid-19 virus, first detected in South Africa, and which the World Health Organization has dubbed the omicron variant. Yet whatever is known is not reassuring. The indications are that it is considerably more contagious than even the delta variant, which was first detected in Maharashtra almost a year ago and was partly responsible for India’s devastating second wave earlier this year. What is known is that it has over 50 mutations from the original Covid-19 virus, which was first recorded in Wuhan in late 2019, and that 30 or so of these are in the spike protein, the section of the virus that it uses to bind to human cells. Given that, there is reasonable concern that scientists are now investigating that it might be better able to evade natural immunity or that conferred by vaccines. Whether it will also cause more severe disease or higher mortality rates can only be discovered on the basis of real-world evidence.

The fact is that new variants were always a possibility when the penetration of vaccines in large parts of the world remains low. South Africa and its scientific and medical establishment deserve full credit and indeed global thanks for so quickly discovering and announcing the danger from the new variant. Other governments must also step up their genome-sequencing capacity in order to ensure that the variants, including omicron, are detected the moment they start circulating in the population. It is possible that this will involve fresh constraints on international travel, for example, and the tightening of certain quarantine norms that had begun to loosen. But over the course of the pandemic much has been learned on how to ensure that travel continues with minimal necessary disruption. These lessons must be put into practice. Outright bans on travel from certain countries may serve as a reasonable initial reaction but the fact is that they are no replacement for proper testing, tracking, and (where necessary) quarantining all travellers. Shortcuts like “air bubbles” have outlived their usefulness and now only serve to drive up prices of air travel without any corresponding increase in safety.
 

The time has also come to closely examine India’s vaccination programme. The gains that had been made in the middle of the year must not be allowed to dissipate. Most importantly, although over 80 per cent of the adult population have received at least one dose as of last week, the numbers of those coming back for the second dose are not satisfactory. In Uttar Pradesh alone, 106 million people are yet to get their second shot. Altogether, India’s fully vaccinated population is yet to hit half of those eligible. Meanwhile, recent research has suggested that the protection provided by vaccines declines over time. The government’s scientific establishment must, therefore, answer swiftly on whether booster shots for the most vulnerable population, including the elderly, should be rolled out as several other countries have done. It is also clear that mixing vaccines when it comes to booster shots might provide better outcomes. It is thus essential that the question of access to the Indian market for mRNA vaccines, which much of the rest of the world is using as a booster for those who have taken two shots of AstraZeneca/Covishield, is revisited with an open mind.