Another Covid surge

Authorities should keep an eye on the new variant

Even as the world is heading into a holiday season and travel is expected to increase, Covid-19 cases are again rising globally. Countries and regions with more effective surveillance mechanisms are reporting a surge in infections, driven in particular by a new variant that has been called JN.1. This is a sublineage of BA.2.86, which had emerged over the past year as the dominant strain of Omicron. Singapore’s ministry of health noted that the week after December 3 saw 56,000 infections, compared with 32,000 the previous week. Even more worryingly, the state of Kerala has reported four deaths due to Covid in the past week. The JN.1 subvariant had previously been identified in a random sample of RT-PCR tests taken in the state. In this context, the Centre has done well to issue fresh advisory to state governments.

Most health authorities have noted that there is no reason to suppose that infections caused by the new variant are deadlier than Omicron cases, which have, in general, had a reasonably low fatality rate — even among the unvaccinated. It is probably unnecessary, therefore, to take any drastic public health steps immediately. But it is worth noting that Singapore has reissued mask mandates in crowded places. Governments will need to be ready to react quickly to developments surrounding this new variant. The question to be asked would be how prepared public health authorities are, at this late stage, for the new variant. Unfortunately, in many parts of the world, the reduction in concerns about Covid and the official end of the pandemic have not been accompanied by a scale-up of genomic processing of tests or other forms of disease surveillance. In India, for example, the laboratory network Insacog (Indian Sars-CoV-2 Genomics Consortium) is not operating at the level it should. A quicker detection of surge would enable better counter-measures. The second concern is vaccine efficacy. It should be checked how well the original sets of vaccines perform against these newer variants. In many countries, updated vaccines with better efficacy against the newer Omicron strains have been issued. Scientific advice on whether such vaccines should be made available in India is essential.

Hopefully, most JN.1 cases will continue to be mild and not require hospitalisation. It is not clear whether the four deaths in Kerala came from JN.1 or another strain. Mock drills being conducted at local health facilities to assess their preparedness for a surge is a welcome move. The authorities should also have a clear sense of how many additional cases might require reissuing the mask mandate like Singapore. Kerala has always been the first in the country to identify new cases — partly due to its effective health machinery, and partly because it is more closely interlinked with the outside world than others. But, with both inter-state and international travel set to pick up in the coming weeks, fears of a surge are real. The government should be prepared.