COVID surge and future strategies: Dr Soumya Swaminathan explains

As COVID-19 cases begin to rise again in parts of Asia, questions are surfacing about the implications for India. Are we prepared? Should the public be worried? And what’s next in terms of policy and vaccination strategy?

In this interview, Dr Soumya Swaminathan, former Director General of the Indian Council of Medical Research (ICMR) and former Chief Scientist at the World Health Organization, shares crucial insights on surveillance, vaccination, and public health response.

Q: With the surge in COVID-19 cases in countries like Thailand, Hong Kong, and Singapore, and a slight uptick in India, should we be worried?

Dr Swaminathan: I would say there is a need to be alert. We must closely monitor surveillance data, and public health authorities should regularly inform the public about COVID and other respiratory infections, as well as whether there is a new strain or increased risk of severe disease. From the ICMR surveillance centres, we have seen a relative increase in COVID compared to other respiratory viruses. So, there is a clear need for increased awareness and precaution.

Also read: NB.1.8.1, LF.7 variants of COVID detected in India: INSACOG data

Q: The current dominant strain seems to be Omicron JN.1. Given India's widespread vaccination and natural immunity, how protected are we against this variant?

Dr Swaminathan: That’s a very good question. We have been fortunate in a couple of ways. Most new variants since 2022, including JN.1, are Omicron sub-variants. They have minor mutations, but the core structure remains the same. The vaccines have worked fairly well so far and continue to protect against severe disease. Also, natural infections during each surge help boost immunity. When Omicron first hit, many had already been vaccinated, so illness was mostly mild—it acted like a booster. We are awaiting sequencing results from NIV, but it is likely the same or a related JN.1 sub-variant circulating in Southeast Asia.

Q: Experts say that COVID is here to stay and there is a periodic rise witnessed at least once or twice a year. We know that those who have comorbidities or are in an immunocompromised state can be at a high risk. Is there a vaccination strategy that can be brought up specifically, similar to the yearly flu vaccine, to keep the high risk category people protected?

Dr Swaminathan: Absolutely. Some countries, like the US, update vaccines yearly based on circulating strains, similar to how we approach influenza. For COVID, we don’t yet have long-term data to guide how often boosters are needed or what type. In India, we haven't had a booster programme since the initial vaccinations. We need data to see if hospitalizations or deaths are rising in vulnerable groups, and when they were last vaccinated. Common sense says yes, people with underlying illnesses should get boosters—but we need scientific discussion to decide the timing and formulation.

Also read: Kerala : Health Minister issues alert after surge in COVID cases

Q: What kind of research is needed to shape a future vaccination or prevention strategy? Is there something ongoing at ICMR?

Dr Swaminathan: Yes, there are several data sources. ICMR has a network of labs monitoring not just COVID but other respiratory viruses. There's also data from public health centres via the India Health Information Portal, and mortality data from the Registrar General of India. What’s needed is integration of these datasets to analyse trends whether mild illness leads to more hospitalizations or deaths, and in which demographic groups. That analysis can guide policy on vaccinations.

Q: Covaxin and Covishield were largely used for the public vaccination programme against COVID. Can the clinical trial and post-vaccination data still inform future strategies?

Dr Swaminathan: That's a very important point. Most trials followed people for up to 12 months. But it should be possible to revisit those participants, assess their antibody levels after four years, and study how long immunity lasts or how fast it’s boosted by a new shot. That would be valuable research. In addition to Covaxin and Covishield, we also have an mRNA vaccine developed by CFR that was approved by CDSCO. mRNA vaccines are easier to update for new strains and show strong immunogenicity. We have several vaccine options in India and the capacity for much more research. A NITI Aayog report on pandemic preparedness, of which I was part, outlines the steps India needs to take.

Also read: India reports slight increase in COVID cases amid new wave in Asia

Q: There is panic and misinformation about rise in cases and the possibility of lockdown due to the same. What’s your message to the public?

Dr Swaminathan: People have painful memories of COVID and no one wants a repeat. That’s why clear public messaging is vital, and why we must avoid rumours and disinformation. A recent viral outbreak sparked unnecessary panic, despite being a typical respiratory infection. Regarding COVID, we shouldn’t panic. Vaccine-derived immunity is still protecting most of us. Yes, some may fall sick, especially the vulnerable, just like with the flu. But what’s critical is good ongoing research, solid data analysis, and effective public health messaging.

I’m glad to see more people wearing masks now. It’s a good habit, especially if you have a cough or cold, wear a mask to prevent spreading infection. Respiratory illnesses can make you miserable, even if they don’t kill. Simple practices like mask-wearing, hand-washing, and not spitting in public should be year-round habits—not just during surges.

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