Immunity, jabs place Indians in better position to tackle Omicron 2.0
India’s Omicron wave is mostly over but health authorities are now keeping a wary eye on the unfolding global situation — there’s a spike in cases in the Western Pacific region and in parts of Europe. And, the World Health Organisation (WHO) is asking countries not to slacken on surveillance and vaccination.
But what explains the surge in some regions just when cases globally have been declining since the start of the year? More significantly, where does that place India where daily cases have been dipping all through February and March to stand at 2,876 fresh cases as of Friday, March 18?
“Two years into the pandemic, every country and every setting is very different in terms of natural infection, vaccination, type of vaccine used and so on,” Chandrakant Lahariya, a public policy and health systems expert, told The Federal. While China, like a few other Asian countries, followed a stringent zero-COVID policy, which meant lockdowns to tackle even a small number of cases, that approach possibly also left much of the population susceptible despite vaccination coverage, he pointed out. “The better approach is natural infection followed by vaccination.”
Comfortable zone
That’s largely the scenario which played out in India, most experts reckon. “At this point in time, we are in a relatively comfortable zone where, in the first half of 2021 a very large number of people got infected and in the second half a very large number of people got vaccinated,” Prof K Srinath Reddy, president of the Public Health Foundation of India (PHFI), told The Federal. For a large part of the population already infected by the widespread second wave, vaccination was essentially a booster dose.
“After the Delta wave, the seropositivity in the population jumped from somewhere about 20 per cent to about 67 per cent. And, with the Omicron wave, I think seropositivity is possibly in the high, around 80-90 percent, which means either those people have been exposed to the virus or vaccinated, or both,” virologist Shahid Jameel told The Federal. “So, even if another variant comes in, I think India would remain protected from the disease. We may see cases going up but I don’t think we should panic.”
In January, when Omicron had reached the community transmission phase in the country, a bulletin from India’s genome sequencing consortium ISACOG had noted that the BA.2 lineage of Omicron was contributing to a substantial fraction of cases.
BA.1 and BA.2 lineages
Globally, the BA.1 and BA.2 lineages are both in circulation. Jameel said this follows a natural course of virus evolution where sub-lineages emerge and circulate.
“I would be worried if one of these overtakes the other but that doesn’t seem to be happening. In the US, it’s mostly BA.1, in Europe it’s mostly BA.2 and that could be simply because what got introduced later in Europe was BA.2, what we called a bottleneck effect,” said Jameel.
The global COVID situation and the response to it varies from country to country.
“If you look at South Korea, for example, they touched a record number of cases yesterday,” said Reddy. “But their hospitalisation deaths are still extremely low, mostly of 60-plus people who were not vaccinated. So, the fact is, we are going to be seeing a large number of cases if you count only the infections and if you test everybody.” South Korea, he pointed out, is testing intensively and it still has COVID restrictions in place.
Also read: Increase testing, be cautious: Centre to states after COVID spike elsewhere
“But Europe decided that they have vaccinated enough number of people enough number of times and they can go ahead and open up fully without any restrictions,” he added. There too, he pointed out, infections are bound to rise.
“Again, there the question is who are the people actually getting hospitalised and dying? Are the deaths also rising quite rapidly among people who were vaccinated a relatively long time ago or people who refused to get vaccinated? These are some of the questions we need to look at,” said Reddy, adding that COVID precautions are still necessary in India.
“I would say that for at least another 2-3 months, until the global situation becomes clear and we are also sure that we are not going to see a new variant emerging, we ought to wear masks outside of our homes, especially in indoor gatherings. We must try and avoid very large crowds,” he added.
Global numbers
Over the past week, China has recorded an average of 1,600 daily new cases while South Korea clocked 3.9 lakh cases and Vietnam, 2.5 lakh cases. Meanwhile, the UK saw 90,815 cases on March 17 while the Netherlands recorded 53,667 cases.
Epidemiologist Jayaprakash Muliyil reckons that a zero-COVID policy looks good on paper but isn’t an effective approach especially with a highly transmissible variant such as Omicron.
“Omicron is a different breed — even the narrowest chance and it catches you,” he told The Federal. But its mortality rate is low compared to Delta, said Muliyil, citing a recent study of 53,000 patients in southern California which observed that among hospitalised symptomatic cases, the average duration of hospital stay was 70 per cent shorter among patients with Omicron as compared to Delta infections.
Also read: Why Indian scientists think boosters are essential to combat Omicron
Much as it is difficult to predict what course the pandemic will take, Jameel said, it won’t be infection counts alone that will steer the broader response to it.
“It depends on what you decide as your own benchmark…whether you are going to worry about every symptomatic infection or you are going to worry about disease cases that fill up hospitals,” he said. “If a variant which is causing more disease takes over from an existing variant, then I would be worried, not at this time. What we are seeing is something natural — the virus is going towards endemicity. When the pandemic is over will be decided by multiple things, not just by daily cases but also by other competing social, economic and political factors,” said Jameel.
