New Delhi: The ever-mutating COVID-19 virus has once again put the world on high alert. India’s policymakers have issued guidelines keeping in mind the cognisance of the virus. The Omicron sub-variant BF.7 is not entirely new it is related to the BA.5 variant which has been earlier circulating, so, it comes from that sub-lineage. It has received a new name because of certain structural variations, but it’s part of the overall Omicron family.
Given the fact that world over the BF.7 variant has not caused such a major rise in the number of cases, and in India too it has been around for some months, and it has not caused such a high rise in cases. The situation remains critical in addressing the public health scare caused due to the pandemic. During a media briefing recently, Dr Tedros Adhanom Ghebreyesus, Director General, World Health Organisation (WHO) stated that the WHO is very concerned over the evolving situation in China, with increasing reports of severe disease.
Currently, the situation for every country would be different depending on the COVID-19 vaccination progress and the herd immunity built. Experts are of the view that COVID-19-appropriate behaviour needs to be adhered to at all times while also ramping up COVID-19 vaccination and genomic sequencing to track and trace the virus.
Speaking to ETHealthworld Prof K Srinath Reddy, Former President, Public Health Foundation of India said, “The genomic analysis has come down to the fact that there have been no major reports of a rise in hospitalisations, or deaths. It has not obviously caused the kind of scare and trauma that China is seeing. In China, the situation is different. Many people lack immunity from previous exposure to the natural virus or to the vaccines where the immunity seems to be fading even in those who have been vaccinated early on in the pandemic.”
Healthcare thought leaders believe that this particular variant is unlikely to cause the same level of problems, in other countries, especially in India.
Deliberating on the current situation in China Prof Reddy shared, “We know that many people are getting infected. But how many of them are getting seriously infected, we’ll have to wait and see. There are reports of deaths and ambulances. But recognizing that people who are vulnerable because of age or immunocompromised are likely to die in larger absolute numbers.”
Disease threat vs Immunity level
In other countries, where there has been considerable population exposure to the natural virus, and where there has been a fairly high level of vaccination, like India, the data from this particular variant doesn’t appear to be a serious issue to be alarmed about.
China has domestically approved 12 COVID-19 vaccines to vaccinate its citizens, while completing most of its initial vaccination in 2020, with homegrown vaccines. India and other nations started vaccination for COVID-19 in early 2021.
Elucidating on the immunity of vaccines waning Prof Reddy added, “Firstly, we need to look at whether immunity is fading or not. Immunity induced by the vaccines does fade in terms of antibody levels after a few months. But still, there is cellular immunity from T cells.”
Adding further Prof Reddy continued, “Everybody wouldn’t have lost the benefit of the vaccination. Some cellular immunity is likely to have remained. Second of course is that the natural infection also acts like a booster dose and Omicron in January was pretty widespread in India, in terms of infections, not in terms of serious illness or deaths. So, that also would have acted as a booster dose. But we are now in December, some people may be having lower levels of immunity, we have to consider two issues. What can happen if there is a rise in Omicron-related infections, most of them are likely to be mild in any case, as has been reported in other countries over the last year. We have seen this even in January. Certainly, some people will be vulnerable people, like the elderly, people with comorbidities and immunocompromised persons, they would certainly benefit from a boost to their immunity.”
Efficacy of COVID vaccines/intranasal vaccines against Omicron
The COVID-19 virus has been mutating rapidly and causing surges, vaccine manufacturers have been working to develop variant-specific vaccines to end the global chaos caused due to the pandemic.
Most of the new Omicron variants are not very responsive to the antibodies that are produced by the vaccines. The likelihood is that what the boosters will lack in quality they’ll make up in the quantity of the antibodies. So they may be able to overcome the virus at least in some cases.
Commenting on this Prof Reddy mentioned, “One will have to look for a relatively safe vaccine which is likely to be acceptable to people. The thing is, if we do have a vaccine, which can create a good immunogenic response even for the antibodies, neutralising antibodies, then there is a possibility that one may be able to protect vulnerable people with that without having adverse effects. How much of this is going to hold against the new Omicron variants is still unknown, because even those studies were done with the older viruses, Delta as well as some of the newer versions of Omicron. One goes on the assumption that it is likely to be of some use, it will not be of harm.”
Prof Reddy is of the view that the nasal vaccine is dependent upon the theory that a nasally administered vaccine will elicit not just a systemic immune response, but a local mucosal response because the virus first gets into the nose and the throat, and then after getting there, it moves into the lungs and the blood vessels. Omicron does not have much of a tendency to get into the lungs or the blood vessels, but they still get in the nose and throat, and from there, there are abdominal symptoms.
Based on the scientific study and clinical trials of the intranasal vaccine Prof Reddy is optimistic that if it is effective in stimulating mucosal immunity in the mucous membrane of the nose, by creating a lot of secretory antibodies it will not allow Omicron to settle down in the nose and the throat. So, that is the advantage. The second advantage is that lots of people are getting a little wary of getting too many injections. So, people may find it easier to get a mucosal nasal vaccine, they may be more willing to accept it rather than another injection and it will be easy to administer also for the frontline health workers rather than people having to troop into vaccination centres. So there are added advantages and benefits of the intranasal vaccine.
Immediate measures needed
The Indian government is taking proactive measures to prevent the Delta-wave-like scenario in the country where COVID-19-related infections and deaths were at an all-time high. There was a shortage of healthcare personnel, medical equipment, oxygen, hospital beds, personal protective equipment, essential medicines and COVID vaccines.
Prof Reddy emphasised, “We ought to reassure people first, that we are keeping a watch on the situation, we will monitor through both clinical surveillance as well as by testing and genomic surveillance, whether the cases are going up because of a particular variant. And then we’ll be able to decide our strategy.”
“In winter, you do expect respiratory infection but none of them are reporting any major rise in hospital admissions. They’re reporting a rise in hospital admissions due to respiratory influenza but not so much because of Corona. We must be prepared, but there’s no point in creating a panic situation,” concluded Prof Reddy.
With several videos and news reports emerging from China on the current situation in the country, it has been causing mass panic and anxiety. The Omicron variants aren’t as potent as Delta and India has had better vaccine coverage and effective vaccines to curb the spread of the virus. The immune response has been good amongst the Indian population. Indian health experts believe that there is no reason to panic and the nation is prepared to handle the crisis.