More than five years after the first outbreak of COVID-19 and long after the pandemic ceased to be a public health emergency, a few new variants have brought forth fresh concern. As of June 8, India’s Ministry of Health and Family Welfare has on record 6,133 active cases, nearly a third of which were reported from Kerala. Sixty-five persons from India are reported to have died due to COVID-19 this year.
Governments have been quick to quell fears, reassuring the public there is no need for panic, even as the customary guidelines – wearing of masks for the elderly and those with comorbidities – were reinforced. Only the spread is more, but the infections are not severe, say doctors. The new variants include LF.7, XFG, JN.1, and the NB.1.8.1 subvariant.
It is by now understood that a new wave will come along every six months or so, and the number of cases does not matter, says Dr Aravind Reghukumar, Head of Infectious Diseases, Thiruvananthapuram Medical College.
“New variants will arise, and if a state’s surveillance is strong, these will be detected, an alert will be sounded, and testing will be enhanced. What we need to know is that only 0.5% hospitalisation is expected of all these cases, meaning only one in 200 infected persons will be admitted or have a severe infection,” Dr Aravind tells TNM.
Kerala accounting for 32% of the total cases is also nothing new or worrisome, the doctor says, while disregarding the significance of numbers in the same breath. The state had been in the eye of the storm when it reported a high number of cases and deaths during the early years of COVID-19. However, recently released data on the civil registration system – recording births and deaths – showed a massive excess of deaths in 2020 and 2021, proving several states had misreported casualties due to COVID-19.
A report on Scroll showed that Bihar and Gujarat had 30 times more deaths than they reported in this period, while in Uttar Pradesh, it was 15 times more. Among the states that stuck to near actual numbers were Kerala, Delhi, Rajasthan, Maharashtra and Karnataka.
Guidelines
Kerala has earlier published guidelines, stating that COVID-19, like influenza, will recur seasonally and describing the steps or precautions to be taken. The respiratory infection spreads like influenza and is risky for the same group of people—the elderly and people with comorbidities. "It has been said before. People with comorbidities should keep those in check so that if they are infected by influenza or COVID-19, the outcome will be okay. We say this because some people may not know the status of their diabetes or hypertension. The others should follow routine measures such as keeping hands hygienic and masking in public or congested spaces, avoiding hospital visits and so on,” Dr Aravind says.
The same guidelines are to be followed throughout the year, only that every six months, when a fresh variant emerges, these have to be reinforced.
While COVID-19 cannot be written off since it can still cause deaths, it should not take attention away from other infectious diseases such as influenza, leptospirosis or hepatitis A, Dr Aravind says. "Theoretically, everyone will get COVID-19 in a new wave, and like a booster dose, it will give you antibodies. But in six months, these will wane, and the next variant may evade the antibodies, and you will get sick again."
Dr Aravind agrees that some variants can be more dangerous than others, depending on factors such as transmissibility, immune evasion and severity. When these are high, it becomes a variant of concern or a variant of interest (as categorised by the World Health Organisation to prioritise global monitoring and response). The first two factors were high for most variants that came after Delta. This is determined by the ability of the virus to make a healthy person seriously sick. If it is not severe, the priority is to keep it from spreading to the vulnerable population.