India’s preparedness for the Omicron COVID-19 variant

As of 14th December, 2021, a total of 8,826 confirmed cases caused by the Omicron variant of the COVID-19 virus were reported worldwide across 75 countries, according to European Centre for Disease Prevention and Control,

On 26 November 2021, the World Health Organisation designated the variant B.1.1.529 a variant of concern, named Omicron, on the advice of WHO’s Technical Advisory Group on Virus Evolution (TAG-VE) and was first detected in Johannesburg, South Africa. The scientists sequenced samples from 77 COVID-19 infected individuals between November 12th and November 19th, They were not able to find a single Delta sequence (the then dominant COVID-19 strain), instead they found a new sequence which was labelled as the Omicron Variant. 

For any organism to survive in the wild, they undergo evolution through mutations which happen to occur the fastest in the microscopic viruses. The SARS-CoV-2 virus is no exception. Some of these mutations are lethal to the virus itself (loss of function mutations) and some mutations were extremely beneficial to the virus (gain of function) as it went on to further strengthen its infective and spreading capacity. 

Doctors and scientists worked hard to devise the appropriate treatments and vaccines to prevent the deadly airborne SARS-CoV-2 virus from spreading and causing more deaths. The SARs-CoV-2 virus underwent several mutations so as to override these preventative measures and sustain itself. Some of the predominant variants of the virus that arose from these mutations are the Alpha, Beta and Delta variants, with the Delta being the most infective and currently, the dominating SARS-CoV-2 virus. However, the Omicron variant may replace the Delta variant due to the high speed at which it is spreading. 

There are several schools of thought as to how the Omicron variant may have originated. Some researchers say that the SARS-CoV-2 virus might have undergone genetic recombination/reassortment with the Deer coronaviruses. Others believe that the Delta and the Beta variants might have crossed over in an immunocompromised individual to give rise to the Omicron Variant. The Omicron Variant has around 30 mutations in the spike protein region and has the ability to become the new dominant species in a matter of weeks. 

The patients infected by the Omicron variant presented non-fever and non-cough symptoms, which was unusual. In a webinar conducted by MedPiper Technologies, JournoMed and the All India Institute of Hygiene and Public Health, expert speaker Dr. Sayan Bhattacharya briefly discussed the symptoms seen in patients infected by the Omicron Strain were: 

  1. Muscle Pain 
  2. Extreme Fatigue
  3. Negligible fall in Oxygen Saturation levels i.e. hypoxia was a rare phenomenon
  4. Towards the later stages of the infection, scratchy throat was a prominent symptom. 

Dr. Bhattacharya expresses major concern over the newly designated VOC as almost 50% of the infections have occurred in vaccinated individuals. This indicates that the established vaccines are unable to provide complete immunity against the newer virus variants. If there are so many mutations in the spike protein, the vaccines that have been developed against the known mutations will not be able to protect against them. Dr. Bhattacharya stresses on the need for both vaccines and yearly vaccine boosters as the risk of infection is much higher in unvaccinated individuals. 

How prepared is India’s healthcare infrastructure to tackle the Omicron Variant? 

In an interaction with Dr. Subramaniam Swaminathan, the current strategies to tackle the possible repercussions of the Omicron Variant was discussed at length. Dr. Swaminathan is the Director of Infectious Diseases and Infection Control and an HIV Physician at the Gleneagles Global Hospitals Chain (Chennai, Bangalore, Hyderabad),

“The Delta Variant is on it’s way out and the new variant is on the way in. It is inevitable that the Omicron variant will sweep the world”, says Dr. Swaminathan. He expresses his concerns about the rate at which the virus is spreading and the high hospitalisation rates due to the Omicron variant. However, the death rate is not high with only one death reported in the UK caused by the Omicron variant (as of December 14th, 2021) and the infections are not that severe. 

After the disastrous second wave caused due to the Delta Variant, Dr. Swaminathan drives home the importance for the hospitals and authorities to be prepared well in advance. The oxygen supply and ventilators along with the nursing and support staff should be available and ready to go at the moment’s notice as the Omicron variant strikes fast. 

The speaker stressed on the need to hasten the vaccination campaign. The vaccines may not be able to offer complete protection against the Omicron variant but it can help to reduce the death rates. He also encourages vaccine booster shots as the efficacy of the vaccine only lasts for around 7-8 months. Masks are still effective in keeping the virus at bay and although the efficacy of social distancing measures is low it should be maintained as much as possible. Banning travel measures can slow down the spread of the virus but not significantly .

“Although the interventions are in good swing, it is near impossible to catch the air” states Dr. Swaminathan on why strict quarantine lockdown measures are not feasible. Taking a middle road where the economy is not severely affected and curtailing the spread of the virus as much as possible is the solution that authorities should be looking to implement. 

Note: The article is based on the data available till 15th December, 2021

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