Only testing will help us know how the virus is mutating and prepare experts to face another possible surge.
Representative Image of Covid 29 vaccine drive (Wikimedia Commons)
With Maharashtra reporting the first case of BQ.1, a sub-variant of Omicron, in India, experts have urged all to continue testing, besides following Covid-19 protocols.
The state also reported India’s first case of XBB, a recombinant lineage between two Omicron sublineages, BJ.1 and BA.2.75.
Both are known to be fast-spreading variants.
People, however, have lowered their guard. South First spoke to genome sequencing experts and doctors on the new variants — and why it is important to test for the virus, even if your symptoms are mild.
“It is still very important to test for Covid-19. Earlier, even those people with a common cold or cough used to get tested. Now, we need to look at cases of hospitalisation. Patients admitted to hospitals with Covid-19 should undergo rigorous testing,” opined Harsha Pulleri Kandi, Program Manager of Infectious Diseases from Strand Life Sciences.
There is a spike in viral fever cases which have Covid-like symptoms.
“There was a significant increase in people coming in with complaints of cold, cough, fever, and Covid-19 in September. The numbers are now coming down. Instead of mass testing, authorities should continue testing at specific places to look for any changes in the variant,” Dr Ravi Mehta, a Pulmonologist at Apollo Hospitals in Bengaluru’s Jayanagar, said.
Additionally, it is imperative to watch for symptomatic changes in clinical scenarios as well. “Now it is not possible to ask each patient to take a Covid-19 test,” Dr Mehta added.
Doctors said similar to the recombinant viruses, a combination of infections is being reported from the southern states. Untimely rains have triggered a spurt in dengue, chikungunya and viral fever.
“Respiratory syncytial virus (RSV) infection, influenza and Covid-19 show symptoms such as cold, cough and fever. It is difficult to differentiate Covid-19 from others. However, we are asking people in the high-risk group — the elderly, children below 10 years of age, and those with co-morbidities like heart-related ailments, tuberculosis, HIV, etc., to undergo a Covid test,” Dr Vijayalakshmi, infectious diseases specialist at SIMS Hospital in Chennai said.
“This is to ascertain if they require hospitalisation or change in the mode of treatment. However, not many are severely ill. They are recovering with medicines and rest,” she added.
The doctors South First spoke to recommended that genomic sequencing and wastewater surveillance should continue. Harsha Pulleri Kandi opined that the severity of each variant should be noted. One should check whether there is an increase in hospitalisationsm, he suggested.
“It is important to collect samples for genome sequencing from ICUs to track the emergence of any new variant. In Karnataka, we have been sequencing samples daily and have not found anything alarming,” Dr Harsha added.
Testing is important for two reasons: First, to know if the virus is behaving differently and to detect new variants at the earliest.
“This can be done at a larger level by the authorities, and INSACOG and several other researchers have been conducting sentinel sequencing, Dr Rajeev Jayadevan, Senior Consultant Gastroenterologist and former President of Indian Medical Association (IMA), Kochi, said.
INSACOG is an Indian consortium monitoring and sequencing the Covid-19 genome.
The second reason why members of the public should voluntarily test is the high transmissibility of the virus. Also, the severity of the disease in each person could vary. Dr Jayadevan explained why one should test for Covid-19 even after getting infected by the virus more than once.
“Suppose, if someone falls and breaks a leg and again breaks the same leg, the bone will get weak. Similarly, in Covid-19, we have anecdotal and research evidence indicating additive damages. Covid-19 is known to affect multiple organs. Just because it is not seen or felt immediately, it doesn’t mean that the chances of long Covid are less. So, it makes sense to have a record of your infection,” he said.
“It is important for the doctor to know that he is treating the patient for Covid-19 and also for the patient to know that he has been infected and, hence, should follow Covid protocols,” he added.
Meanwhile, Dr Angelique Coetzee, a private practitioner and former chair of the South African Medical Association, who first alerted the world about the Omicron variant, spoke to South First.
“I am seeing an increase in Covid-19 cases, but all are mild. Symptoms are easily missed since they resemble anything from sinus and cold to flu,” she said.
Dr Coetzee felt that problem lies in a lack of testing.
“My gut feeling is that doctors don’t test due to various reasons, of which two are that there are no funds for medical schemes and quite a few patients refuse to test,” she said.
“I am on high alert clinically to identify severe disease which will mean, most probably, a totally new variant or subvariant. Also, it is clear that regardless of whether one is vaccinated, taken boosters, or has had Covid previously, one can get infected again after six to nine months,” she added.
Though the situation is not alarming, experts said that wearing masks in crowded places is still important. While reviewing the Covid situation recently, Union Health Minister Mansukh Mandaviya urged all to wear masks and follow Covid-appropriate behaviour.
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