India: Rising Covid Cases, Health Experts Worried About Potential New Variant

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After flattening the curve, India is again experiencing rapid rise in infections



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Photographer: T. Narayan / Bloomberg

As India’s daily Covid-19 infection tally rises to a record over 200,000 cases for three consecutive days, public health experts fear a new – possibly more virulent – variant of the coronavirus may cross the country overpopulated with more than 1.3 billion people.

The new variant, which has a so-called double mutation, is believed to fuel India’s deadliest new wave of infections that has made it the second-worst-affected country in the world, overtaking Brazil, and has already started to overwhelm his country. hospitals and crematoriums. The Asian nation has so far reported more than 14.5 million cases of Covid and more than 175,600 deaths.

“It’s an interesting variant that we are following,” Maria Van Kerkhove, the World Health Organization’s technical officer on Covid, told reporters on Friday. “Having two of these mutations, which have been seen in other variants around the world, is concerning,” she said, adding that there was a similarity to mutations that increase the transmission and reduce neutralization, possibly delaying the ability of vaccines to suppress them.

The new strain highlights the insidious nature of the viruses and threatens to thwart containment efforts in India, despite strict measures such as the world’s largest lockdown last year. An explosive outbreak in India risks reversing a hard-won victory over the pathogen for others as well, especially since the strain has now reached at least 10 other countries.

Here’s what we know so far:

How did the “double mutation” variant come about?

The new variant, called B.1.617, was initially detected in India with two mutations – E484Q and L452R. It was first reported late last year by a scientist in India and more details were presented to the WHO on Monday, according to Van Kerkhove.

Viruses are mutating all the time, as part of evolutionary biology. Some mutations weaken the virus while others can make it stronger, allowing it to proliferate faster or cause more infections.

Why the transfer Coronavirus The variants are so disturbing: QuickTake

The Indian Ministry of Health first recognized the presence of such a “double mutant” at the end of March, but has since played down it. While this is an interesting variant, it “has not been stamped as a ‘worrying variant’ to mean it’s more deadly or more contagious,” scientist Aparna Mukherjee told Bloomberg on Friday. at the Indian Council of Medical Research, which works under the country’s Ministry of Health.

The double mutation has been found in several countries including Australia, Belgium, Germany, Ireland, Namibia, New Zealand, Singapore, the United Kingdom and the United States, according to an April 16 statement. from the Indian government. “A higher transmissibility of this variant is not yet established,” he said.

Is this causing a record increase in infections in India?

Genome sequencing indicates that the variant is a possible culprit although the Indian government has not confirmed it.

The average prevalence of the variant climbed to 52% of samples sequenced in April from almost nothing in January, according to the tracker website epidemi.info, which uses data from the global GISAID repository.

People gather near stores closed at night during a weekend lockdown in Mumbai on April 10.

Photographe: Dhiraj Singh / Bloomberg

In some districts of Maharashtra state – home to the country’s financial hub Mumbai and the epicenter of the current wave that is currently subject to lockdown rules – the prevalence of this variant was over 60%, according to Anurag Agrawal, director of the genomics institute of the National Council for Scientific and Industrial Research which performs the sequencing. B.1.617 was present in samples from around 10 Indian states and, although the percentage may vary, it is expected to increase because “it has two critical mutations that make it more likely to transmit and evade prior immunity. Said Agrawal.

Both mutations are known to decrease – but not completely eliminate – the binding of antibodies created by infection and vaccination, according to Jesse Bloom, associate professor of genome science and microbiology at the University of Washington.

“Mutations at the E484 and L452 sites have been observed separately, but this is the first major viral line to combine the two,” Bloom said. “I think this new viral variant is important to watch out for.”

“We did the math – we believe that much of the increase in breeding numbers can be explained by these mutations,” Nithya Balasubramanian, head of healthcare research at Bernstein India, told Bloomberg. TV this week. “So, yes, the mutations are a big cause for concern.”

After being complacent in mapping virus genomes in recent months, India performed less than 1% positive samples last month – the country is now interference to cover the lost ground. “We try to make at least 5% of the samples available,” said Mukherjee of ICMR.

Dr Aparna Mukherjee talks about “Bloomberg Markets: Asia”.

“It appears to be spreading faster than the pre-existing variants,” said Rakesh Mishra, director of the Hyderabad-based Center for Cellular and Molecular Biology – another Indian lab that performs genome sequencing of Covid samples. “Sooner or later it will become widespread across the country, given the way it spreads.”

Has it been found outside of India?

This variant has been detected in at least 10 other countries, including the United States, United Kingdom, Australia and New Zealand, according to the situation report on epidemi.info.

As of April 16, 408 sequences of the B.1.617 line have been detected, including 265 in India, according to the report. A UK government surveillance report said it had found 77 cases in England and Scotland to date, naming it as a ‘variant under investigation’.

New Zealand has temporarily suspended arrivals for its citizens and residents of India due to the increase in the number of returns with Covid. Brazil was also shunned as a Covid super-spreader by its neighbors who were nervous about the neighboring virus strain.

India’s second wave – given its size and rapid pace – is going to worry other countries that have pretty much handled their own epidemics after weeks of devastating lockdowns.

Is it more deadly than other variants?

Researchers are still trying to figure this out. The characteristics of the double mutant variant are under investigation, but the L452R mutation is well characterized in US studies, according to Agrawal. It increases viral transmission by around 20% and reduces the effectiveness of antibodies by more than 50%, he said.

Globally, three disturbing variants that have emerged so far in the UK, South Africa and Brazil have given rise to particular concerns. Studies suggest they are more contagious, and some evidence indicates that one is more deadly while another leads to re-infections.

Variant of concern Alternative names Land of discovery
B.1.1.7 501Y.V1

COV 202012/01

England
501Y.V2 B.1.351 South Africa
P.1 501Y.V3

B.1.1.28.1

Brazil / Japan

This double mutant strain, first found in India, has started to trouble virologists everywhere.

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