Centre holds Covid meet; no cause for alarm, say experts

According to the government, infections in India are significantly low compared to the global scenario, but there is a need to be vigilant.

The government has called for increased testing and surveillance to track new variants, including the JN.1 sublineage of the BA.2.86 variant.

Rhythma Kaul, HT, New Delhi, Dec 21, 2023: With some regions in the country, particularly Kerala, reporting a slight surge in Covid-19 infections at a time when 20 cases of the JN.1 sub-variant have been found across India, the Union health minister on Wednesday chaired a high-level meeting to review the overall Covid preparedness in the country, according to an official statement.

Union health minister Mansukh Mandaviya along with other officials during a Covid-19 review meeting, in New Delhi on Wednesday (ANI)

Experts, however, stressed that so far there have been no reports of rise in hospitalisations or cases of Covid-related pneumonia, and deaths related to the viral disease remain low, despite a very minor uptick being caused by infections among those with several comorbidities.

“Union minister of health and family welfare today chaired a high-level meeting to review the Covid-19 situation in India and preparedness of public health system for surveillance, containment and management of Covid-19 in view of the recent spike in cases of Covid-19 in some states...,” according to a health ministry statement.

Union health minister Mansukh Mandaviya directed states to remain alert but not panic, as cases have started rising in the country again after a hiatus of several months.

On average, 344 new infections of Covid-19 were reported every day in the past week in the country, according to government data tabulated by HT. A week ago, this number was 165, and it was 79 the week before that. The last time the case rate (as the seven-day average of cases is known) was this high was on June 1 this year when there was a minor surge due to the XBB.1.16 Omicron variant.

For context to these numbers, the three full-blown waves of Covid-19 peaked at weekly averages of 93,617 (mid September 2020), 391,819 (early May 2021), and 312,180 (end of January 2022).

And while the seven-day average of daily deaths has also seen a slight uptick – going from 0.9 a week ago to 1.9 for the week ended Tuesday – senior government officials said the numbers were largely due to people suffering from “severe co-morbidities” getting infected.

“There is no surge in deaths and hospitalisations as per the trend seen so far; therefore, there is no cause to panic at the moment. We need to be vigilant though. The rise in cases in certain states also could mean they are testing adequately, which is why cases are picked up in time,” said the official cited above, requesting anonymity.

Underlining the challenges posed by the increasing number of Covid-19 cases in some countries such as China, Singapore, Brazil, Germany and United States, the health minister highlighted the importance of being prepared and remaining alert against new and emerging strains of Covid-19, especially in view of the upcoming festive season.

According to the government, infections in India are significantly low compared to the global scenario, but there is a need to be vigilant.

There has, however, not been any rise in hospitalisation levels – a key metric that serves as an early warning sign in the pandemic.

“No increase in hospitalisation rates have been witnessed, and people who are hospitalised are due to other medical conditions – Covid-19 appears to be an incidental finding. A rise in daily positivity rate has been observed in a few states like Kerala, Maharashtra, Jharkhand and Karnataka,” said Union health secretary, Sudhansh Pant, during the meeting.

The bulk of the new cases have been reported from Kerala, which currently accounts for 88% of the 2,311 active Covid-19 cases across India. Of the three Covid-19 fatalies reported in the past 24 hours, two were in the southern state.

Experts flagged that while the state has seen a high incidence rate in the community – as depicted in the test positivity rate – they warned that there is no immediate cause for concern.

There has been a steep rise in positivity rate across multiple centres in Kerala, but most of these cases do no require hospitalisations and Covid-related pneumonia has not been seen, wrote Rajeev Jayadevan co-chairman of the national Indian Medical Association (IMA) Covid Task Force in a post on X.

The preventive measures suggested by the cental government, meanwhile, included strengthening the surveillance system for whole genome sequencing of positive case samples to track the variants through Indian Sars-CoV-2 Genomics Consortium (INSACOG) network.

States and Union territories have been requested to ramp up testing and refer large number of samples of Covid-19 positive cases and pneumonia-like illness to INSACOG Genome Sequencing Laboratories (IGSLs) on a daily basis, for sequencing, to track new variants, if any.

India has already reported cases of the JN.1 sublineage of BA.2.86 variant that is also known as Pirola and seeing a sustained growth globally. Late on Tuesday, the World Health Organization (WHO) classified JN.1 as a Sars-CoV-2 variant of interest, after noticing a rapid spread around the world.

According to the government statement, however, all the cases were mild and have recovered well. “The new JN.1 variant of SARS-CoV-2 is currently under intense scientific scrutiny, but not a cause of immediate concern. No clustering of cases has been observed in India due to JN.1 and all the cases were found to be mild and all of them have recovered without any complications.”

At least 20 cases of JN.1 have been found across the country with 18 detected in Goa and one each in Kerala and Maharashtra, according to INSACOG data.

“It does look like the current surge could be due to the sub-type of BA.2.96 lineage, which is JN.1, as it is known to cause a surge globally as well. However, there’s no cause for concern as we have only seen mild symptoms in at least 90% cases,” said VK Paul, member (health), Niti Aayog.

States, in the meantime, have been asked to share information on cases, tests, positivity etc., in real time on the Covid portal to enable timely monitoring and prompt public health measures