By Express News Service
BENGALURU: Eminent virologist, nodal officer the INSACOG lab at NIMHANS, Head of Research and Development, Tata Medical and Diagnostic Centre, Dr V Ravi, in an exclusive interview with The New Sunday Express, speaks about the INSACOG’s changed strategy and also on how districts in Karnataka will now have to be careful as they will start to peak soon. Excerpts from an interview:
The last time we spoke, you had termed the Omicron variant as Usain Bolt amongst all SARS-COV2 variants. This has now spread across the globe.
How much do we know now about the variant?
We have much more information about the variant now. The virus has now spread across to more than 100 countries and in India, it is causing a large number of infections in major metros as of now. We know from genomic sequencing results, even though in small proportions, that Omicron has taken over in Mumbai, Delhi and Bengaluru. The good news amidst the surge, however, is that most of the patients who have got Omicron have mild illness. I think vaccination has helped in a big way to minimise the severity of the disease and drastically reduce mortality. It is still the Usain Bolt of SARS-COV2.
Karnataka is now seeing a surge. Yet we have had several political rallies, fairs, festivities.
What are the most likely scenarios over the next two months?
I would like to say wherever there are crowds, especially in closed spaces, the transmission is going to be very high. It is the festive season and people are fed up with restrictions. For the next few weeks, there definitely will be an increase in the number of transmissions. The severity of the disease will be less, but that leaves no room for complacency whatsoever. Bengaluru will peak first and then it will go out to the districts. That is where festivities, travel and rallies are going to contribute to the migration of the virus, from being a Bengaluru-centric pandemic right now, to other districts.
When will it exactly peak?
Bengaluru will peak in the last week of January and other districts will peak in mid-February. I would say, at the end of February, we will see a decline across the state and Bengaluru will start declining much earlier, and it will probably trail into March. But there may be a tail which will wag till the end of March. How long it will wag is difficult to say.
Now that we know it is an Omicron-driven wave, what is INSACOG going to look at? Are we still sequencing international travellers and clusters?
INSACOG is changing its strategy; it is now going to focus on hospital admissions. We will be sequencing patients with different grades of severity, continue to watch variants and look at clusters in newer areas. For example, right now, it is all city-centric. Once the cases start to move to the districts, we will start looking at clusters in newer samples. Children will now be on the INSACOG radar.
What are we trying to find out from this?
Clinical correlation of genomic sequencing is very important. We will also need to see if there is any evolution of this lineage. As of now, predominantly, the Omicron lineage is producing more or less mild form of disease, but if it does produce severe disease in certain individuals, it will give us some insights into whether comorbidities are responsible for the severity or whether the lineage itself is evolving into sub-lineages, because there will be mutations continuing to occur in the lineage.
Omicron is evolving? How many sub-lineages we have?
I have been associated with the development of the RT-PCR kit known as ‘Omisure’ and every day we watch out for variants. We know that apart from B.1.1.529, we now have BA.1, BA.2 and BA.3 sub-lineages. While BA.2 and BA.3 are increasingly being reported from some parts of India like the Northeast and Rajasthan in Karnataka, it has predominantly been B1.1.529, but a few are BA 1 and BA 2 too.
Will we keep needing booster shots?
An honest answer is, I don’t know. But the way Omicron is spreading, it will give a booster kind of effect to all those who are vaccinated as well as the unvaccinated, if they get infected. To that extent, we should expect that for sometime, at least after this wave subsides, there will be a lull. Looking at what happened during the Spanish Flu a century ago, it subsided after three waves. This virus comes with surprises. My own guess is another precautionary dose vaccine, as we call it in India, and a booster dose for all should be enough. I think there may not be a need to go on tinkering with the vaccine.
What is the relevance of Omisure to understand the clinical picture?
It is an RT-PCR test that can specifically detect the Omicron variant. It can also detect other SARS-COV2 virus which is not Omicron. This has clinical relevance, especially in those who are hospitalised, to know if it is Delta or any other variant. Delta is still around. It also helps in knowing if monoclonal antibody cocktail drugs can be used for those patients.
Also, when you see new clusters in the districts, you want to know if the virus is from the main metro or a new one. If it’s not Omicron, then sequencing it will yield faster results to know if it’s a sublineage of Omicron or a new variant itself.
