The sudden increase of COVID-19 in China-Should it is a cause of concern for Indians?

A sudden surge of covid cases caused by a new variant has created Fear and Panic among people all over the world including India. Are Indians also at risk of increased morbidity and mortality with this variant? But We have analysed that there seems little cause for worry for vaccinated healthy citizens of India. Indians have better immunity because of the following reasons

Natural infection of a large section of the Indian population: large scale infection of the Indian population during the second wave of Covid-19 gave solid immunity to Indians. As we all know Immunity imparted through natural infection by live Sars-CoV-2 during the Pandemic is likely to be more robust and longer lasting.

Efficacious Indian vaccines: Vaccines used in India are proving to be more beneficial in terms of safety and effectiveness. India opened up Vaccination of masses after April-May 2022, which coincided with the second Wave of Covid-19. Most people received their vaccine after the Second wave.?Hence, the timing of even the First and Second doses of primary series vaccination by default (not by design) served as the Second dose and Booster dose, respectively, imparting robust immunity to a large section of the Indian population. So, it doesn't matter if we gave enough 3rd dose boosters. Sars-CoV-2 immune responses have followed the principle of Original Antigenic Sin. Therefore, the effective vaccines made using the original Wuhan Variant have proved efficacious in curtailing further waves worldwide.

Enough supply of vaccines by many Indian manufacturers: Many Indian manufacturers like Serum Institute and Bharat Biotech effectively maintained the supply chain of vaccines throughout the pandemic which was further facilitated by Govt of India’s support in the form of Free vaccines to all the Indian population! (Hats off to PM MODI)

Availability of enough manpower to serve the population in need: A Huge Asha worker manpower created by the Indian Govt (PM MODI) was successful in taking the Vaccination program to the farthest and most difficult-to-tread nooks and corners of Indian villages despite weather and terrain challenges (hats off to Indian govt PM MODI!)

What about vaccine efficacy against changing variants of Sars-Cov-2 in the world and India? It was observed that During the First and Second waves same Virus Variant infected most countries worldwide. But since the discovery of Omicron, the genomic curves of different regions show different variants with differing infection rates and disease severity. The phenomenon could be attributed to different vaccines used in distinct regions. USA, Europe, and several other nations relied upon mRNA vaccines while India largely banked upon Serum's vector-based vaccine and, to some extent, killed virus vaccine by Bharat Biotech.

mRNA vaccines code for a particular epitope of the virus and hence produce different immunity than Vector-based vaccines and can thwart specific variants more effectively. Possibly, therefore, BA.4 and BA. 5, which created ripples in the west, were not allowed to take over in India. There can be several confounders to this process, like ethnic variations.

The situation in China is different from India:

It needs to be understood that the immune conditions of the population are different in China and India. Indian population has a robust immunity driven by exposure during the second wave followed by effective vaccines, while the Chinese citizens are still behaving like a naive population in the wake of poorly efficacious vaccines and little infection of masses because of the Zero-Covid policy in China. China is now going through the Second Wave of Covid-19. 40% of the Chinese population is already infected.

Status of a current variant of COVID in China and the world

Currently, a massive outbreak of COVID in China is caused by the BF.7, a sub-lineage of the BA.5 Omicron variant. More precisely BF.7 is BA. 5.2.1.7 . It has been the prevailing variant Since October 2022. It had enough time and opportunities to travel to India and cause harm but fortunately, little so far. ?BA.1 and BA.2 sub-variants of Omicron were the main drivers of the January 2022 wave in India.?The sub-variants BA.4 and BA.5 that followed could never take over Indian Virosphere despite being dominant strains in Europe and US. As per data from India’s national SARS-CoV-2 genome sequencing network, BA.5 lineages accounted for only 2.5% of cases on November 22. Also, India saw very few cases of BF.7

Although current variant BF.7 is more infectious than the original Wuhan Variant with a higher likelihood of the variant spreading in a population and replacing other variants. However, practical experiences were milder in the USA. BF.7 accounted for more than 5% of US cases and 7.26% of UK cases in October. Scientists in the West were watching the variant closely; however, there was no dramatic increase in the number of cases or hospitalizations in these countries.

Status in India: Although only a few cases have been reported so far in India in the last couple of days, and from the above discussion we can hope that, newer Chinese variants will not be able to evade the immunity acquired by infection and vaccination of Indian population

The high-risk population still may get troubled by this new variant despite past covid, vaccination. i.e., elderly, previous or current lung issues, obese, Diabetics, cancer patients, HIV, other immunocompromised status, transplant patients, etc.

My suggestion: Don’t panic, Prevention is always better than cure!

Vaccination:

·??????Unvaccinated people should go for immediate vaccination,

·??????People with comorbidities and immunocompromised should be very careful and should avoid unnecessary exposures (avoid large gatherings and take precautions) and it would be better for them to go for a fresh Booster.

Social distancing and wearing masks: Do we need to wear a mask? Do we need to wear N95 masks? Do we start social distancing?

·??????General population: Mask up. you can wear 3 ply masks, there is nothing harmful in that. Social distancing is a good option till the situation becomes clear.

·??????All Health care personnel: Mask up, I haven't stopped wearing the mask in my clinic yes, they should wear 3-ply masks, and depending upon the situation N 95. Healthcare personnel needs to take extra precautions in the hospital and other facilities.

·??????This info I have shared includes input from doctors all over India. But we are also Waiting for further information.

Testing for covid:

During Winter in India- almost every household has 2-3 cough, cold, and fever cases. I would encourage rapid home tests of elderly or sick people at home if they develop fever or respiratory problems. In case of a positive report, doctor’s supervision for 7-10days.

We will not go back to lockdown. Experience has taught us that we can’t stop respiratory viruses through lockdown