As the second COVID wave batters India, scientists continue to be baffled over the reason for the dramatic surge in cases. They seem to be still groping in the dark as there is sill no clinching evidence on why cases started to decline in the country from September after a daily peak of around 100,000 cases.
This led people to throw caution to the winds and head off to Goa, Maldives and to any available holiday destination. Wearing masks and physical distancing were not strictly followed, bars and hotels were crowded and people were freely fraternising with each other. People spoke vaguely of creating “bubbles” (family or friends who you felt safe to meet) and moving around within that circle.
Obviously, nobody even remotely knew what they were talking about. So, when the second wave hit India, people blamed it on social interactions, religious gatherings, election rallies, marriages etc. But elections did not happen in Maharashtra, Delhi, Punjab or Karnataka. So, what explains the fact that these states have been severely affected in this second wave? Moreover, the second wave started before polling began in April, pointed out experts.
Not practising COVID-19 appropriate behaviour has brought us to this crisis and is being offered as one reason for the spike in cases since March. But according to experts that may just be one side of the story.
The emergence of virus variants being the culprit
Researchers say that the speed and scale of the current outbreak may be triggered by ‘emerging variants of the virus’. In the last few months, several new variants of the virus have been found circulating in the Indian population. According to a scientist, as the virus spreads, it is able to mutate more because for every new person the virus infects, it has a new opportunity to frantically copy its genome. And in its rush to duplicate its genome, the virus makes mistakes—repeatedly—and those mistakes sometimes end up making the virus fitter and stronger. Those “mistake” versions become variants that start to outcompete and dominate other, less fit viruses.
However, when a person is infected, it could also mean they contracted a viral variant that causes more severe, and even deadly disease. These variants are easier to transmit and more deadlier.
The different variants in India
One COVID-19 variant that has gained a lot of attention in India is known as B.1.617, first found in Vidarbha region of Maharashtra. It is being watched because of its ability to transmit at a faster rate and because it can dodge the immune response. Following a rise in cases in the UK and evidence of community transmission, Public Health England has reclassified B.1.617 from being a Variant Under Investigation to a Variant of Concern (VOC). The characteristics of this variant is still being studied.
Scientists are also focussing on other fast-transmitting variants, such as the one that first emerged in the United Kingdom, called B 1.1.7, which is seen in large numbers in northern India. It is said to be 50 per cent more transmissible and is generally not associated with greater severity. But increased hospitalisation and case fatality could lead to more severity and lethality.
The Brazilian variant is associated with reduced neutralisation of the virus post-vaccination. The South African variant is also associated with 50 per cent more transmission and reduction in vaccine efficacy.
Are these variants the reason for the COVID-19 surge or not?
Even as scientists acknowledge that these variants are responsible in some way for the surge in India, they admit “epidemiological evidence” is still not coming together to prove that this is a major cause. Though the Indian government has linked the B.1.617 to the spike in cases in some of the states. According to the Public Health England website, there is currently insufficient evidence to indicate that any of the variants recently detected in India cause more severe disease or render the vaccines currently deployed any less effective.
As it plays out, not every surge in COVID cases can be placed at the door of variants
Scientists are saying that the new variants which are circulating in the country may not be responsible for every surge in different states. Even within a state, these faster-transmitting variants could be responsible for spreading the virus in some areas but other factors would be at play in other areas, said an Indian Express report.
For example, the B.1.617 variant was largely seen in the Vidarbha region in Maharashtra but it was not present among the Mumbai population. The only way scientists could explain the significant surge in Mumbai was due to the opening of the local trains, which led to a lot of close intermingling among travelers, added the news report.
In Kerala too, the variant N440K which was found in this southern state was not visible in areas where COVID-19 cases were rampant. In fact, studies showed that the surge was found to be at its highest in areas where his variant was prevalent in a small way.
Yet, Punjab and Haryana tell a different story
In Punjab and Haryana however it is clear what is causing the spike in cases. In both states the UK variant dominates and in a recent study, more than 80 per cent of the samples tested from infected people in Punjab had this variant.
Delhi cases too has this variant but there are variants from the different states of India circulating among the population as well. And experts believed that most of these variants were not impacting the spike in cases.
In the final analysis – it is not just one factor
Scientists are now saying that a sharp increase in cases or a drop can only be explained by a combination of factors. Almost every state has one variant or the other, but in many places they have not played any active role in sharpening the curve. Scientists have said that in epidemics, small changes in inputs, or initial conditions, can lead to unexpected outcomes. So, the spike may have been caused a large-scale wedding in the area or a mela or even a rally.
Variants under observation
The new variants are being closely monitored the world over. The Indian government has already classified the B.1.617 as a ‘variant of concern’ and according to an Indian Express report, this particular variant has undergone further mutations, and at least three different sub-variants, named B.1.617.1, B.1.617.2 and B.1.617.3. They are deadlier and can spread rapidly and cause bigger damage than the parent variant.
The UK and the South African variant too are worrisome, say experts.
WHO has also established a SARS-CoV-2 Risk Monitoring and Evaluation Framework to identify, monitor and assess variants of concern. It will involve components like surveillance, research on variants of concern, and evaluation of the impact on diagnostics, therapeutics and vaccines. The framework will serve as a guide for manufacturers and countries on changes that may be needed for COVID-19 vaccines.
How can future new variants of the COVID-19 virus be prevented?
Stopping the spread is the key. According to WHO, current measures to reduce transmission – including frequent hand washing, wearing a mask, physical distancing, good ventilation and avoiding crowded places or closed settings – will continue to work against new variants by reducing the amount of viral transmission and therefore also reducing opportunities for the virus to mutate.