Even as Maharashtra reports a slight uptick in COVID-19 cases, experts urge calm. The current rise, driven largely by better testing and heightened public awareness, has not led to any reported deaths. Dr Sanjith Saseedharan, Consultant and Head of Critical Care at S.L. Raheja Hospital, Mahim (A Fortis Associate), shares his insights on the current situation, the nature of emerging variants, and why the virus continues to evolve.
Q: What are your observations about the COVID spread in Maharashtra/Mumbai right now?
A: COVID testing has become part of most infectious disease panels and hence it is now picked up more than otherwise. There is an increase in the number of COVID-19 cases because of the availability of testing and heightened awareness that a common cold could be COVID-19. However, not a single death due to COVID-19 has been reported in the state and the present virus seems to be mild. This mild nature of the infection could be attributed to a substantial amount of natural immunity to the infection.
Nagpur and Mumbai have reported a relatively sharp increase in the detection of COVID-19. Presently, the spread of COVID-19 is sporadic and it is nowhere closer to the pandemic proportions that the world had witnessed earlier.
Q: Tell us more about the JN.1 variant.
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A: The variant that has been around for the last 8 to 12 months is JN.1 which is a descendant of BA.2.86 that belongs to the Omicron family. Recently, a new subvariant has been found which is christened as the Nb.1.8.1, a variant that has several mutations which could evade natural immunity and have a higher affinity towards human receptors. Epidemiological studies and more data on the various effects of the infection with this variant are being studied and data should emerge soon.
Q: Do you see a surge in the coming months?
A: Kerala, Tamil Nadu, and Maharashtra have reported the maximum number of cases in the last few months. However, the numbers are very small and not of any major concern. With rains and the dip in the temperature, there is an increase in viral illness. Any viral illness, COVID-19 or otherwise will have periodic rises in the cold months. Also, we must understand over time there might be a ‘natural immunity contraction’ in the population which will lead to a further spike in the number of people infected.
It is also important to realise that international travel has seen a spike which may lead to mutations and the virus can evade immunity and infect more people. However, there is no reason to indicate that the infection or the effects of the infection will reach pandemic proportions.
Q: Could you tell us more about the coronavirus that makes these variants keep coming?
A: Variants are of three types - a variant of interest, a variant of concern, and a variant of high consequence. Coronavirus does not have the capacity to form new variants. But surprisingly COVID-19 keeps producing different variants time and again. Whenever a virus infects a human cell, it starts to replicate and during the process errors can occur in its genetic composition, potentially resulting in the emergence of new variants. Some of these mutations may prevent the virus from replicating while others may enhance its ability to survive, evade the immune system, or even increase its virulence.
Importantly, if more people are infected there is a possibility for new variants to be formed. Therefore, to reduce the formation of variants, we need to control the number of people who are infected. This is not a phenomenon which is unique to the COVID-19 virus, and in fact, almost all seasonal viruses have the same nature. For example, the influenza virus keeps on mutating and forming new variants and hence in every season, a new influenza vaccine is reengineered to match a particular variant.
