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Omicron in India is an evolving threat: Dr Subramanian Swaminathan

Nandita Vijay, Bengaluru
Friday, December 10, 2021, 08:00 Hrs  [IST]

Omicron in India is an evolving threat, and we are now detecting new cases at an ever escalating rate. Furthermore, cases are being found as clusters, which suggest that community transmission is in effect and that further spread across the country is inevitable, stated Dr. Subramanian Swaminathan, director - infectious diseases, Gleneagles Global Health City, Chennai.

Most countries globally are on a trajectory comparable to what is being seen in South Africa, and it is probable that this variant will sweep the world and replace the delta variant as the primary variant in very short order, he added. 

Our central and state governments have instituted measures to slow the progress and manage the situation. Vaccine uptake needs to be on a war footing. But a vaccine takes 2 weeks to give a benefit.  Travel restrictions are in place, but this will not prevent the inevitable. Mask usage is the key. Preventing people congregating indoors is also important, and for this reason, all functions and meetings should be deferred. Non-essential travel should be postponed. Schools should be closed, as children have been shown to be hyper spreaders, pointed out Dr Swaminathan.

Diagnosis of Covid can still be made on the basis of a positive PCR test, but to confirm it as omicron, gene sequencing is needed. As a screening test, the S gene based PCR systems are being use, as omicron variant would cause a negative S gene test, but a positive PCR, he added. 

Early data from Tshwane Metro in Pretoria suggests increased infection and hospitalization in children under 18, but it appears that they have mild disease and are discharged within 5 days. Most of the severe disease is in adults, and those who have not had 2 doses of the Covid vaccine seem vulnerable to severe disease. Also of note, prior infection with Covid- what is known as natural immunity seems insufficient to protect against this variant.

The usual treatment protocols for severe Covid still apply in the treatment of the new variant as well. However, specific antivirals are still being studied for their potency against this threat. Early studies have shown that some of the monoclonal antibodies may not be effective against this variant. One monoclonal, sotrovimab, has been confirmed to be effective, but we do not have access to this drug currently. It is hoped that the oral medicines like molnupiravir will retain effectiveness against this variant, Dr Swaminathan told Pharmabiz.

Although the primary vaccination which is the first 2 doses is of greatest importance, there is a growing body of data indicating benefit from a booster dose in those vulnerable, like the elderly. The Government has taken a call not to go for booster doses, as this may take doses away from those who need it for primary vaccination. It should be noted that although more than 40% of our adults are double vaccinated, data from Europe suggests that countries with 66% double vaccination and under have high mortality with a Covid wave, and therefore this needs emergent attention, said Dr Swaminathan.

Black fungus or mucormycosis cases have reduced significantly and are now a rarity. However, there could be a resurgence if the wave is big and we have not learnt the lessons of the previous wave like judicious use of steroids and proper diabetes management.


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