Centre sounds Covid alert, asks states to track positive samples

In a letter to the states and UTs, Union Health Secretary Rajesh Bhushan said, “In view of the sudden spurt of cases being witnessed in Japan, United States of America, Republic of Korea, Brazil and China, it is essential to gear up the whole genome sequencing of positive case samples to track the variants through Indian SARS-CoV-2 Genomics Consortium (INSACOG) network. Such an exercise will enable timely detection of newer variants, if any, circulating in the country and will facilitate undertaking of requisite public health measures for the same.”

Medical staff moves a patient into a fever clinic at Chaoyang Hospital in Beijing, China December 13, 2022. (Reuters)

“…all states are requested to ensure that as far as possible samples of all positive cases, on a daily basis, are sent to the designated INSACOG Genome Sequencing Laboratories (IGSLs) that are mapped to the States and UTs,” he said.

Currently, the INSACOG network of over 50 laboratories across the country has been sequencing only select samples – positive cases detected among 2% international passengers tested at random, samples from designated sentinel sites, and samples from any cluster or outbreak in the community, according to the guidelines for surveillance by the Health Ministry. In addition, laboratories have also been testing for viral RNA in the sewage system.

Other than increased surveillance, there has been no change in protocol for international arrivals as of now. The protocol revised last month does away with the need for either a negative RT-PCR or complete vaccination certificate. It said in-bound passengers should “preferably be fully vaccinated as per the approved primary schedule of vaccination against Covid-19 in their country.”

Globally, the number of Covid-19 cases has remained almost stable at around 3.3 million in a week. However, the number of deaths increased by 10% over the preceding week, according to the latest situation report of the World Health Organisation released on December 14.

“The number of newly reported weekly deaths increased across three WHO regions: the African Region (+975%; partly due to batch reporting from South Africa), the Region of the Americas (+37%), and the Eastern Mediterranean Region (+81%),” the report said.

There have also been reports of a surge in cases and deaths from China as the country eased its “zero Covid-19” policy earlier this month. The easing of the norms was followed by increase in hospitalisation, shortage of flu medicines, and some schools moving back online.

An Omicron sub-variant BF.7 is reportedly linked to this surge. BF.7, which is a nomenclature assigned to BA.5.2.1.7, has already been detected by the INSACOG network in India, according to those in know of the matter.

As per data from India’s national Sars-CoV-2 genome sequencing network, BA.5 lineages accounted for only 2.5% of the cases in November (BF.7 is an offshoot of BA.5). At present, a recombinant variant XBB is the most commonly seen variant in India, accounting for 65.6% of all cases in November.

Dr Anurag Agarwal, former head of INSACOG, said, “China is now experiencing the Omicron wave that other countries have already seen. Other countries report an increase in cases from time to time, but it has largely not been accompanied by a high number of severe cases and deaths.”

He said there is no need for travel restrictions any longer, especially in India where almost everyone has had the infection and been vaccinated, but surveillance and testing of in-bound passengers from a country experiencing a surge may help.