Updated: April 26, 2020 9:09:23 am
Gujarat’s high fatality rate could be due to the significant presence of L strain of coronavirus over the S strain, said Dr Atul Patel, infectious disease specialist at the Sterling hospital, which is one of the three private hospitals in Gujarat designated to treat COVID-19 patients.
In Kerala the mortality rate was low because most of the patients came from Dubai which has the milder S strain, said Patel at a media interaction presided over by chief minister Vijay Rupani and deputy chief minister Nitin Patel on Saturday that began with a presentation on the state’s handling of the corona virus, in comparison to other states and countries.
Dr Atul Patel was replying to a question on the high fatality rate in Gujarat.
“I was talking to the medical advisor to the Kerala government who said that most of the patients came from Dubai. There are two distinct strains of the coronavirus — L and S strain– of which L is the original Wuhan strain which is more pathogenic and leads to more severe disease and early death. After Wuhan, there was spontaneous mutation of the L strain, which converted to S strain, which is milder, less pathogenic”.
However, the first three patients in Kerala discovered in January were students from Wuhan.
Kerala, said Patel, has more cases of the S strain, while the L strain was more common in Italy and France, causing rapid death. “In the US, the New York data is entirely different from the rest of its states. Patients from New York were all travelers from Europe. Here we have people coming from European countries, the US, and New York and thus we have a mixed strain of the virus. We need do research on which is the predominant strain here. But I believe probably we have little higher of the L strain which leads to mortality”.
So far, three strains of the coronavirus have been detected in India, depending on the provenance of the cases – the strains from China, Europe and the US.
According to Dr RR Gangakhedkar, the head of epidemiology and infectious diseases at ICMR, there are minor variations in the strains. Talking about the strains last week, Dr Gangakhedkar had said: “The first cases were from Wuhan (of airlifted students) and these are similar to the Chinese strain as the sequence is the same as that of Wuhan…then came cases from Italy and Iran. For Iran, there are some fragments in the genome that resemble the Chinese strain. In case of Italy and the US, there is a little bit in the genome from different countries because people travel a lot. The important question for us is which is the predominant variety. That we will know in some time but it is unlikely that if a drug is developed it will show different efficacy for different strains because all strains use the same mechanisms for replicating within the cells. It may be different for vaccines though. The good thing is that it does not seem to mutate too often,” he said.
Dr Atul Patel also blamed the mortality rate on the multiple comorbidities of diabetes and hypertension in Gujarat.
Pulmonologist Parthiv Mehta said delayed reaction to the symptoms could also be a reason why there was death within “six to 24 hours”. The doctors present in the briefing, including cardiologists Dr Tejas Patel, Dr RK Patel, and Dr Mehta, appealed to the government to instill confidence in the doctors to open their clinics.
Gujarat, according to chief minister Vijay Rupani, was readying itself based on the doubling rate of corona cases.
“The entire world is discussing doubling rate. We should also calculate based on the doubling rate, and our readiness- if worst comes to worst, should be to prepare for projection till end of May – with beds, COVID Care centres and PPE suits,” Rupani said.
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