COVID-19 third wave inevitable, could strike India in 6 to 8 weeks, says AIIMS chief

Is Delta Plus more virulent? Can a recovered patient get reinfected? 5 big questions answered

The delta plus variant of the coronavirus has been spreading fast across India. The strain is a mutated form of the delta variant which wreaked havoc across the world. Dr Tanu Singhal of Kokilaben Dhirubhai Ambani Hospital answers some crucial questions about the variants and Covid-19.

The world is grappling with the more virulent strain of the coronavirus, the Delta Plus variant. It has been spreading rapidly, causing more infections. Some reports even claim that it is impervious to vaccines and therapies generally used to treat Covid-19 patients.

But is that a reality? How dangerous is the delta plus variant? And how long with the coronavirus disease continue to wreak havoc. Dr Tanu Singhal, Consultant, Paediatrics and Infectious Disease at Kokilaben Dhirubhai Ambani Hospital, speaks to hindustantimes.com on these and other issues.

Q: Does Delta Plus variant adversely affect vaccine efficacy?

Dr Singhal: The Delta Plus variant is a mutation in the Delta variant. The original Delta variant was first discovered in India and drove the second wave. It had acquired two new mutations – one was L452 R and other was E484 Q. We know that this variant is highly transmissible and possibly more virulent and less impacted by vaccines.

This Delta Plus variant has been recently discovered and has another mutation – K417 N – which is also found in the beta and gamma variants which is the South American and the Brazilian variants but the practical experience with Delta Plus variant has been very less because there are only about 50-odd cases which have been sequenced in India so far.

So, the first important point I would like to make is we don’t have sufficient knowledge about the transmissibility or the virulence or the immune escape properties of this Delta Plus variant. It has been hypothesised that because it has the K417 N mutation, which was also there in the Brazilian variant, it may escape vaccine induced immunity but there is no practical data to support it so far.

There is one woman in Rajasthan who was fully vaccinated yet got infected with Delta Plus variant but her disease was mild. So until now it has been discovered that while variants can cause breakthrough infections in vaccinated people overall the severity of the disease is milder.

Q: What happens if a recovered patient contracts the infection again, this time the Delta Plus variant?

Dr Singhal: Firstly, so far reinfections have been few. That means most of the patients who got infected in the first wave did not get infected in the second wave. So we know that prior infection with the other original virus did give long-lasting protection even against the delta variant. But we do not know how common that is going to be for reinfection with the delta plus. But until now all reinfections have been mild and not required hospitalisation unless person is vulnerable.

Q: What are the symptoms of infection with Delta Plus variant? Are they different from the Delta or Alpha variants?

Dr Singhal: We do not have data so far to establish that the symptoms are milder or more severe as compared to the delta variant.

Q: Is the third wave of Covid-19 going to be as devastating as the second one? Are we better prepared for it in terms of vaccines and oxygen supply?

Dr Singhal: We have sero-prevalence surveys that says about 60-70% of our population is immune which was about 25-30 per cent at the end of the first wave. Therefore, chances are that natural immunity is comparatively higher now than what it was after the first wave. Also we have vaccinations levels now which are much better.

Hence, possibility of third wave being as severe as second wave is unlikely and it should rather be a smaller and less ferocious wave hopefully. This could change though if we have a new variant which emerges and is able to escape immunity provided by either previous infection or vaccination.

We will be better prepared to handle the third wave as compared to the second wave because what happened was after the first wave everybody became complacent as there were very few cases in the months that followed the first wave and people thought that India has achieved herd immunity and Indians are more immune than other people and Covid is gone from India and we did not build infrastructure which we should have between the first and second wave.

So I think the message is gone through clear and authorities are trying to ramp up the infrastructure. Which is a good step and much desired for regular health services and also builds our preparedness for other future pandemics if they were to occur.

Q: How many waves are expected to hit before Covid-19 is declared under control? When are we expected to reach herd immunity?

Dr Singhal: No one has an answer to this question. But looking at the previous pandemics like Spanish flu, the Asian flu of 1957-58, the Hong Kong flu of 1967, or SARS or MERS outbreaks, or H1N1 flu of 2009, most pandemics have lasted for two years. As an extension to that, and also with the world achieving herd immunity and vaccinations increasing, I feel personally in another six month time we should have better control of this pandemic.

First case of Delta plus in Kangra dist of Himachal Pradesh

The first case of Delta plus found in Kangra district of Himachal Pradesh. There are 69 cases of Delta variant in Kangra: Chief Medial Officer (CMO) Kangra, Dr Gurdarshan Gupta

Centre rushes teams to six states reporting high number of Covid cases

The Centre on Friday deputed multi-disciplinary teams to Kerala, Arunachal Pradesh, Tripura, Odisha, Chhattisgarh and Manipur in view of the high number of COVID-19 cases being reported by these states.

Teams will be supporting the states in their efforts to carry out a targeted Covid response and management, and effectively tackling the pandemic, a Union Health Ministry statement said.

The two-member high level team to these states comprises a clinician and a public health expert, the statement said.

The teams will visit the states immediately and monitor the overall implementation of COVID-19 management, especially in testing, including surveillance and containment operations; Covid Appropriate Behaviour and its enforcement; availability of hospital beds, sufficient logistics including ambulances, ventilators, medical oxygen etc., and COVID-19 vaccination progress. The teams will monitor the situation and also suggest remedial actions, the statement said

How Are Delta Variant Symptoms Different From The Original COVID Symptoms?

Are Delta variant symptoms different from the original COVID symptoms?

Over a year has passed since the novel coronavirus impacted our lives in many ways. Not only did it take a massive toll on our lives but also deprived us of our mental well-being. Now, with the new emerging variants, it does not get any better. As per experts, the new variants, like the

Delta and Delta Plus variants, have evolved greatly and pose more risk to human life. Additionally, as per recent findings, the symptoms experienced from the Delta variant may also differ from that of the traditional vaccines.

Original vs. Delta strain: How are the two different?

As is known, viruses are programmed to mutate into new strains.

According to the WHO, a virus replicates or makes copies of itself, which is usual. These changes, by definition, are called “mutations”. A virus with one or more new mutations is referred to as a “variant” of the original virus.

That said, when it comes to SARs-COV-2 virus, it has mutated into many strains, of which the Delta variant, also known as the B.1.617.2, is considered to be the most dominant strain till date.

In opposition to the original strain, the mutations can have a difference in genomic sequencing, which may allow them to surpass, or attach themselves to the healthy cells more profoundly.

The Delta variant, first identified in the state of Maharashtra last October, is considered to be a cross between E484Q and L452R mutations, which is why it is said to be more infectious and transmissible as compared to the original strain.

Can the symptoms of the Delta variant differ from the original COVID symptoms?

When it comes to being infected by a viral infection, it can depend on two factors. One pertains to the viral factors, whereas the other involves the host factors.

The viral factors include the rate of infection, the speed of the replication, mode of transmission and more. It changes with the mutation of the virus.

On other hand, host factors take age, gender, medications, diet, exercise, health and stress into consideration.

Therefore, when it comes to signs and symptoms of a particular virus, ample data needs to be collected from individuals to ascertain the most common out of the many.

Since the Delta variant is a mutation of the original strain, it is said that the symptoms may also have altered during the course of mutation.

According to a self-reporting system through a mobile app, data from the United Kingdom suggest the most common COVID symptoms may have changed from the original COVID symptoms.

What does the report say?

The data collected on the symptoms app suggests that while fever, cough, headache and sore throat remain to be common COVID symptoms, a runny nose was hardly reported in the earlier data. Apart from that, loss of sense of smell, which was originally quite common, now is the ninth most common symptom.

Experts believe that the changes in the symptoms could be a result of vaccination drives. While more older adults are vaccinated, the younger population contribute to the majority of COVID cases and they are more likely to develop mild infections.

Apart from that the evolution of the virus may also be the reason behind the change in symptoms. Given the different characteristics (viral factors) of the Delta variant, the symptoms also tend to alter. However, there is no solid evidence proving the same.

Vaccine efficacy against the new emerging variants

There has been a lot of buzz around whether the COVID vaccines will be effective against the Delta or the new emerging variants. While much is under speculation, studies have claimed that certain COVID vaccines can prove effective against the Delta Variant.

Bharat Biotech’s Covaxin and Serum Institute of India’s Covishield and Russia-made vaccine Sputnik V are all said to be effective against the Delta variant. In addition, Pfizer BioNTech vaccine is also said to reduce the risk of hospitalisation, according to a UK study.

While researchers are trying to find more answers to the variants and the efficacy of the vaccines against it, it is important that everyone gets their COVID vaccines in time and at all cost.

Who are ‘highly protected’ against Delta variant of Covid? ICMR study reveals

Covid recovered with even one dose of the vaccine have higher protection against Delta variant than those who have never been infected but have got vaccinated.

Those who have recovered from Covid and have got either one or two doses of Covid-19 vaccine have the maximum protection against the Delta variant of SARS-CoV-2 Vitus, an Indian study conducted by the scientists from the Indian Council of Medical Research, National Institute of Virology, Department of Neurosurgery, Command Hospital (Southern Command), Armed Forces Medical College, Pune, has revealed. The study was only on the impact of Covishield.

In the study, the immune response of 5 categories of people was evaluated-

1. One dose vaccinated

2. Two-dose vaccinated

3. Covid recovered plus one dose vaccinated

4. Covid recovered plus two doses vaccinated.

5. Breakthrough cases, which mean infection after one or two doses of vaccination.

The findings suggest that breakthrough cases and the cases where Covid-19 recovered individuals received one of two doses of vaccine have relatively higher protection against Delta variant in comparison with those who have never been infected but got either one or two doses of the vaccine.

“Prior vaccination results in less severe disease against subsequent infection provide evidence that both humoral and cellular immune response play an important role in protection,” the study said.

The study also mentions Delta Plus (AY.1), the new variant of Delta, which has been reported from India and many other countries.

Explaining how variants might impact the efficacy of vaccines, the study said, "The worldwide endeavour of scientists to create a safe and effective COVID19 vaccine has resulted in the availability of 18 vaccines, which have received Emergency Use Authorization.

The vaccines available against SARS-CoV-2, have shown efficacy ranging from 51 % to 94% against the original strain D614G in phase 3 clinical trials. Immune response to SARS-CoV-2 infection involves innate immune activation and antigen-specific responses of B and T cells.

Particularly, the questions about the immune escape of, newly emerging VOCs in vaccinated individuals are still being explored. For example, the efficacy of AZD1222, which was reported to be 70% in the UK and Brazil, only reached 22% in South Africa."

Those who have once been infected are supposed to develop natural antibodies, for which the government has suggested that they should delay their vaccination. But the study reveals that the natural protection can be augmented by even one dose of vaccine against the Delta variant.

“Long-term follow-up of participants could help understand the impact of natural infection and vaccination on long-term protection from SARS-CoV-2 offered by Covishield. It is important to track the breakthrough infections to look for unexpected changes.

Monitoring of breakthrough infection would make us understand the impact of new variant or VOC on the escape of vaccine-induced immunity. Data has shown again and again that if the individuals get infected post-vaccination, had been protected from severe disease," the study said.

‘Dangerous period’ of pandemic, says WHO chief after Delta variant found in 100 countries

As the Delta variant continues to mutate and evolve in nearly 100 countries, the Director-General of the World Health Organisation (WHO) said the world is in “a very dangerous period”.

The Director-General of the World Health Organisation (WHO) said on Friday the world is in “a very dangerous period” of the Covid-19 pandemic after the contagious Delta variant was found in nearly 100 countries.

At a press briefing, Dr Tedros Adhanom Ghebreyesus said the India-born Delta variant is still evolving and mutating to emerge as the most dominant variant of Covid-19 in many countries.

Suggesting that vaccination would effectively end the acute phase of the pandemic, the WHO chief said, “I have already urged leaders across the world to ensure that by this time next year, 70 per cent of all people in every country are vaccinated.”

“It’s within the collective power of a few countries to step up and ensure that vaccines are shared,” Dr Tedros added, noting that over 3 billion doses of vaccine have already been distributed globally.

However, the inequality in the inoculation process could still be a concern, if not checked at the right time. Of the total Covid-19 jabs administered globally, fewer than two per cent have been in poorer countries.

Even though rich countries like the USA, Britain, France and Canada have pledged to donate 1 billion vaccines, the WHO has estimated over 11 million doses to inoculate the entire world.

Asserting that it’s a threat to everyone on earth when some countries fail to vaccinate their population, Dr Tedros called for a global effort to vaccinate at least 10 per cent of the population of every country by September, at least 40 per cent by the end of the year, and at least 70 per cent by the middle of next year.

“Vaccine equity is not just the right thing to do. It’s the best way to control the pandemic and reboot the global economy,” the WHO chief said as he warned that “until we end the pandemic everywhere, we will not end it anywhere.”

3rd wave could hit peak between October-November if Covid-appropriate behaviour not followed: Scientist

The third wave of coronavirus could hit the peak between October-November if Covid appropriate behaviour is not followed, but may see half the daily cases recorded during the second surge, according to a scientist of a government panel tasked with modelling of COVID-19 cases.

He, however, said the third wave could spread faster if any new virulent variant emerges.

Manindra Agarwal, involved in the "Sutra Model’ or the mathematical projection of trajectory of COVID-19, also said the model has three scenarios—optimistic, intermediate and pessimistic—for the prediction of the third wave.

The Department of Science and Technology had last year formed the panel to forecast the surge of coronavirus cases using mathematical models.

The panel had also received flak for not predicting the exact nature of the second wave of Covid.

Agarwal, who is part of the three-member panel, said loss of immunity, effects of vaccination and possibility of a more virulent variant, have been factored while predicting the third wave, something which was not done during modelling the second wave.

“We have created three scenarios. One is “optimistic’ one. In this, we assume that life goes back to normal by August, and there is no new mutant. Second is “intermediate’ one. In this, we assume that vaccination is 20 per cent less effective in addition to optimistic scenario assumptions.

“Third is “pessimistic’ one. This has one assumption different from intermediate one: a new, 25 per cent more infectious mutant spreads in August (it is not delta+, which is not more infectious than delta),” he said in a series of tweets.

According to the graph shared by Agarwal, the second wave is likely to plateau by mid-August, and the third wave could reach its peak between October and November.

In case of the “pessimistic’ scenario, the third wave could see cases rise up between 1,50,000 to 2,00,000 in the country, the scientist noted.

The figure is less than half of what was recorded when the deadly second wave had hit its peak in the first half of May, flooding hospitals with patients and claiming thousands of lives daily.

If a new mutant comes, the third wave could spread rapidly, but it will be half of what the second wave was. Delta variant is infecting people who were infected with a different variant. So this has been taken into consideration,” Agarwal said.

He said as vaccination progresses, the possibility of a third or fourth wave will be less.

Yes, there are a lot of speculations about the third wave coming. The second was more severe than the first. I hope that the third wave is not as or more severe than the second one.

Is New Delta Plus Variant a Pandora Box?

Delta Plus variant has a greater affinity to the mucosal lining in the lungs, higher compared to other variants. But the severity of its damage is not clear yet and its impact on the general population remains to be seen. The variant can be a cause for worry and need to keep a very close watch, alert experts.

The new Delta Plus variant is characterised by increased infectivity, higher transmissibility rate or resistance to vaccines and treatment it’s tagged as a Variant of Concern (VoC) and its impact on Indian population is still unfolding. Experts cite that the virus, being more virulent, is heeding a clarion call to the healthcare segment to collectively tackle the new challenge.

The Delta variant (B.1.617.2) was first identified in India in October 2020, and the World Health Organization (WHO) has designated it a “variant of concern” on May 11, 2021. The Delta variant has multiple mutations. Three of these mutations — E484Q, L452R and P614R — allow the spike protein of the virus to attach more easily to the ACE2 receptor on human cells. One mutation is at the furin cleavage site of spike protein, which increases the fitness of the virus in the airway.

According to scientists, Delta Plus has an extra mutation called K417N in the spike protein that enhances attachment of the virus to the infected cells. The K417N mutation has been seen in other variants of the virus – in a strain from Qatar in March 2020, and in the Beta variant. This mutation may increase the chances of the virus for immune escape that can influence vaccine effectiveness; its impact on transmissibility is not clear yet.

“Most of the COVID-19 vaccines are designed such that the body’s immune cells recognize the spike protein, or parts of it – the place where Delta Plus’ extra mutation is. The mutation K417N present in the Beta Plus variant is reported to have immune evasion property. This can reduce the effectiveness of the current COVID-19 vaccines. Specific vaccine effectiveness against transmission, hospitalization, and levels of disease severity is still uncertain,” said Dr Tarun Bhatnagar, a scientist at the Indian Council for Medical Research (ICMR).

The country has just come out from the second COVID wave, where cases spiked four-lakh mark per day, with Delta strain driving the second wave, infecting millions and pushing health care to the brink. If the new Delta Plus variant demonstrates increased transmissibility, then a third wave is possible, coming even sooner than predicted, alert experts.

Delta Plus — A trigger for the third wave?

Delta Plus being a sub-lineage of the Delta variant, the health experts emphasize to be cautious of the former variant because it is not clear how virulent this new strain could be compared to other variants.

“The prevalence of Delta Plus is still low in India currently as the Delta variant remains dominant. However, there is no certainty, and this low number cannot indicate whether Delta Plus can instigate the third wave or not.

Even the B.1.617 variant that caused the devastating second wave in India had very few numbers before reaching a devastating level in the next two months. Some states like Maharashtra believe that Delta Plus could trigger the third wave and are taking precautionary measures,” said Dr Kanav Kahol, Founder and CEO, DIVOC Health.

Pointing out that new mutations or changing the genetic makeup of the virus are linked to waves, Neeraj Gupta, Founder and CEO, Genes2me Pvt Ltd, said, “So, there is a possibility of a wave because of this new variant.

But whether a third wave may actually occur will also depend on other factors. India has seen a second wave in the last three months. It is continuing as we are now seeing cases being at 50,000. In some places, cases continue to grow, and thus the wave has not settled down. The second wave will influence the community’s response to the new variant. Depending on the proportion of the population infected in the second wave, the third wave may not be severe. If the large population gets infected in the second wave or most of the population becomes vaccinated, then people may not develop a serious or fatal illness.”

Stressing the causes of the surge and the ways to control it, Dr Bhatnagar informed that another surge in cases in any area would be a result of interaction between the agent (virus variant), host (human) and environmental factors (public health containment measures).

Spread of the Delta Plus variant will thus depend on how common the variant is among the population, effective COVID appropriate behaviours and vaccine coverage, and people are still susceptible in terms of either not vaccinated or naturally infected with the virus, and meticulous ways to be followed in contact tracing, testing and isolation.

He also added that preliminary evidence from England and Scotland suggested that people infected with Delta variant are about twice as likely to be hospitalized.

“In the situation of a more transmissible variant, many more people will be infected that can potentially increase hospitalization, thus overwhelming the medical infrastructure and likelihood of more deaths due to lack of appropriate care rather than on account of the virus variant itself.

However, it may be noted that a recent Public Health England study for the Delta variant reported that people with one and two doses of Oxford or AstraZeneca are 71 percent and 92 percent less likely to be hospitalized,” Bhatnagar mentioned.

Adding to it, Dr. Rajib Dasgupta, Chairperson, Centre of Social Medicine and Community Health, JNU, New Delhi, said, “Most states have just experienced while few are still in the grip of the Delta variant, whether that will render adequate protection to Delta Plus is something we need to closely look at. That does not mean that all population groups are protected even in the best case scenario. A molecular epidemiology study — which entails field epidemiology studies in tandem with genomic surveillance — contributes to this understanding. This needs a lot more investment than current activities suggest.”

Genome Sequencing: Dissecting the deadly virus

Top epidemiologist professor Eric Feigl-Ding has cited that the lack of genomic sequencing in India has led to the spread of the Delta variant across the globe. He cited that genomic sequencing is required to understand the emergence, identify the possible mutation in the early stage, and check the doubling time of the variant to prevent its spread across the world. On the contrary, few experts had a different opinion.

“It is not correct to say that India was unaware of the Delta variant due to its inadequate genome sequencing. For India, genomic sequencing is an arduous task because of its population. Rapid and temporal sequencing of viral genomes is required across multiple states to identify potential concerns and mitigate the spread of the virus. For example, we have incorporated further sequencing measures by upscaling genomic surveillance programs across the country. We have ramped up our efforts in sequencing, bioinformatics and data sharing,” Gupta said.

Stressing that genomics is the way forward for handling not only infectious diseases but also personalized and precision medicine, Gupta said, “Given that we now may have to live with epidemics and pandemics, India should certainly encourage and indigenize its genome sequencing capabilities over the next two-to-three years.”

Additionally, experts inform that a meticulous characterisation of the people infected with the variant will also be critical to understand the transmission potential of the variant and identify potentially high-risk individuals for infection with the variant.

“Information related to demographics, health status, prior COVID infection and COVID vaccination (vaccine type, doses, and dose intervals) monitoring the impact of vaccination with specific vaccines on the emergence and spread of the variants is needed,” Bhatnagar added.

As the researchers are still investigating Delta Plus to determine its transmissibility, they have also indicated that Delta and Delta Plus both have the capacity or ability of immune escape which means individuals infected in the past can still develop an infection. Breaking the chain of transmission is crucial.

Breaking the transmission chain – A must

Current data by researchers indicate that the Delta variant has better “fitness” in human airway cells. This means that there is an increased amount of the virus in the infected person, so they may transmit more virus to other persons. Testing data from the UK shows that the CT value (cycle threshold)—the number of amplification cycles needed for the virus to be detected—seems to be lower in samples from people infected with Delta virus. It has also been suggested that people may become infected after a lower exposure to the virus on account of this variant being better at infecting human airway cells. No conclusive evidence is available as yet.

Emphasizing that adherence to COVID appropriate behavior is crucial, Dr Bhatnagar informed, “Use of mask avoiding crowded places, hand washing, and better ventilation in indoor spaces – to prevent the spread of this and any other variant. At a public health level enhanced contact tracing, testing, and isolation would be critical, especially in areas where Delta Plus has been reported.”

Adding to it, Dr Kahol said, “The chain of transmission can be broken through strict compliance along with precautionary measures like masks, sanitization, and social distancing. The need of the hour is vaccinating at least 60 percent of the population to reach herd immunity so that this variant doesn’t spread.”

The vaccine effect

As per the Indian Council of Medical Research (ICMR), both Covishield and Covaxin work against the SARS-COV-2 variants Alpha, Beta, Gamma and Delta. Research is now being conducted to examine the efficacy of vaccines against Delta Plus.

The two vaccines being administered currently are suspected not effective against the new variant. However, the experts say that there is no default rule to it.

“Most of the COVID-19 vaccines are designed such that the body’s immune cells recognize the spike protein, or parts of it – the place where Delta Plus’ extra mutation is. The mutation K417N present in the Beta Plus variant is reported to have immune evasion properties. This can reduce the effectiveness of the current COVID-19 vaccines. Specific vaccine effectiveness against transmission, hospitalization and levels of disease severity is still uncertain,” Dr Bhatnagar informed.

As researchers repeatedly stress that the Delta Plus is similar to the Delta variant, they also indicate that the new variant has a greater affinity to the lungs.

“Delta Plus has a greater affinity to the mucosal lining in the lungs, higher compared to other variants. But the severity of its damage is not clear yet. We are tracking the virus, and its impact on the general population remains to be seen. Yes, the new variant can be detected through RTPCR/antigen testing. Furthermore, it has also shown higher resistance to monoclonal antibodies cocktail treatments. But the resistance to the therapy is not an indication of higher virulence or severity of a disease,” Gupta said.

Experts indicate that right now there is no need to panic about the variant, but alert that it can be a cause for worry and a close watch is required to break its transmission. Globally, people reeling under the pandemic fatigue are tired of lockdowns and they are eager for normalcy. But, if prudent prevention is not followed, it is just like unlocking the Pandora’s box.

Delta variant 8 times less sensitive to vaccine antibodies, says study

The Delta variant of coronavirus is eight times less sensitive to antibodies generated by vaccines as compared to the original strain that came from China’s Wuhan, according to a new study.

The study, which was conducted on more than 100 healthcare workers (HCWs) at three centres in India including Sir Ganga Ram Hospital (SGRH) here, found that the B.1.617.2 Delta variant not only dominates vaccine-breakthrough infections with higher respiratory viral loads compared to non-Delta infections (Ct value of 16.5 versus 19) but also generates greater transmission among the fully vaccinated HCWs.

The collaborative study, “Sars-Cov-2 B.1.617.2 Delta Variant Emergence and Vaccine Breakthrough: Collaborative Study”, from India with scientists from Cambridge Institute of Therapeutic Immunology and Infectious Disease is yet to be peer-reviewed. It revealed that in vitro, the Delta variant is approximately eight-fold less sensitive to vaccine-elicited antibodies compared to Wuhan-1. (PTI)

A worrying Delta sweep puts unvaccinated people at higher risk

Is a third wave of Covid-19 infections imminent? How will the Delta variant impact those who are yet to receive the vaccine?

The falling caseload in India notwithstanding, the spike in infections in some of the countries such as Iran, Iraq, Russia, Bangladesh, Myanmar, Malaysia, Indonesia, and Thailand is a cause of concern.

Genome sequencing in most of these countries has tracked the mutations largely to the Delta variant. It is as high as 92.4 per cent in Indonesia.

First identified in India last fall, the variant, also known as B.1.617.2, has spread to at least 85 countries the world over, according to the World Health Organization.

Last week, WHO Director-General Tedros Adhanom Ghebreyesus described Delta “as the most transmissible of the variants identified so far”.

DELTA SWEEPS ASIA

Average new infections per million in Bangladesh, for instance, rose from 9.9 on June 4 to 49 on July 4. In Indonesia and Thailand, their numbers jumped from 21 and 51 to 88 and 79 respectively.

Myanmar’s new infections per million rose from 1.7 to 32.15 and Russia’s from 61 to 153.

Among these countries, the average daily deaths per million population has shot up in Russia and Indonesia from 2.5 and 0.6 to 4.5 and 1.8 respectively in the last one month. The daily death figures have also risen for Bangladesh, Iraq, Myanmar, and Thailand in the same interval.

In Russia, Bangladesh and Malaysia, 89 per cent, 75.5 per cent, and 85.7 per cent of the genome sequencing cases are linked to Delta, according to GISAID, a global database of genetic information about the virus.

THIRD WAVE IMMINENT?

Meantime, a report by SBI Research said a third wave may hit India next month and peak in September 2021.

“Going by the current data, India can experience around 10,000 cases somewhere around the second week of July.

However, the cases could start rising by the second fortnight of August," according to the report.

UNVACCINATED PEOPLE AT HIGHER RISK

According to the US Surgeon-General, Dr. Vivek Murthy, unvaccinated people are at a higher risk from Delta.

“This is, again, a serious threat and we are seeing it spread among unvaccinated people,” he told CNN last week.

In India, only 6.45 crore people have been fully vaccinated till now, according to government data. Around 35 crore doses have been administered in the world’s second most populous country since the vaccine rollout earlier this year, according to official data.

Variants of Concern found in 174 districts

Variants of Concern of SARS-CoV2 have been found in 174 districts in 35 states and union territories in the country with the highest numbers in Maharashtra, Delhi, Punjab, Telangana, West Bengal and Gujarat, the Union health ministry said on Wednesday.

The Variants of Concern (VOC) detected by the Indian SARS-CoV-2 Genomics Consortium (INSACOG) in community samples are Alpha, Beta, Gamma and Delta. B.1.617.2.1 (AY.1) or commonly known as Delta Plus variant which signifies Delta variant with an additional mutation.

The B.1.617 lineage, first observed in Maharashtra, was associated with the unusual rise observed in several districts of the state. It is now found in many states in India, the health ministry said. (PTI)

Delta Plus variant confirmed in one sample sent for testing from Uttarakhand

Delta Plus variant of COVID19 confirmed in one of the samples that were sent for testing, to Delhi last month. This first case of Delta Plus variant was found in Udham Singh Nagar district: Uttarakhand Health Secretary Amit Negi (ANI)

Uttar Pradesh reports first two cases of Delta Plus variant, one dies

Delta plus, the lethal and more infectious variant of the coronavirus disease (Covid-19) has found its way to Uttar Pradesh.

In a first, the state detected two cases of the Delta plus Covid-19 variant from Gorakhpur and Deoria. One of the patients has died, the publication confirmed, adding that the news has generated a considerable stir in the region.

Among the two cases, the 66-year-old resident of Deoria died during treatment, while the other works as a 23-year-old resident doctor at the Baba Raghav Das Medical College, Gorakhpur.

The Delta plus Covid-19 variant in eastern UP was detected through samples of Covid-19 patients earlier sent for genome sequencing to the Council of Scientific Industrial Research (CSIR) at the Institute of Genomics and Integrative Biology in Delhi.

Tripura confirms 138 of 151 samples sent for testing found positive for Delta plus, while 10 samples had Delta variants, three contained Alpha variants

As many as 138 samples of the total 151 that Tripura sent for genome sequencing turned out positive for the Delta plus variant of the SARS-CoV-2 coronavirus, which scientists say may drive a potential third wave of the Covid-19 pandemic in India.

At least 90 per cent of samples in Tripura that were sent for genome sequencing have been found to be containing the highly transmissible Delta plus variant, the chief nodal officer of the state has said. Tripura – which is the first northeastern state to report the new strain – now has 138 cases of the deadly and highly infectious variant of COVID-19.
“About 151 samples were sent to a government laboratory in West Bengal. As many as 138 or 90 per cent of these samples have found to contain the Delta plus variant,” Dr Deep Debbarma, COVID nodal officer of Tripura, said.

“While 10 samples had Delta variants, three contained Alpha variants,” the health official said.

“115 of the samples that contained the Delta Plus variants were found in west district alone while 8 samples in Sepahijala district, Gomati district (5 samples), Unakoti district (4 samples) and 2 each in North and South districts contained Delta Plus variant,” he said.

One sample each in Khowai and Dhalai districts also were found to contain the Delta Plus variant.

This is the first reported case of the deadly and highly infectious variant of COVID-19 in the northeast.

Russia blames increase in deaths in June on delta variant

The head of Russia’s state coronavirus task force says the number of deaths nationwide in June this year rose nearly 14% over June 2020, due to the spread of the delta variant that caused infections to soar and a record spike in deaths.

Deputy Prime Minister Tatyana Golikova said Friday that current data show a 13.9% increase in mortality in June, year-on-year. Russia has been struggling with a surge of infections since early June, with daily new cases rising from about 9,000 at the beginning of the summer to over 23,000 in early July.

On Friday, the task force reported 25,766 new infections. For the first time in the pandemic, the daily death toll this week exceeded 700, with 726 new deaths registered Friday. (AP)

Mexico enters 3rd wave of coronavirus, infections up 29%

Mexico is entering its third wave of the coronavirus pandemic, as infections rose by 29% compared to the previous week. But the country’s health department said Friday the growth is largely coming from infections among younger, less vulnerable people.

Case numbers are now as high as the beginning of the last surge in September; that wave peaked in January and steadily declined until June.

But at present only about 22% of the country’s hospital beds are occupied; hospital beds in many parts of the country were essentially filled to capacity during the last wave. (AP)

Delta Variant Can Shatter Vaccine Cover, Single Dose of Pfizer, AstraZeneca ‘Barely’ Give Protection: Study

If a person has taken two regular doses of Covishield or Covaxin, then a third dose of Sputnik V in the form of a booster will be good and helpful, a doctor suggested.

Single shots of Pfizer-BioNTech and AstraZeneca (AZ) Covid-19 vaccines “barely" offered any protection against the Delta variant, a new study has found.

According to a report published in Hindustan Times, “Sera from individuals having received one dose of Pfizer or AstraZeneca vaccine barely inhibited variant Delta," a group of French researchers said in an article published in journal Nature on Thursday. “Administration of two doses generated a neutralising response in 95% of individuals," said Olivier Schwartz, the lead author of the study. He is also the head of the Virus and Immunity Unit at the Pasteur Institute in Paris.

Meanwhile, another study in India found that the Delta variant of Covid-19 can possibly shatter the vaccine cover, as SARS CoV-2 — the virus which causes the disease — has the potential to acquire deadly mutations, health experts said on Wednesday.

As new variants are formed, it causes change to the spike protein and the structure undergoes a complete change — a reason why it can render the current vaccines, originally designed to target the protein, ineffective.

Spike proteins, on the surface of SARS CoV-2, are what enable the virus to attach to and enter our cells, and all current vaccines are directed against them. Changes on the spike protein can determine how far and quickly the virus can spread.

“There is an alteration in the structure of the virus proteins due to mutations, which can bypass the targets of some vaccines. This means there is a possibility that the virus may elude the vaccine coverage,” Dr Praveen Gupta, Director Neurology, Fortis Memorial Research Institute, Gurugram, told IANS.

When mutation changes, it can possibly breach vaccine protection.

“There’s no doubt about it. We hope the vaccine will work. But with mutation, the virus changes its structure to become a new virus, while the vaccine remains the same. As bacteria develops resistance, so can the virus change mutation," emphasised Dr S.P. Byotra, Chairman of Department of Medicine, Sir Ganga Ram Hospital (SGRH), New Delhi.

A recent study by the SGRH revealed that the Delta variant of Covid-19 virus shows eight-fold approximately reduced sensitivity to vaccine elicited antibodies compared to the Wuhan strain.

The study, available online as a non-peer reviewed preprint version in Research Square, noted that the Delta variant (B16172), first identified from India, not only dominates vaccine-breakthrough infections with higher respiratory viral loads compared to non-Delta infections, but also generates greater transmission between fully vaccinated people as compared to the other variants — Alpha (B117), or Kappa (B16171).

The findings can be explained by the fact that despite high vaccination rates, Israel — 60.6 per cent have received the first dose of the vaccine, while 5.18 million have received the second dose — is seeing an outbreak of Covid-19 due to the Delta variant. Similar is the case with the UK (48.7 per cent) and the US (47.1 per cent) and other countries with reasonably high inoculation rates.

A recent study by Israeli researchers has also shown that Pfizer vaccine efficacy against Covid-19 has dropped to 64 per cent. However, this does not mean that we should not be vaccinated. All the current vaccines have shown to be effective against severe outcomes from Covid.

The experts stressed that vaccinations undeniably play a great role in curbing the spread of Covid-19.

“Vaccines offer protection. It could be lowered against new variants like Delta plus but still will confer protection. We shouldn’t create unnecessary panic but there should not be complacency either," Dr H.K. Mahajan, Anaesthesiologist, Indian Spinal Injuries Centre, Vasant Kunj, told IANS.

Does this open the case for booster shots?

“Yes, booster shots will be helpful. If a person has taken two regular doses of Covishield or Covaxin, then a third dose of Sputnik V in the form of a booster will be good and helpful. It will prevent new variants or mutations. Therefore, it may be a matter of time when people will use a booster dose with a new medicine to enjoy long term protection against Delta and Delta plus," Mahajan said.

However, experts also noted that it is important to evaluate the need for boosters with time.

“We need to first understand how the mutant virus interacts with the vaccine induced immunity then only we can decide whether a booster will be sufficient or a new vaccine is needed," Gupta added.

(With inputs from IANS)

Out of 30 positive cases, Delta variant found in 27, Delta Plus in 2: UP hospital

Uttar Pradesh: Gorakhpur’s BRD Medical College has confirmed 27 more cases of Delta variant and two cases of Delta Plus. Dr Amresh Singh, Assistant Professor, Head Microbiologist, BRD Medical College-Gorakhpur, today said that the hospital had sent around 72 samples to IGIB Gene Sequencing Centre, Delhi.

“We received reports for 30. Delta variant found in 27 of them, Delta Plus confirmed in 2 of them and 1 patient had Kappa variant,” he said.

On Friday, two cases of Kappa variant of Covid had been detected in Uttar Pradesh. Genome sequencing of 109 samples was done at King George’s medical college in the past few days.

Experts Warn Against ‘Superspreader’ Kanwar Yatra as Uttarakhand Records Delta Plus Variant Case

Kanwar yatra will be much more dangerous than Kumbh as about 3 to 4 crore pilgrims will visit Haridwar in a fortnight compared with the 70 lakh that came during the 30-day Kumbh, he added.

Experts have cautioned against another superspreader event- Kawar Yatra, stating that the pilgrimage could be “five times more likely to be a superspreader than the Kumbh festival." This comes after the Uttarakhand government is mulling to allow the annual Kanwar yatra.

The risk of spread of Covid-19 infection is higher in Kanwar yatra than it was at the Maha Kumbh mela as the number of devotees undertaking the yatra is likely to be significantly higher than those who attended Kumbh, Experts told the Times of India. The footfall for Kanwar yatra in the previous years has ranged between 2 crore and 5 crore.

“Even if standard operating procedures regarding Covid behaviour are put in place and the kanwar yatra allowed, the SOPs will be impossible to implement. We have seen that at the Kumbh and more recently when lockdown restrictions were eased and tourists flocked to hill stations," Anoop Nautiyal, whose organisation Social Development for Communities Foundation has been tracking the Covid outbreak in the state said.

Kanwar yatra will be much more dangerous than Kumbh as about 3 to 4 crore pilgrims will visit Haridwar in a fortnight compared with the 70 lakh that came during the 30-day Kumbh, he added.

The state will not be able to handle the infection spread post-kanwar yatra and the decision must be taken cautiously as the fear of a third wave looms large. Nautiyal further added.

Dr NS Khatri, deputy medical superintendent and Covid care centre coordinator of the Doon Medical College Hospital- state’s largest Covid facility told TOI, “In an ideal situation it (the Kanwar yatra) should be avoided as Uttarakhand has already recorded its first Delta-plus case."

Meanwhile, on Friday, Uttar Pradesh chief minister Yogi Adityanath directed the officials concerned to ensure strict compliance of the Covid protocol and safety of the Kanwar Yatra starting from July 25.

The chief minister while reviewing the preparations and security arrangements for the Yatra asked for establishing a communication with the Kanwar sanghs in view of the Covid pandemic and to see to it that unnecessary crowds should not gather and proper caution is taken, the release issued here said.