Amid new variant concerns, BMC revises Covid-19 guidelines

As Union govt tells states to step up vigilance against B.1.1.529, Mumbai reinstates home isolation and stamping for passengers from 11 countries; experts demand urgent second dosing and booster shots for India

In view of the new Coronavirus variant that has worried health experts and scientists world over, the BMC on Friday revised the COVID-19 guidelines. It has made the RT-PCR test at the airport and home isolation mandatory for travellers from countries that have reported B.1.1.529 cases and eight nations witnessing a surge in infections. Meanwhile, health experts have urged the citizens to be cautious and follow the COVID safety rules, while demanding the Centre to approve a booster shot. 

The new variant has been found in Botswana, and Hong Kong in travellers from South Africa. People arriving at the airport from these three nations will have to be in home quarantine for 14 days.

Travellers from South Africa, Botswana and Hong Kong will have to undergo COVID-19 test at the airport even though they are fully vaccinated or have an RT-PCR negative report. They will also have to isolate themselves at home for 14 days.

A traveller is tested for COVID-19 at Mumbai international airport. File pic/Anurag Ahire

International travellers from eight countries reporting a surge in cases are required to undergo RT-PCR test, irrespective of their vaccination status, at the airport. Over the past months, countries such as Austria, The Netherlands, UK, Germany, Italy, Brazil, have seen a spike in infections.

The move comes a day after the Union health ministry issued an advisory to all states, directing them to monitor international travellers. Meanwhile, amid fears that the new variant could evade the current COVID-19 vaccines, health experts have urged the Centre to administer booster doses to the fully vaccinated citizens.

Additional Municipal Commissioner Suresh Kakani told mid-day, "From today (Friday), we started screening and testing all passengers coming from South Africa, Hong Kong and Botswana. They will be home quarantined for 14 days. If they are found COVID-19 positive, their samples will be sent for genome sequencing to find out if they are infected with the new variant. We will take all the precautions." There will be no compulsory institutional quarantine for these passengers.

The Centre has also instructed that the contacts of travellers from these three countries must also be closely tracked and tested.

“We have requested the COVID-19 task force to provide us with the details of the new variant. The data would help us to be better prepared, in case a vaccine is not effective on some new variant,” said Kakani. He appealed to the public to follow the COVID-appropriate behaviour, like wearing masks and maintaining physical distancing.

Advisory for schools

There are very few COVID-19 cases in the city and the state government has announced reopening of schools for Std I-Std VII from December 1. But the new variant is a new cause for concern for the BMC.

Kakani said, “We have provided all civic-run schools with hand sanitisers and masks for students and teachers. Private schools will have to ensure that all COVID-19 safety protocols are followed on campus. Also, people who have not taken the vaccine yet should get vaccinated at the earliest, while those whose second shot is pending must get the second one soon.”

Dr Rajesh Dhere, dean of COVID jumbo centre at BKC, said, “We have heard about the new variant, and are looking forward to guidance from the higher authorities including ICMR…”

Genome surveillance critical

Dr Jasdeep Singh, research scientist at IIT Delhi who had done extensive study on earlier Coronavirus, said, “Extensive genome surveillance will be the key factor for India to check the prevalence of the new variant. Early community-based sequencing will be necessary to check any probable spread of this variant among the population. The government should also take proactive measures, like restricting the number of international travellers especially from the affected countries.”

“We are still unaware about the available vaccines' efficacy on the new variant, and it is therefore a matter of concern especially among the younger population, who are still not fully vaccinated. We have seen with Delta variants that the younger population and paediatric age group were the vulnerable category. Speedy full vaccination of the remaining population should be the priority of the government at both central and state levels,” he said.

“Unlike the previous variants, B.1.1.529 carries more number of mutations, and therefore, they might confer survival advantage to the virus, which also means that we may witness multiple waves, if the new variant penetrates into the community. We should continue following the COVID-appropriate behaviour,” said Dr Jasdeep.

Demand grows for booster

Dr Santosh Bansode, HoD of Emergency Medicine at Wockhardt Hospitals, said, “B.1.1.529 is the most infectious and transmissible variant. It has changed spike proteins. Our vaccines are designed to fight with specific spike protein viruses. So, there's a high chance that our current vaccines will not be much effective against B.1.1.529. If vaccines fail to protect us from this variant, then we will again face a huge problem. We must take adequate precautions to stop entry of this variant in our country."

He suggested that vaccines' effectiveness on the new variant in the countries must be monitored, and also the serious symptoms caused by it.

"Fully vaccinated people should also take adequate precautions. We should not behave causally and carelessly after getting fully vaccinated. We must also study how long the antibodies last in our blood. If the antibody level is reduced after a few months, then we must think about a booster dose of vaccine. This research should be done at a faster rate so that we can be prepared ahead of time," Dr Bansode said.

14 days
The home quarantine period for travellers from 11 nations

32
No. of mutations in B.1.1.529’s spike protein

With inputs from Prajakta Kasale

‘We must be prepared for worst’

Speaking with mid-day, Dr Jacob John, expert virologist from Tamil Nadu, answered some of the queries surrounding the new variant

What is your view on B.1.1.529?
It is a very important development to watch, and too early to say anything definitively. We must be cautious, not anxious. India must test every arrival from Malawi, Botswana, South Africa, Israel and Hong Kong, and after 48-72 hours of strict hotel quarantine, re-test and if negative, let free travel. The Centre must keep hourly watch for any additional country reporting the new variant.  We ignored Delta for weeks and learned our lesson, didn’t we?  INSACOG must sequence viruses from airport cities.
 
What does it mean for India’s vax programme?
In case people are reluctant on account of nasty reaction to the first dose, the government must allow them to switch to the other vaccine. That is wisdom. Since vaccine-induced immunity after two doses may not suffice against this new variant, the wisest step now is to offer booster doses six or more months after the second one. That is in the national interest. The ICMR must obtain the variant virus and check out its immunity parameters and transmission potential — and keep the public informed. We must expect the best but be prepared for the worst.

Should India be worried about new variant?

What is B.1.1.529?
The new variant of SARS-CoV-2, B.1.1.529, has left scientists worried because of a high number of mutations, which could affect how easily it spreads to people. It has 50 mutations overall, including 32 spike protein, which penetrates the body’s cells. It is nearly double of what’s found in Delta that killed lakhs in India during the second wave.

Detected in Africa
The daily cases in South Africa jumped from over 200 in recent weeks to over 1,200 on Wednesday and to 2,465 a day later. Scientists studied patients’ samples and found B.1.1.529. South African experts said there are no indications to date that it causes more severe or unusual disease, and noted that as with other variants, some infected people don’t have any symptoms.

Scientists worried
With scientists world over constantly warning of wan-ing vaccine effectiveness due to mutations in the SARS-COV-2, which causes COVID, B.1.1.529 seems to pose a greater risk because of the most number of mut-ations among all variants.

Can vaccines deactivate it?
Sharon Peacock, who has led genetic sequencing of Coronavirus in Britain at the University of Cambridge, said it would take several weeks to determine if current vaccines are still effective against B.1.1.529.

Who can get it?
Professor Francois Balloux, the director of the UCL Genetics Institute, London, said the large number of mutations in the variant apparently accumulated in a “single burst”, suggesting it may have evolved during a chr-onic infection in a person with a weakened immune system, possibly an untr-eated HIV/AIDS patient.

‘We don’t know very much about this yet. What we do know is that this variant has a large number of mutations. And the concern is that when you have so many mutations, it can have an impact on how the virus behaves’ Dr Maria Van Kerkhove, technical lead on COVID-19, WHO

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