Omicron variant XBB 1.16: Experts call for dynamic genome sequencing

The new recombination of the SARSCoV2 variant Omicron XBB 116 has triggered a concern once again due to the steep increase in number of hospitalisations due to it across the countryHealth experts warn that though most recombinations may not give rise to viable viruses However there is a possibility that a recombination could result in the creation of a new lineage of the virus with better functional capabilities than either of the parent lineagesThey say this calls for the government to institute dynamic genome sequencing and a warning system to look for early emergence of such recombinants during crowded public celebrations and events which may be a reason for the present surge in casesAlso Read Mumbai Health experts alarmed after respiratory viruses soarDoctors want you to mask up even when travelling File picSameer MarkandeDr Wiqar Shaikh professor of medicine Grant Medical College and Sir JJ Group of Hospitals recalled a midday report titled lsquoShould India be worried about the fourth waversquo on March 21 2022 He said if the present surge is not curtailed then the probability of another wave cannot be ruled outHe said that in India there were 3824 cases as of April 2 2023 and five COVID19 deaths He said Maharashtra is the worst affected with 669 new cases on April 1 Dr Shaikh pointed out that as of March 28 2023 the WHO said there were more than one lakh new COVID19 cases worldwide and 636 deathsDr Shaikh said the current surge in India is the result of uncontrolled processions all over the country He said in India almost 90 per cent of current cases were caused by the XBB116 variant of Omicron The remaining 10 per cent were caused by the XBB115 BQ11 and BQ1 variantsldquoSARSCoV2 continues to evolve by accumulating genetic variations Not uncommonly as also with other viruses such as the flu or HIV a coinfection of multiple lineages of the virus in some people would result in recombination between genomes of two or more lineages After SARSCoV2 it ran out of variants such as alpha beta gamma delta before reaching Omicron as a result of the global vaccine programme recombinants of Omicron started to emerge by combining BA210 and BA275 in some hotspot areas as XBB in China and Singapore in June 2022 and XBB15 also called lsquoKrakenrsquo in New York in October 2022 Most of XBB15 was controlled by booster vaccines in the United Statesrdquo said Dr Subhash Hira professor of Global Health at University of WashingtonSeattle and member of health core group of G20Sequencing neededDr Hira said ldquoAs India has gone through a crowded festive season without COVID etiquette in place masks sanitisation physical distancing etc a fastspreading XBB1 descendent of recombination with parent XBB from ChinaSingapore generated the XBB116 here and in few other Southeast nations such as Bruneiand SingaporerdquoldquoAlthough early clinical observations from several Indian states suggest that XBB116 caused mild illnesses and fewer hospitalisations among the elderly and those with underlying comorbidities early immunologic workup suggested that most of these patients had not received the nasal booster vaccine Applying the US experience with bivalent vaccine boosters given in October 2022 that stopped the spike of XBB15 Indian vaccine companies are on track with multivalent nasal booster vaccines This should be combined with compulsory use of masks in hospitals in public places on transport and home care of elderly in society buildings that will help cut 40 per cent60 per cent transmissionrdquo Dr Hira suggestedReinfection with XBBDr Ketan Vagholkar professor of surgery at DY Medical College said ldquoXBB is currently the most antibodyevasive strain but it is not as lethal as the delta variant Any person who was previously infected with an earlier Omicron variant continues to be susceptible to infection with XBB The protection offered by booster doses isdebatable and hence not affirmatively advisedrdquoldquoThe sudden surge of the XBB variant is mainly because of the change of environment Whenever there is change in environment there will be a temporary surge in some COVID variantsrdquo said Dr Santosh Bansode emergency medicine specialistldquoItrsquos a possibility that some variant may exist in the environment but remain unnoticed It may happen because of its mild nature If any variant shows severe symptoms then there is a high chance it will get detected in testsrdquo said Dr BansodePrevention better than cureDr Shaikh said the worldwide mantra has been ldquoprevention is better than curerdquo This is a lesson not learnt by our governments or even the public He said people have Thrown caution to the wind and stopped wearing masks and hand sanitisers have long been discarded and rather unfortunately processions and gatherings have been the norm all over the countryldquoI urge the Indian government the Maharashtra government and the BMC to impose the mask mandate and urgently make hand sanitisation compulsory and impose a complete ban on processions gatherings and ralliesrdquo Dr Shaikh said636Global COVID deaths as of Mar 28