News Analysis India

Tag: B.1.617.2

  • Prevalence of Delta variant not different between vaccinated and unvaccinated groups: ICMR study

    By PTI

    CHENNAI: A study by the ICMR on covid-infected individuals in the city has indicated that the prevalence of B.1.617.2 (Delta variant) “was not different between the vaccinated and unvaccinated groups.”

    B.1.617.2, or the Delta variant of covid causing Sars Cov2 was the dominant circulating strain and one of the primary drivers for the country’s covid second wave, the study, approved by the ICMR-National Institute of Epidemiology, Chennai, said.

    Those involved in the study include researchers from the National Institute of Epidemiology, here.

    Covid-infected persons, both vaccinated and unvaccinated ones, who visited the Greater Chennai Corporation’s triage centers between May 3 and 7, were enrolled in the study.

    “The study findings indicate that the prevalence of B.1.617.2 was not different between the vaccinated and unvaccinated groups. Delta variant was the dominant circulating strain and one of the primary drivers for the second wave ofRS-CoV-2 in India.”

    “Studies have documented reduction in neutralization titres among Covishield and Covaxin recipients after infection with delta variant. This might be the reason for the breakthrough infections observed in the fully vaccinated individuals,” it said.

    However, the proportion of patients progressing to severe illness and mortality was lower in the vaccinated groups, it added.

    While B.1.617.2 has the potential to infect both the vaccinated and unvaccinated individuals, however, the progression of illness seems to be prevented by vaccination.

    “Therefore, non-pharmaceutical interventions must continue to slow down the transmission. Additionally, the pace and scale of vaccination has to be increased to mitigate the further waves of the pandemic,” it said.

  • India was in dark on Delta variant: Dr Eric Feigl Ding

    Express News Service
    BENGALURU: The Delta variant of B 1.617.2 lineage has created havoc and is spreading fast even in the most-vaccinated countries. India, too, is still reeling under the effects of the deadly second wave due to this variant.

    Dr Eric Feigl-Ding, a US-based epidemiologist and Senior Fellow at the Federation of American Scientists, told The New Indian Express that India, where the Delta variant first emerged, was in the dark for a long time and with the evidence of the variant escaping vaccine efficacy, the country needs to now seriously ramp up genome sequencing and testing to mitigate the virus.

    “If a variant rises from your country, to stop it from spreading to the world and harming your own citizens, you need to invest in resources. Many variants may emerge and if there is a delay in identifying them, there might be many lockdowns in the future, not just in India, but across the world,” Dr Feigl-Ding said. 

    India has to speed up its genome sequencing, and invest in technology to ramp up not only whole genome sequencing, but also testing. Many variants may emerge, and if there is a delay in identifying them, there might be many lockdowns in future, not just in India but across the world, said Feigl Ding, epidemiologist, Senior Fellow at the Federation of American Scientists, in an exclusive interview with TNIE.

    India reeled under a deadly second wave of the coronavirus, caused mainly by the Delta variant of the Covid-19 virus. But now we are already talking about the third wave. Will India see another wave?It’s hard to say. I think India is still very vulnerable. We don’t know enough about Delta-Plus but it’s likely to be as transmissible as the Delta variant. Obviously, India doesn’t have enough vaccines rolled out, especially two doses. Delta is very evasive against one dose. Knowing that Delta-Plus has reinfection potential, I think it is worrisome.

    We are seeing Delta create havoc across the world. Do you think India identified the variant late?I think India doesn’t have genome sequencing capabilities like the UK does. Very few countries have the expertise. This data allows us to find out and know the variant in advance. Although we identified the variant months ago, we did not have the sequencing in order to know how much it was growing, how quickly, and to what percent it had spread in the population. Does the vaccine work against it? For this information, a lot of people have to be sequenced. Right now, we know that Delta is twice as contagious as the original strain, has about four times greater risk of hospitalisation, 2.5 times greater than Alpha, and four times more transmissible than the original variant. It is a very risky variant. But we learnt all this only because Delta has invaded the UK, and it is able to track down these numbers epidemiologically and genomically. But India was in the dark for a longer time.

    What should India do now?There should be a rule that India should do more testing. There are also shortcut tests like genotyping, instead of full genome sequencing. You need to develop genome typing shortcut tests, laboratory capabilities for genotyping, typing and do them fast. It requires infrastructure and investment from the government. Each country has different lessons to learn from each other. But if the variant rises from your country, then to stop it from spreading to the world and harming your own citizens, you need to invest in these resources. We need to wear masks, especially indoors. Ventilation is as critical as masks.

    Is it necessary that the next variant is more transmissible?It is not always worse. Mutations go in random directions until there is an evolutionary reason to direct into certain directions. We are reaching the point where we have more people who were infected and fewer people who have never been infected. The virus will now search to become more evasive — of immune system, vaccines etc. That’s the trend. Delta-Plus is not just another random mutation, it is Delta with a previously known tricky mutation that is known to be evasive.

    How important is vaccination?Vaccination is important but a country cannot rely only on this as a strategy, until vaccination is 80 per cent or more. Herd immunity by vaccination is a term used by many countries, but unvaccinated people have almost no protection, even if 40 per cent of the population is vaccinated. It happens only when almost 80 per cent vaccination is achieved. However, two vaccine doses definitely prevent hospitalisation.

  • Second Covid wave deadlier, fatalities higher in younger patients: Study

    Express News Service
    NEW DELHI: An important study carried out by 10 super specialty hospitals of a major corporate chain across five states has shown that the second wave of Covid had a markedly higher mortality rate as compared to the first one last year. 

    The retrospective research by the Max group of hospitals on clinical outcomes of nearly 20,000 patients showed that 40% more patients died between January and mid-June this year, as compared to those between April-December last year. The fatalities were particularly higher in younger patients, the research results said. 

    The results from the study “Differentials in the characteristics of Covid-19 cases in Wave-1 and Wave-2 admitted to a network of hospitals in North India” have now been released on BioRxiv, the preprint server for medical sciences. 

    For the study, medical records of a total of 14,398 cases admitted in the first wave to the Max network of hospitals in north India — Delhi, Uttar Pradesh, Uttarakhand, Punjab, and Haryana — and 5,454 cases admitted in the same hospitals during the second wave were compared. 

    Overall, in each wave, almost two-thirds were males and females were admitted slightly more in the second wave as compared to the first wave while the age group 60+ years continued to have a disproportionately large share, nearly 40%.  

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    Relative to their population (less than 10% at the all-India level) 60+ age group was nearly four times as likely to be admitted and patients of age less than 45 years comprised 28.3% and 27.1% in the first and second wave. 

    However, the most striking finding, which the researchers noted, was the overall higher severity of the disease at admission and a significantly higher mortality rate in the second wave, especially in younger patients. 

    In the second wave, 10.5% of the admitted patients, for instance, died as compared to 7.2%  in the first wave and the increase in mortality was seen in both males and females. Younger patients, aged less than 45 years, saw the sharpest increase in mortality to 4.1% from 1.3% in the first wave and not only was the mortality higher this year for patients in ICU (19.8% vs 25.1%) but steeply higher even for those admitted inwards (0.5% vs 3.1%). 

    Since there were no significant demographic differences in the population during these two waves, various other factors such as increased comorbidity and higher occurrence of secondary bacterial and fungal infections may have contributed towards increased mortality, the scientific exercise led by Max group director Sandeep Budhiraja concluded.  

    Additionally, said the paper, as reports indicate that a higher percentage of infections having been caused by delta variant (B.1.617.2) of SARSCoV2 in the second wave, which was not only more transmissible but also potentially more lethal, could be another important factor. 

    “Late presentation of patients in wave 2 due to non-availability of hospital beds could also have contributed towards higher mortality,” it said. 

    Importantly, the study showed that more patients required oxygen support this time (74.1% vs 63.4%). But on a rather positive note, more than one-fifth (21.4%) of patients stayed for less than 5 days in the hospital this year compared to 15.7% in the first wave. Cases with a long stay of over 15 days also reduced from 10.4% in the first wave to 7% in the second.

  • B.1.617.2 variant behind majority of breakthrough Covid infections in India: Study

    Express News Service
    NEW DELHI: Majority of the breakthrough infections following vaccination with Covishield and Covaxin were caused by SARS CoV2 lineage B.1.617.2, which is a variant of concern (VoC), according to study based on the genomic analysis of vaccine breakthrough infections in collaboration with clinicians at the AIIMS, New Delhi.

    The analysis included 63 cases of vaccine breakthrough infections in Delhi, out of which 36 patients received two doses, while 27 had received one dose of vaccine. Ten patients received Covishield while 53 received Covaxin.

    “B.1.617.2 was found to be the predominant lineage with 23 samples (63.9%) out of which 12 were in fully vaccinated and 11 in partially vaccinated groups. Four samples with 11.1% and 1 sample with 2.8% were assigned the lineages B.1.617.1 and B.1.1.7 respectively,” according to the study in preprints.

    The patients had a mean age of 37 (21-92), in which 41 were males and 22 were females. None of the patients had any comorbidities which could act as a predisposing factor for breakthrough infections. AIIMS collaborated with the CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB) for the study.

    Variants of concern B.1.617.2, first detected in India, and B.1.1.7, detected in Maharashtra, were responsible for cases surge in April-May 2021 in Delhi, were the predominant lineages among breakthrough infections.

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    Of the breakthrough infection cases analysed, 10 patients (8 with double doses of vaccine and 2 with single vaccine dose) additionally had total Immunoglobulin G (IgG) antibodies assessed by Chemiluminescent Immunoassay (Siemens), of which 6 patients had IgG antibodies a month before the infection, while 4 had antibodies after the disease episode.

    “While antibody levels for a subset of patients were available, they became infected nevertheless and presented to the emergency just like other patients, putting in doubt the protection offered and or clinical relevance of total IgG as a surrogate of Covid immunity,” the study noted.

    Of the 63 cases of vaccine breakthrough infections, including 36 who received full doses, there are no reports of mortality even though almost all cases presented with high-grade unremitting fever for 5-7 days.

    “Viral load at the time of diagnosis was high in all the patients irrespective of vaccination status or type of vaccine received. The initial course of disease with high-grade non-remitting fever lasted for five to seven days in the vaccinated group, similar to the clinical presentation in unvaccinated patients,” it further said.

    The authors said the present report is unique in many aspects as this is one of the first reports of symptomatic vaccine breakthrough infections, and breakthrough infections in a tertiary care setting apart from being the earliest reports of breakthrough infections with BBV152/Covaxin and B.1.617.2 variant of SARS-CoV-2.

  • B.1.617 variant of SARS-CoV2 has sub-lineages; B.617.2 more infectious: Expert on COVID mutations in India

    By PTI
    NEW DELHI: The double mutant B.1.617 variant of SARS-CoV2 is further mutating and one of its sub-lineages, the B.1.617.2, reported in India, is more infectious than its parent and fast increasing its footprint, Rakesh Mishra, former Director of the Centre for Cellular and Molecular Biology, said on Wednesday.

    He also said there is nothing called the “Singapore variant”, a term that has led to a war of words between the Centre and the AAP government after Singapore objected to Chief Minister Arvind Kejriwal’s tweet that a “new” coronavirus strain in the city-state is very dangerous for children.

    Singapore’s health ministry on Tuesday night said the strain that is prevalent in many of the COVID-19 cases in recent weeks is the B.1.617.2 variant, which was first detected in India.

    Amid criticism over Kejriwal’s Singapore COVID-19 variant remark, Delhi Health Minister Satyendar Jain on Wednesday claimed there was a “different strain” of coronavirus spreading in that country.

    However, Mishra said B.1.617.2 has already been reported in India and is in the majority of the new cases in Karnataka and Andhra Pradesh.

    Mishra is part of the INSACOG, a consortium of 10 institutes of the Centre, that is involved in the genome sequencing of coronavirus.

    Explaining about the sub-lineage, Mishra told PTI, “B.1.617 was the mutant which was increasing in some part of the country like Maharashtra, West Bengal, Karnataka and now gradually it has led to three sub-lineages (B.1) 617.1, 617.2 and 617.3.”

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    “Among these three, B.1.617.2 is more infectious than B.1.617. That does not indicate a greater worry except the numbers are more and symptomatically. Otherwise, we have not seen any other difference. So this is now replacing others.” 

    He said the same thing is being observed in the UK where B.1.617 was found and the sub-lineage has started to take over.

    “This is the same thing we are seeing in Singapore. Most of the cases in Singapore are B.1.617 and a majority is B.1.617.2B.1.617. 2 sub-lineage is majority in the new cases in Karnataka and Andhra Pradesh,” Mishra said.

    “Gradually it is increasing its footprint and it will be a major one replacing other variants,” he added.

    Another virologist, who did not want to be quoted, said the sub-lineage was first detected in India in December.

    Sujeet Singh, the Director of the National Centre for Disease Control, said in a webinar in April that in Maharashtra, the B.1.617 variant was found in over 50 per cent of samples in many cities while the UK variant was found in 28 per cent of samples in the second week of March.

    B.1.617, termed as a double mutant, has three new spike protein mutations.

    Two mutations E484Q and L452R are in the area important for antibody-based neutralisation.

    The third mutation P681R in B.1.617 along with the reversion of E484Q allows its sub-lineage to be more infectious.

    The World Health Organisation (WHO) has termed it as ‘Variant of Concern’.

    According to the Centre for Disease Control and Prevention of the US, B.1.617.1 and B.1.617.3 sub-lineages have two receptor binding domain mutations — L452R and E484Q.

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    The former has seven spike mutation while the latter has 7-8.

    In case of B.1.617.3, it has 9-10 spike mutations and two receptor binding domain mutations — L452R and T478K.

    In case of all the three sub-lineage, it has the potential to reduced antibody efficacy and potentially reduced neutralisation by vaccine sera, which, however, remains to be established.

    On Tuesday, Kejriwal had tweeted, “The new form of coronavirus in Singapore is said to be very dangerous for children. It could reach Delhi in the form of a third wave. My appeal to the Central government: 1. Cancel all air services with Singapore with immediate effect 2. Work on vaccine alternatives for children on a priority basis.”

    Responding to Kejriwal’s tweet, Singapore’s health ministry on Tuesday night said: “There is no Singapore variant. The strain that is prevalent in many of the COVID-19 cases in recent weeks is the B. 1.617.2 variant, which originated in India.Phylogenetic testing has shown this B.1.617.2 variant to be associated with several clusters in Singapore,” it said in a statement.