News Analysis India

Tag: Gagandeep Kang

  • Covid isolation period can be reduced to five days in India: Virologist Gagandeep Kang

    By Express News Service

    BENGALURU: At a time when India is wondering how to deal with absenteeism due to Covid-19 illness affecting livelihoods, renowned virologist and microbiologist Dr Gagandeep Kang said isolation days can further be reduced to five days in the country.

    Speaking at a fireside chat hosted by Biocon chief Dr Kiran Mazumdar-Shaw on ‘Preparing the Nation for Omicron Scare’, Dr Kang said, “With two doses of vaccination, it is important that we now convert what could have been a serious illness into just two to three days of illness.”

    Dr Kang explained that the argument made for reducing days of isolation to five is “it will miss about 30 per cent of potentially infectious people, but many of those numbers are based on a virus that had a much longer generation time. Delta variant and others were not as quick as Omicron. With Omicron, we have seen doubling time of two to four days, whereas for other viruses, it was four to six days”. She said that based on this information, it will not be a problem to shorten isolation to five days.

    Agreeing that reducing isolation period to fewer days may help many, Dr Shaw said people are hoping this is the end of the pandemic. However, Dr Kang warned that going by the history of pandemics, many come in wave patterns, and most of these patterns are varied. “With most pandemics, you tend to see an oscillatory pattern, so the first wave may be small, second larger, third may be smaller or larger than the second wave, but as you get to the tail of the pandemic, you see the oscillations beginning to decrease in size and become stretched out over time,” she said. However, she warned that it cannot be guaranteed that we will get lucky, like we have with the Omicron variant.

    Answering a question on when people could travel freely, she said, “If no new challenging variant comes along, and it continues to be antigenically related to the variants we have seen so far, we can expect to see travel opening up in 2022, and further in 2023.”

    Speaking on booster doses, Dr Kang says people must now junk the idea that we are going to get permanent protection against infection. She reasons that infection is short-lived, and it won’t make sense to keep vaccinating every three months to gain protection against infection. The focus has to be on the severity of the disease and preventing deaths, and double vaccine dose is working.

    Appreciating the government’s technology-based apps providing real-time data to manage the pandemic, Dr Kang said there is definitely a need to integrate and link databases.

  • Omicron may already be in India: Dr Gagandeep Kang

    Express News Service

    BENGALURU: While fears of the highly divergent Omicron variant of the coronavirus loom large in India, renowned microbiologist Dr Gagandeep Kang has expressed fears that it may have already entered the country. The focus now should be on ramping up genome sequencing and introducing S-Gene PCR testing to quickly detect it and act on containing the spread, she stressed.

    Speaking exclusively to TNIE, Dr Kang, microbiologist and virologist, Christian Medical College, Vellore, said, “It’s very likely that this variant is already in much more than the 12 countries identified so far. It may be in India too, but our genome sequencing is so slow that we don’t know if it is here.

    There is no use if sequencing data comes one month after an event has occurred. Then, it becomes an academic exercise. It does not help with control of the new variant if it has entered the population. Hopefully now, the sequencing will be faster and we will have an answer to that.” 

    She explained that this variant has something called as S Gene dropout, which means there’s no need for genome sequencing too if S Gene PCR tests are done. This can give a report on the presence of the Omicron in a few hours.

    “This will allow us to get very rapid epidemiological information and once we have that, we will have a sense of spread.” While mutation of the virus was expected, what came as a surprise is that the Omicron has more mutations (30-plus in the spike protein) than any other variants seen before, she said. 

    ‘Rate of infection spread a worry’

    To understand transmissibility better, it may take a week’s time, Dr Kang added. “If we have a virus that is spreading easily in a vaccinated population, then there will be a quicker answer to immune escape. In South Africa, only about a quarter of the population is vaccinated, but reports from Israel say that it has infected even those who were triple-vaccinated with mRNA vaccine doses,” Dr Kang explained. But she says the infection is not the worry, it is more about how the disease is behaving, the clinical features it is presenting and whether hospitalisations are going up like in South Africa and elsewhere.

    On the increase in clusters in Karnataka, Dr Kang stressed that any crowded event can cause infections, even in the vaccinated population, but added that the rate of spread is worrying. “What one needs to be worried about is transmission of the infection to vulnerable populations. Genome sequencing of such clusters, observing what kind of population is infected, whether it is breakthrough infection, the clinical features, etc., need to be observed immediately, she said. Dr Kang also felt that no government should introduce travel bans.

    “It will delay a proportion of new viruses coming in. But we have to remember these viruses spread in asymptomatic individuals. We cannot permanently exclude any variant from travelling unless you shut the world down completely again, and we don’t need to do that,” she said. She suggested that state governments should get to tracking people. Also, sequencing reports should come in faster and the country should define its public health response, she added.

    “If the goal is to stop transmission, then timeliness becomes very important. If the goal is to stop the overwhelming of health systems, then it is important to track what is happening in terms of clinical information from cases everywhere in the world and prepare your health system for that. Actions taken are very dependent on the goal for public health or policy.”

    “If the purpose is to prevent Omicron from coming in, then it may already be here. But if the goal is in the short term — to rapidly ramp up testing in the hope of stopping it from coming in — then at least two tests for every incoming traveller have to be done, either before they travel and five days later, or once they arrive in the state and a week later again,” she noted.

  • ‘Omicron may already be in India, need to ramp up genome sequencing’: Dr Gagandeep Kang

    Express News Service

    BENGALURU: While fears of the highly divergent Omicron variant of the coronavirus loom large in India, renowned microbiologist Dr Gagandeep Kang has expressed fears that it may have already entered the country.

    The focus now should be on ramping up genome sequencing and introducing S-Gene PCR testing to quickly detect it and act on containing the spread, she stressed.

    Speaking exclusively to TNIE, Dr Kang, microbiologist and virologist, Christian Medical College, Vellore, said, “It’s very likely that this variant is already in much more than the 12 countries identified so far. It may be in India too, but our genome sequencing is so slow that we don’t know if it is here. There is no use if sequencing data comes one month after an event has occurred. Then, it becomes an academic exercise. It does not help with control of the new variant if it has entered the population. Hopefully now, the sequencing will be faster and we will have an answer to that.” 

    She explained that this variant has something called as S Gene dropout, which means there’s no need for genome sequencing too if S Gene PCR tests are done. This can give a report on the presence of the Omicron in a few hours.

    “This will allow us to get very rapid epidemiological information and once we have that, we will have a sense of spread.”

    While mutation of the virus was expected, what came as a surprise is that the Omicron has more mutations (30-plus in the spike protein) than any other variants seen before, she said. 

    ‘Rate of infection spread a worry’

    To understand transmissibility better, it may take a week’s time, Dr Kang added.

    “If we have a virus that is spreading easily in a vaccinated population, then there will be a quicker answer to immune escape. In South Africa, only about a quarter of the population is vaccinated, but reports from Israel say that it has infected even those who were triple-vaccinated with mRNA vaccine doses,” Dr Kang explained.

    But she says the infection is not the worry, it is more about how the disease is behaving, the clinical features it is presenting and whether hospitalisations are going up like in South Africa and elsewhere.

    On the increase in clusters in Karnataka, Dr Kang stressed that any crowded event can cause infections, even in the vaccinated population, but added that the rate of spread is worrying.

    “What one needs to be worried about is transmission of the infection to vulnerable populations. Genome sequencing of such clusters, observing what kind of population is infected, whether it is breakthrough infection, the clinical features, etc., need to be observed immediately,” she said.

    Dr Kang also felt that no government should introduce travel bans.

    “It will delay a proportion of new viruses coming in. But we have to remember these viruses spread in asymptomatic individuals. We cannot permanently exclude any variant from travelling unless you shut the world down completely again, and we don’t need to do that,” she said.

    She suggested that state governments should get to tracking people. Also, sequencing reports should come in faster and the country should define its public health response, she added.

    “If the goal is to stop transmission, then timeliness becomes very important. If the goal is to stop the overwhelming of health systems, then it is important to track what is happening in terms of clinical information from cases everywhere in the world and prepare your health system for that. Actions taken are very dependent on the goal for public health or policy.”

    “If the purpose is to prevent Omicron from coming in, then it may already be here. But if the goal is in the short term — to rapidly ramp up testing in the hope of stopping it from coming in — then at least two tests for every incoming traveller have to be done, either before they travel and five days later, or once they arrive in the state and a week later again,” she noted.

  • Only way to decrease variants of COVID is by increasing vaccination: Gagandeep Kang

    By PTI
    NEW DELHI: Stressing that the only way to decrease variants of COVID-19 is by increasing vaccination, prominent clinical scientist Gagandeep Kang said massive inoculation being a mistake is a topic brought up with “pseudo-scientific messy incorrect immunology”.

    She was reacting to French virologist and Nobel laureate Luc Montagnier’s comments on mass vaccination.

    Kang said that apparently he did not say all vaccinated people will die in two years, as claimed by some, but he did say that new variants are created through selection imposed by antibodies made through vaccination.

    “And he said there will be much stronger infection by variants in vaccinated individuals due to antibody dependent enhancement, massive vaccination is an enormous error, a medical mistake,” Kang tweeted, and termed his claims as “not true”.

    Kang said, “When we are infected or vaccinated we make antibodies in response to a whole virus or part of a virus. In a viral infection, the body’s immune responses, including antibodies, shut down viral replication and we recover from infection”.

    “Massive vaccination being a mistake is a topic brought up with pseudo-scientific messy incorrect immunology that I have addressed previously,” she tweeted.

    Calling vaccination an exercise in “preparedness and prevention”, the vaccinologist said the immune response that is made has nothing to fight immediately but “we train the immune system to recognise the virus if and when it comes”.

    “In a small number of individuals, special, because they are immunocompromised (therefore not usually out & about to spread virus) it is possible that virus replication may be prolonged. In such (rare) cases there may be a development of variants that escape the immune response,” she said in another tweet.

    Kang said variants are many, but variants that escape immunity are few.

    “As the virus spreads through populations and multiplies massively, the few variants that are more capable of escaping immunity that is induced by vaccines will make vaccines somewhat less effective,” she said.

    “While this may be what we are currently seeing with B1.351 and B1.617.2, even there two doses of vaccines protect reasonably (data from Qatar and UK).

    “The only way to decrease variants is not to stop vaccination, but to increase it to stop virus circulation and replication!” she said.

    She said it is seen from effectiveness and impact studies that vaccination reduces viral replication in individuals and decreases transmission in communities, effectively decreasing the overall viral load in the community and the world.

    “Clear and simple- if viruses are not replicating they cannot mutate and become new variants. Vaccinate to decrease viral replication and variants,” she said.

    She said all vaccines are being evaluated to see that they make high amounts of neutralizing antibodies and they are.

    “What about with variants because neutralizing antibodies to an older version of the virus might not be enough? This is analogous to the situation with dengue where it is not old and new versions of the virus but four different serotypes that may infect sequentially,” she tweeted.

    “With repeat dengue infection, where low levels of antibodies from the first infection with 1 type of virus or vaccination can trigger enhanced/severe disease when a person does get subsequently infected with a type to which there is not good neutralizing antibody,” Kang added.

    Noting that with SARS-CoV2 vaccines based on older virus/spike the ability to neutralise new variants is lower but not absent, Kang said vaccines seem to be working.

    “A booster dose of old or new versions of mRNA vaccines has been shown to broaden the immune response, which is encouraging,” she added.

    “We need to continue to study long-term protection, and particularly study the immune response in vaccine breakthrough cases to understand what is happening with immunity and safety. But reassuringly, so far there is no signal,” she tweeted.

  • Current surge of COVID may see a decline in middle to end of May: Vaccinologist Gagandeep Kang

    By PTI
    NEW DELHI: The current surge in coronavirus cases may go down by the middle to the end of May, noted vaccinologist Gagandeep Kang has said.

    She said there could be one or two more peaks of coronavirus cases but they may not be as bad as the current one.

    Right now it’s doing a “world through” in areas it did not do last year, in the middle class population, in the rural areas and there is going to be “very little fuel” for the virus to continue to go through, she said.

    Allaying fears about vaccines, she said they are efficacious and emphasised the need to ramp the inoculation drive.

    She also expressed concern over the declining number of coronavirus tests.

    The proportion of cases is actually much larger than the tests reveal but in absolute numbers in “what we track and count”, Kang said.

    “Best case estimates from a number of models are somewhere between the middle and the end of the month.

    Some models have it going into early June but based on what we are seeing, right now middle to end of May is a reasonable estimate,” she said in response to a question in a webinar organised by the Indian Women Press Corps.

    On forecasting waves of virus, she said one can definitely use the characteristics of the strain, characteristics of a pandemic in a particular place to predict what is going to happen in that location if the data is available at that level for mathematical modelling.

    She said there are few infectious disease modellers in the country.

    “And all the ones that exist will tell you that their models are as good as the data they have and the models are accurate up to two weeks. You cannot expect a prediction for three months or six months or two years from now as yet. We don’t know enough about the virus. We don’t know enough about how it is going to,” he said.

    On being asked about the prospects of coronavirus, she said this will become like “a really bad flu virus”.

    “This will become seasonal, like a really bad flu virus. It will be something like becoming more seasonal, that will settle down, that people will acquire a certain level of immunity because of repeated immunity and vaccinations,” she said.

    Kang added that people will acquire a certain level of immunity because of repeated infections and vaccinations.

    “It may be imperfect in immunity, so we may need boosters if we keep having enough virus replications to have new mutants that have immune escape, but I am pretty sure that we are not going to have in this situation that we are in today too many more times. At least, not with this virus,” she said.