India must be vigilant, but without panicking
China’s Covid surge has the world worried | Photo Credit: NOEL CELIS
A season of unhinged WhatsApp messages is upon us again, with dire warnings of an upcoming Covid-19 apocalypse. As Covid-19 cases in China rise abruptly, there are, of course, legitimate fears about what might happen in the coming weeks.
China’s zero-Covid strategy has failed. But, for a country with a sufficiently powerful state apparatus in place to monitor its population, this was not an unreasonable starting point. Public health measures for a rapidly spreading infectious disease consist of spreading out any increase in cases over a longer period. The tools here are: enforcing distancing and reducing transmissibility through lockdowns, masking and crowd reduction.
This is what China did until recently. Such measures need to be in place till a significant portion of the population is vaccinated.
What went wrong had more to do with the virus and its changing form than anything else. SARS-CoV-2 is a shape-shifter, rapidly mutating its genetic sequence. Occasional changes in sequence can increase the ability of the virus to move between people.
All variants of current concern, BA.2, BA.4 and BA.5, are off-shoots of the original Omicron strain. In China, about 130 Omicron sub-lineages have been reported in the last three months, including XBB. The BF.7 sub-variant is another that is believed to be driving the rise in Chinese cases.
India continues to record very low case numbers, with just 185 new cases on December 22. Active cases have declined to just 3,402.
Any global surge in cases is bad news. More infections means more opportunities for the virus to mutate. At least a small number of these could be even more transmissible and immune evasive. It is thus important for China to reduce numbers of those infected. On the positive side for India, though, is it has now gone through three waves, each associated with a different variant. Much of India was infected through the Omicron variant.
Omicron-related variants, including those currently found in China, have been detected in India. They have not, however, lead to any sharp rise in cases.
It can be argued that what makes the difference is the hybrid immunity that most Indians possess, from a combination of infections and doses of vaccinations and boosters. This is where India and China differ. Our history with the virus is different.
India has seen sustained and repeat infections with Omicron. The at-risk population has very largely been vaccinated, although booster coverage could be increased further.
In China, the latest Omicron variants are encountering a population that is unexposed to the disease. This population is also vaccinated with a vaccine that, although reasonably effective with respect to an earlier variant, may be less effective in the current background. And not all their citizens are vaccinated or boosted to the required degree.
How should we respond? It makes little sense to close down flights indirectly from China, or indeed, elsewhere. Encouraging masking in public spaces in a non-punitive manner is a good idea. We should be vigilant against variants which might lead to more severe disease. For this, integrated surveillance, both genomic and clinical, is necessary.
We could, and should, encourage our population to get booster shots. It may be necessary to explore the use of the new protein sub-unit vaccines as additional boosters for the vulnerable population.
At the moment, there is no reason to suspect that we should be anything more than reasonably vigilant. Transparency is important, an area where the Chinese government appears to be failing at the moment.
We should, at all costs, avoid over-reaction and panic, as it is unwarranted for now.
The writer is a Professor at Ashoka University, Sonepat and at the Institute of Mathematical Sciences, Chennai. Views expressed are personal