JN.1 COVID Surge in India: ‘Don't Panic, but Time to Be Cautious,’ Say Doctors

'It's time we started treating COVID like the flu.' Doctors decode the current COVID surge

JN.1 COVID Subvariant in India.

(Photo: FIT)

COVID-19 has made a comeback in headlines with its newest subvariant JN.1 driving up cases globaly. There are speculations of another wave, as well as the travel restrictions, amid calls for COVID mandates to be reinstated.

There’s no denying that parts of India (and even the world) are once again seeing an upsurge in COVID cases.

According to scientists, JN.1, has, a mutation in its spike protein that makes it more infectious than previously identified Omicron subvariants.

However, is the situation really as bad as it's being made out to be?

FIT caught up with doctors in Kerala and Delhi-NCR to find out what it is that they're seeing in their OPDs.

Inside COVID Wards: What Are Doctors Saying?

Speaking to FIT, Dr Muhammed Niyaas, an Infectious Disease specialist based in Thiruvanathapuram, Kerala, says, "We have been seeing a rise in COVID cases since November itself," adding, "The majority, if not all of them are mild cases."

According to data from the Ministry of Health and Family Welfare, the state reported 292 new infections on Wednesday, 20 December, taking the active COVID-19 cases in Kerala over the 2,000 mark.

As of 21 December, there are 2,669 active COVID cases in India, and Kerala accounts for 88 percent of them.

One reason for the disparity in COVID numbers, according to experts, could be the more robust testing and reporting of COVID cases in Kerala compared to other states.

"Many of them are tested when patients are admitted for other ailments and have mild respiratory symptoms," says Dr Niyaas.

Dr Deepak Prajapat, Sr Consultant - Pulmonology & Critical Care, Metro Hospital, Noida tells FIT that there's also been a rise in cases in Delhi-NCR.

"Yes, we are seeing a slight rise in COVID cases right now, but we can’t be sure of the strain of each because there are only a limited number of laboratories doing the testing."

Dr Deepak Prajapat

Both Dr Prajapat and Dr Niyaas, however, underscore that most of the cases coming in have mild illness.

As for the symptoms, they say, there are mainly seeing:

• Low to medium-grade fever

• Respiratory symptoms

• Dry cough

• Throat irritation

• Dasal discharge

• Some people have gastrointestinal symptoms like diarrhoea, pain abdomen, and dizziness

All symptoms that are typically associated with Omicron and its subvariants. "There is nothing alarming as such," adds Dr Niyaas.

Dr Kuldeep Kumar Grover, Head of Critical Care & Pulmonology at CK Birla Hospital, Gurgaon, however, tells FIT that he has seen some atypical symptoms such as chest pain, some anxiety and panic, that should be kept an eye on.

The WHO, in a statement released on 20 December, Wednesday said that while it is being classified as a variant of interest, "the additional public health risk posed by JN.1 is currently evaluated as low at the global level."

On 19 December, while addressing the press, Kerala Health Minister Veena George said that despite the increase in COVID cases in the state, it is not a cause for panic as the state is well prepared to handle the virus now.

COVID vs the Flu: More Cases to be Expected

According to Dr Niyaas, "At this point, we have to look at COVID as flu. We have to take it as we go."

Other experts have echoed this thought in the past. Speaking to FIT for a previous article, Virologist Dr Gagandeep Kang explained that the COVID-19 virus has a peculiar way of replicating.

"Even though it is a virus that has a proof reading mechanism, it has a kind of way of jumping genes and reading different sections differently so the idea that recombinants will arise is something that we should be expecting."

Dr Gagandeep Kang

"We've seen it with the common cold coronavirus as well. We are seeing it with SARS-CoV-2,"she added.

Dr Niyaas explains that while COVID cases have gone up in the past few weeks, "We have an equal number of influenza cases also. We don't report on flu cases like we do COVID."

"This variant of COVID seems to be much less virulent than the flu that is going around right now. Many flu patients, particularly elderly, are needing pneumonia and ventilation."

Dr Muhammed Niyaas

The bottomline, he concludes, is that we are now at a point where thanks to vaccines and prior infection, though we might get infected (with COVID), most of us will have mild illness.

"Prior vaccination and the infection seem to still be protecting against severe illness," he adds.

However, some people can develop severe illness and this will depend on the variant and if your preexisting health status. This is true whether you have COVID or the flu,

'Don't be Complacent'

So, all of this doesn't mean it's okay to get complacent.

"In healthy adults, it is mild mostly. But in those groups of patients where comorbidities are there, like cardiac patients, patients who are on dialysis, or those who have chronic lung disease, they have severe disease also, and they need to be a bit cautious," warns Dr Prajapat.

"Although initially presenting as mild cases, (in these patients) the severity can escalate rapidly within 2 to 6 days," says Dr Grover.

Which is why, health authorities have been emphasising on the need to remain alert and put measures in place to contain the spread of the virus.

Kerala Health minister Veena George reportedly held a meeting of the top health officials in the state on Tuesday, 19 December, where it was decided that masks would be made mandatory at all hospitals in the state. Hospitals have also been asked to prepare special facilities for COVID patients and keep isolation wards ready on standby.

The MoHFW has also asked states to monitor the rise of cases at a district level and prepare for adversity.

As for the general public, people have been asked to mask up when in crowded spaces, especially if you have flu-like symptoms. Frequently wash your hands with soap. Consider getting the flu and COVID-19 vaccines, especially if you fall in the vulnerable category.