After the Omicron led COVID wave, many countries said, we're done with COVID, and decided to do away with COVID restrictions—not only in public places, but also in schools, restaurants, shops, and even some aeroplanes.
What followed was a resurgence in COVID cases, with many countries now seeing record high numbers.
This time around, though, it is thought to be led by the BA.2 Omicron sub-variant.
FIT speaks to Virologist, Dr Shahid Jameel to understand what this BA.2 variant is, how it ties to the COVID situation in the world right now, and how it could impact India going forth.
Many countries, especially in Europe and Asia, are now seeing record high COVID cases, even more than they did in the beginning of the pandemic. What do you make of this situation?
Dr Shahid Jameel: If you look at Europe, they are completely open. Everything is open, all mask requirements are gone.
So instead of requirement, it is just a request to wear masks on public transport.
They have also now taken away the legal requirement to report and isolate yourself if you know that you are positive. Essentially, this means that all regulations are gone.
Omicron, especially BA.2, is highly infectious and is running through the population. But, you would have also noted that the mortality is very low.
In fact, if you look across Europe, both UK and mainland Europe, the mortality is 0.1 percent or less, which is essentially like seasonal flu.
The reason for that is the vaccine status is very high. All of these countries have vaccinated 75 percent or more of their overall population, not just adults.
We know that vaccines protect from disease but not infections
and the Omicron variant, especially the BA.2 variant being infectious, infections are high. So that's what happening in Europe.
Talking about South Korea, for instance, they have also been seeing a rise in deaths even though they have a great vaccine coverage of over 65 percent. What does that indicate?
I calculated the rate today and the rate is very low, In fact, the numbers are in front of me. 0.07 percent mortality (as of 22 March).
South Korea, if you remember, did very well early in the pandemic. They had very few cases, just like New Zealand, which also showed a lot of cases now.
So protecting their population early, they did such a good job that later there were a lot of people that remained unexposed to infection.
There is now evidence that is building up that infection gives a much better protection than vaccination against reinfection.
The pieces in the puzzle are fitting together.
I think, while high numbers are discouraging and high numbers are worrisome, severe illness and mortality are still getting contained.
Can you tell us a bit more about the BA.2 Sub-variant. What do we know so far as transmissibility is concerned? Can it cause more severe illness?
Dr Shahid Jameel: Viruses mutate all the time. BA.2 is a sub-lineage of what was the earlier Omicron variant of concern.
Omicron has multiple sub-lineages which means that minor mutations have developed in Omicron. It is still the Omicron variant but there are sub-lineages.
There are three sub-lineages that are BA.1, BA.1.1 and BA.2. The status right now is that,
About 55 percent of the virus circulating globally is BA.2
About 42 percent is BA.1
1 percent is Delta variant
So, Delta has completely been replaced by the two sub-lineages of Omicron.
BA.2 is more transmissible than BA.1 so it is overtaking the other variants.
This is something very natural. The virus is adapting to high transmission.
In Japan, they did a study on animals (hamsters) and these were unvaccinated animals.
When they compared BA.1 and BA.2, they found that BA.2 caused more severe disease than BA.1.
But, Humans are not unexposed any more.
Humans have either been infected by another variant or humans have been vaccinated.
So, in human populations from multiple countries, the data that is coming shows that there is no significant difference in severity of the illness caused by BA.2 and the earlier Omicron So that's the human data.
Do you think this BA.2 has the potential to lead to a fourth COVID wave in India?
I think that the problem is that in media it is very binary. Its either fourth wave or nothing. I don't see it like that.
There will be sporadic surges happening in different places, and different times.
India is very nicely vaccinated. More importantly, India has had a lot of infections.
I will take you back to July 2021 when the ICMR Sero Survey results came out and that showed 67 percent of people had antibodies.
This was a time when vaccination rate in India was fairly low. 67 percent of India translates to about 930 million people.
If I extrapolate from that to this time, my estimate is roughly 1 to 1.2 billion Indians have antibodies against this virus.
But depending upon the vaccination status, depending upon how much immunity has waned over time, we will see surges happening in different parts of the country. Which is a natural thing.
But I think, that if someone is vaccinated, doubly vaccinated that will protect them from severe disease.
Could opening up boosters to all adults in India help?
As a policy, I think it would be very good if boosters are open to all adults, irrespective of whether you are 59 years of age or 61 years old.
So this policy of opening boosters to just 60 plus is a bit restricitive.
I hope the government will consider opening up boosters for everyone because global data shows boosters do afford extra protection, especially against a very highly infectious variant.
But even without boosters, I think many indians will continue to be protected against severe disease that's how I look at it.
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