The novel coronavirus is showing classic traits of movement towards endemicity, former Indian Council of Medical Research (ICMR) scientist Dr Raman Gangakhedkar told News18 over the latest surge in Covid-19 cases across India.
The country’s top epidemiologist, who was the face of India’s apex medical research agency during government briefings on Covid-19, believes that “coronavirus is already on its way out and hence causing mild infections but low deaths and hospitalisation rates when compared to pre-omicron variants”.
According to Gangakhedkar, the classic traits of a virus moving towards endemicity from a pandemic include the phenomenal fall in its lethality and a noticeable surge in its ability to cause infections.
“The virus will keep on mutating,” he said while explaining that eventually, it becomes milder but more infectious. “Killing the host will be a disadvantage to the survival of the virus. Hence, for survival, it needs to infect more and more people and continue its lineage.”
India recorded 5,880 new Covid cases in 24 hours, government data showed on Monday, taking the active caseload to 35,199. The daily positivity rate stands at 6.91 per cent while the weekly positivity rate is at 3.67 per cent.
‘XBB.1.16 is not a stable variant’
The XBB.1.16 variant was first identified in January. “It means the virus is in the country for the last three months but has not been able to cause any major increase in deaths or hospital admissions,” said Gangakhedkar.
He further explained that XBB.1.16 is a recombinant virus, which is made accidentally in human bodies. “Recombinant viruses are generally not stable, unlike evolving escape mutants that confer higher viral fitness in mutating viruses in the lineages. They are made when two different variants enter the human body and there is mix up of genetic material during reproduction.”
Dr Gangakhedkar, who was involved in the prevention and control strategies against the HIV epidemic in India, said that HIV also saw the emergence of different recombinant viruses but they failed to dominate for too long.
“We must not forget that XBB.1.16 is a recombinant virus which belongs to omicron lineage BA.2. In the third wave caused by omicron, BA.2 was dominating,” he said. “Hence, the number of infections could go up but they will not end up pushing the deaths or hospitalisations.”
Dr Gangakhedkar believes that the world is seeing “convergent evolution” under which organisms evolve to enhance their fitness to infect human beings in response to drugs and/or the body’s immune pressure which includes vaccines and past infections.
‘Take pending boosters, wear masks, and get tested’
Gangakhedkar expressed concern for the elderly and people with chronic comorbidities and he believes that the majority of people having symptoms are not even getting tested for Covid-19.
“While the majority will get milder infection, the section of people who are vulnerable may develop severe disease. Hence, people belonging to vulnerable groups must wear masks, follow Covid-appropriate behaviour, avoid crowded places, and get RT-PCR tested when unwell,” said the expert.
He appealed to protect vulnerable groups. “Everyone must restart wearing masks and isolate themselves when symptomatic. If someone is witnessing the symptoms of Covid-19 but avoids testing and continues coming to work, he/she will end up multiplying the infections even among those who are weak and are at higher chances of getting the severe disease.”
Similarly, parents must take responsibility for not sending ill children to school, he said.
“By now, it is almost clear that Covid-19 rarely causes severe disease among children. But, in turn, children can ferry the disease from one place to another, and via children, their vulnerable teachers or friends’ family members including the elderly at home can get affected,” said the expert.
The former head of epidemiology and communicable diseases at ICMR advises the public to take the pending booster shots.
“If you haven’t taken your third dose, you can opt for it now even if it was due quite some time back,” he said.
However, he does not recommend the fourth dose of the vaccine. “There is no solid evidence to support the second dose of boosters,” he said.
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