Should the India COVID variant scare us?

What do we know today about variant B.1.617?

To date, there are no conclusive studies that indicate the level of transmissibility and lethality, but we can assume that – like the English variant – it has a rather high diffusion capacity. The detection in India does not mean that it has taken over there.

“The prevalence of B.1.617 in India is currently less than 10 percent and in other areas of the world, there are sporadic cases,” said Carlo Federico Perno, Director of the Microbiology Unit at the Bambino Gesù Children’s Hospital in Rome. The situation in India is dramatic, but not because of the variant.

The reason is that when the infections temporarily dropped, all restrictions were removed leaving the virus free to run. What is happening in Italy now, therefore, should have been fully expected. We are talking about a variant and not a virus strain born as a result of vaccination to try to circumvent it – called a vaccine-escape.

In India, the numbers are frightening: 17 million total infections and 192,000 deaths. Every day there are more than 300,000 cases and deaths well over 2,000. However, considering that India has 1.4 billion inhabitants, the percentage of deaths is lower than that is found in Italy (with 200-300 deaths per day for 60 million inhabitants, even though a small part of the population has been vaccinated. In India, 130 million doses have been administered, but only 13 million people also received the booster.

Has the “India” variant arrived in Italy?

The first case of the “India” variant was registered on March 10 in Florence, and then on April 26, two were added in Veneto, in Bassano (Vicenza). Two days earlier, a case of the India variant had been reported in Switzerland (not the first in that country). Many countries are running for cover. UK Prime Minister Boris Johnson has decided – in agreement with his India counterpart – to cancel an official visit to India.

In the United Kingdom, about a hundred cases of importation have been traced, and India has been included among the nations on the “red list” (which includes about 50 countries) to which travel is prohibited and from which it is possible to repatriate only by submitting a series of tests and a mandatory 10-day hotel quarantine at the traveler’s own expense.

Eight cases of the B.1.617 strain have been identified in Israel. Health Ministry Director General Hezi Levy of that country said that according to first impressions, Pfizer’s vaccine is at least partially effective against the variance. Its diffusion is, however, limited. There are a few hundred cases in Europe and a few thousand in the world of the India variant. Several countries – including Germany, Great Britain, and Canada, as well as Italy – have implemented a tightening of air links with India.

Could vaccines be less effective?

The answer to that question is we don’t know. As previously mentioned, we are not dealing with a vaccine-escape strain. Vaccines protect us from the vast majority of variants. Then there are studies in progress and still the investigations do not give us absolute certainty, as state by Italy Minister Speranza. “Where there are elements of greatest weakness in the ability to contrast variants, pharmaceutical companies and scientists are already working to find new vaccines. It is a challenge between the mutating virus and the scientific community. We will win it, but we need graduality. The choice to tighten arrivals from India is due to an attitude of great caution and precaution,” the Minister said.

The coordinator of the Technical Scientific Committee, Franco Locatelli, agrees, saying: “The situation is serious, because the number of infections in India is extraordinarily high, and there is a doubt that the Indian variance may have greater potential [to be] contagious, as it was for the English one.

“Instead, I would be cautious about the possibility that B.1.617 ‘holes’ the vaccines; there is no evidence on this. We do not create alarmism.” What is happening in India, Locatelli concluded, demonstrates that “the pandemic must be tackled on a global level, with the economically more fortunate countries having to help those in difficulty, first of all for ethical reasons.”

Is a structured virus sequencing program active in Italy?

“Unfortunately, no,” said Carlo Federico Perno from the Italy Ministry of Health, adding: “The announced consortium for sequencing has not yet started, and today, only a map of the existing one is made presented in the report of the Higher Institute of Health which lists and updates the variants present in Italy.

“Massive sequencing, on the other hand, would allow us to understand if new ones are emerging. Paradoxically, in India this activity has been greatly enhanced and coordinated by the government with a national program. In Italy at the moment, we have nothing structured and financed in this sense.”

What could happen with the reopening of the business?

“The virus is still present and kills. We have 200-300 deaths a day,” underlined Perno, “But it is clear that our country is in severe economic suffering. I would add that only 10-12 million Italians have been vaccinated with one or two doses. In this scenario, an intelligent political synthesis is needed that reconciles biological risk with that of social default.

“But it is a political decision (and, therefore, a responsibility); it is not up to us doctors. But let’s look at the data: in Great Britain and Israel, where 60 percent of the population has been vaccinated, infections, hospitalizations, and deaths have plummeted. We are further behind, but within 3 months we should be able to vaccinate at least another 15 million people, reaching 50 percent of the population, if supplies are regular.

“The official figures say that in Italy there are 5 million healed (in most cases immune to infections), but given that in the first wave only the symptoms were tested, we can imagine that the healed are much more, in the order of 8 -10 million. Finally, the heat: it is not an absolute element of reducing infections, but it helps to improve the situation together with the restrictions, curfew included.

“It is also very important to keep precautions indoors (masks, spacing, hand hygiene). Following these warnings, I believe that the conditions are in place to have a fairly quiet summer. If, on the other hand, the virus is left free to circulate, as happened in India, the situation gets out of hand, with the risk that further variants and maybe even vaccine-escape strains can be created, but this is unlikely to happen before vaccinations.”

Do we all have to keep wearing masks?

“Yes. I would add that the Ffp2 offers more guarantees, but it is not easy to keep it for long, especially in the heat, with the consequent risk of taking it off or using it badly. [It] is better worn correctly and for as long as necessary.”

#rebuildingtravel

Source: corriere.it

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Avatar of Mario Masciullo - Special to eTN

Mario Masciullo - Special to eTN

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