Experts in India issues caution over Delta+ ahead of third wave

Ahead of an anticipated third wave of the Covid-19 pandemic, India needs to enhance the genomic sequencing process for delta plus and other variants. As of now little presence of the AY.1 variant has been found across the country. Writes ETV Bharat Senior Correspondent Gautam Debroy.

New Delhi: A day after Union Health Ministry declared Delta plus as a variant of concern (VOC), senior public health expert and president of Indian Association of Preventive and Social Medicine (IAPSM) Dr Suneela Garg told ETV Bharat that it's high time people should strictly adhere to the Covid appropriate behaviour.

As Delta plus variant also has been characterised having increased transmissibility and potential reduction in monoclonal antibody response, Dr Garg also highlighted that the vaccine manufacturer should constantly modify their vaccine besides promoting antibody booster. "Following the recent mutation of Delta variant, we have now got Delta plus or AY.1. The Delta plus variant can evade both vaccine and infection immunity. Even we have antibody following infection, Delta plus can evade that. People who are infected once, can still be infected with Delta variant strain," warns Dr Garg who is also the president of the Organised Medicine Academic Guild (OMAG).

Delta plus possess characteristics of the original Delta. "But it has undergone a mutation known as K417N. This was also discovered in Beta variant in South Africa, which also evades vaccine," she said. The mutation K417N has been of interest as it is present in the Beta variant (B.1.351 lineage) which was reported to have immune evasion property. It may be mentioned hereafter evidence shows that the Beta variant evades the vaccine, the South African government had earlier returned the consignment of the Astra Zeneca vaccine.

Read: 'Delta variant greatest threat to US, accounts for 20% of Covid cases'

The Centre on Tuesday declared Delta plus as a variant of concern. VOC can affect more people with more seriousness. To date, among the 45,000 samples sequenced in India, this variant has been observed in Maharastra, Kerala and Madhya Pradesh with around 40 cases identified so far. In Maharashtra, 21 people have been suffering from Delta plus. "We need much more sequencing to determine," she added.

Though India has less number of cases of Delta plus, UK has a huge number of cases. This strain has gone to 9 countries. As of Sunday, 205 sequences of AY.1 lineage was detected worldwide, with the USA and UK having over half the known cases. "We have to follow the Delta variant very carefully, as the original Delta played a significant role in second wave," she said.

Dr Garg suggested that India needs to do genomic sequencing thoroughly which means 5 percent of our community samples need to be tested for genomic sequencing. Regarding vaccine efficacy on this variant, Dr Garg said that the present vaccines can work well against variants "but all vaccines should be updated." "We have three vaccines, COVAXIN, COVISHIELD and Sputnik. Though Astra Zeneca vaccine (COVISHIELD) is 60 per cent effective against Delta variant. Pfizer has 88 per cent effectiveness," said Dr Garg quoting studies from Public Health England (PHE).

Read: COVID Survivors Still At Reinfection Risk From Alpha, Beta Variants

Delta plus was found in April and it was detected in 40 samples from three states. Now few cases detected in Karnataka also. "Earlier we had predominantly Delta strain and now addition of Delta plus have forced us to strictly follow social distancing as well as vaccination," she said. She further said that it time to have much more data on antibodies.

"Different companies are now thinking whether we need a booster or we need to relook at our vaccines. It's also a fact that vaccines also needs to modify," she said. Referring to the unlocking process, Dr Garg said that the process need to be dine with extra caution. "We have to go for unlocking with caution. At the same time we have to strengthen our surveillance mechanism," Dr Garg added.

Meanwhile, the Union Health Ministry said that the role of AY.1 in immune escape, disease severity or increased transmissibility is under continued surveillance. "Currently the number of such Delta plus variants in India are only a few but the distribution and detection in various States during last two months indicate that it is already present in some States and States may need to enhance their public health response by focussing on surveillance, enhanced testing, quick contact-tracing and priority vaccination in defined geographies where AY.1 has been detected," the health ministry said.

Read: COVID-19 'Delta Plus' variant detected in India, nullifies monoclonal antibody use: Centre