Omicron: No getting away from a booster dose

Dr. Shahid Jameel, Director, Trivedi School of Biosciences at the Ashoka University and eminent virologist advises not to let one’s guard down though he feels India is likely to be let off relatively lightly by the new coronavirus variant Omicron unlike the Delta variant during the second wave.

“I think it is a blessing in disguise that many of us got exposed to the virus earlier. I think even if we get a high number of infections due to Omicron, the rate of hospitalisation will be far lower than what we saw with the Delta strain,” he says.

Dr. Jameel believes that more recent estimates from cities like Delhi and Mumbai have shown that close to 90% of people in these cities have developed antibodies. “Antibodies and more importantly the immune memory or T-Cells that have developed in people over time, will help protect against severe disease,” he believes. He hastens to add that people should not become complacent but remain alert as cases being reported in the UK are far more alarming.

Since the household transmission of Omicron is two to three times of the Delta variant and the number of cases of the new strain could rise significantly in the coming days, India could turn out to be vulnerable to symptomatic infections, he says.

“If the numbers become large, serious infections could spike. Surveys, cluster testing, and sequencing need to be done urgently,” he says.

A member of the Task Force set up in Maharashtra, Dr. Shashank Joshi feels that people at large have developed a defiant, devil-may-care attitude. “Maharashtra is making an attempt to upscale testing, but there is little fear among the people. Besides, RT-PCR testing has also got mixed up with self-testing or results of rapid antigen testing. The latter is a reasonable test, if you suspect something and if positive, you immediately isolate yourself. However, even if the result comes negative, it doesn’t mean that you don’t have Covid. One still needs to wait it out and isolate for three to five days,” he says.

Observing that Omicron being ‘mild’ has been played out a little too much, Dr. Rahul Pandit, a member of the National Covid Task Force and Director, Critical Care, Fortis Hospital points out that in India we need to be extremely cautious because our population dynamics are different.

“The government, both at the Centre and in the states are certainly concerned about it and I am sure the government is watching this very closely as well. But the issue is that unfortunately, the ‘mild’ aspect has been overblown in the media. People are somehow convinced that it’s probably going to be as good as a common cold and would not bother us,” he points out.

He believes that even if 10 lakh people get affected and only 1% of them require hospital admission, the number at 10,000 would still be huge.

“So, for those who say that Omicron has a mortality rate of 0.1% or 0.05%, they’re still looking at 500 to 1000 deaths. Every life matters. And we need to realise that the thousand deaths will be unwarranted,” he maintains.

India needs to pick up surveillance and genome sequencing on a larger scale, he believes. Testing needs to improve and most importantly, we need to adhere to Covid appropriate behaviour along with masking and vaccination, he asserts.

“The third dose is going to be needed. Again, we need to prioritise who will be eligible to get that third or booster dose. And it should be ensured that every person in the country should first be vaccinated with the two doses. So that’s the first thing we have to do and that should run parallel with the booster programme. They cannot be run one after the other,” he says.

Dr. Pandit opines that running the two programmes simultaneously is crucial because there is a large subset of the Indian population, which probably is immuno-compromised, and have taken their two doses but have probably not developed enough antibody protection or immune protection.

“And then we have a large population of health care workers who are going to get repeated infections as the period of their exposure to the virus is long and most of them have completed their vaccination in the early part of this year. For them probably the booster dose will be needed,” he adds.

Dr. Jameel echoes this thought and says that science and data both show that booster doses will give higher levels of protection through antibodies, protecting us from symptomatic infection. “Two doses are not enough to fight the Omicron. The bigger worry for India to tackle should be to get the second dose in people who have only one dose and get two doses in people who have no doses,” he says.

(This article was first published in National Herald on Sunday)