China’s Covid Surge No Cause for Alarm

We are into the New Year but the pandemic, it appears, will follow us into 2023. If the world thought this would be the first Covid-free year since 2019, when Covid-19 became an everyday word, then the current suffering in China sends us a reminder that it may not be so easy.

Although it all began in China in late 2019, the true picture of the epidemic was never fully shared with the rest of the world. It was reported that Italy had the SARS-CoV-2 infection (then called just novel coronavirus) during the last quarter of 2019, but it was discovered only after the RT-PCR test became available in January-February of 2020. Details about the origins of the virus and time sequence are still unknown.

Once again, China was playing hide and seek with information during the winter months of 2022. Worldometer (using government-released data) showed a wave during November-December that peaked in the second week of December with just over 4,000 daily cases, steadily declining to less than 3,000 by Christmas, slowly climbing to a little over 3,000 as of December 26.

Other sources, particularly foreign news agencies, reported an epidemic raging in the whole country with Beijing and Guangdong the worst affected. The New York Times reported on Christmas Day: ‘a picture is emerging of the virus spreading like wildfire.’ The current spread is mostly the omicron BF-7 variant, which has been found earlier in isolated pockets in India.

Even in January 2020, when there were obvious signs of a pandemic with the virus detected in many countries in three continents plus Australia, the WHO failed to alert the world. It announced the pandemic only in the second week of March 2020. India’s preparedness and response were also weak and poor. Many deaths have gone unreported. So, it is understandable that India is now worried.

Scientists and epidemiologists are however past the learning curve and are quite well-informed. India has no cause to panic. All we need to do today is to keep watching the daily numbers of diagnosed infections, the pressure on our healthcare system in various states and draw slow but deliberate conclusions. So far there is no signal of any new wave in India.

India had three major waves of Covid-19— in 2020 spread over ten months, caused by the original, slow spreading Wuhan virus and a small proportion of the alpha variant that emerged in the UK; in 2021 spread over March-July, for about five months, caused by the delta variant and in 2022 spread over just two months, January-February, due to the omicron variant.

In epidemiological terms, a wave is an epidemic spread, and the valley, if sustained over a long period, is an endemic spread. India has been in an endemic pattern since March 2022, with a slight increase in daily numbers in June-July-August, partly due to the BF-7 variant. Not quite a wave.

The omicron variant defied predictions. It spewed out many sub-variants; all of them defied immunity from previous infections or from two or even three doses of available Covid-19 vaccines. Reinfections were common and we have already seen the BF-7 sub-variant. So, what should India be afraid of ? True, the SARS-CoV-2 has not followed the rules made by virologists, and caution is the watchword; but panic is certainly not called for.

There was a ruthless lockdown in Wuhan district in early 2020, obviously as they had a calamitous wave, spreading fast and putting immense pressure on healthcare, and causing very high mortality. They let foreigners leave, and medical students returning to Kerala, even in January 2020, had famously carried the virus. China had consistently been ruthless when it came to slowing the spread of the virus, yet kept up the image that all was well in the country. The Chinese even went through the winter Olympics 2021. Then they had the ‘Zero-Covid’ policy in vogue up until the end of November 2022.

Many Chinese were protected from the infection and disease during 2020 and through the last quarter of 2022. But nothing can stop the transmission of BF-7, as the Chinese have learned. Their indigenous vaccines turned out to have low efficacy. Their killed-virus vaccine is with aluminum salt as the adjuvant, but the Indian adjuvant for killed virus vaccine is a novel one called alhydroxyquim, a combination of aluminum to strengthen antibody response and a special, innovative, molecule to markedly enhance cell-mediated immunity. What high immunity does is to protect from severe disease in spite of reinfection.

At present it is reasonable to predict that India is not anywhere near as vulnerable as the Chinese. We have had our share of mortality during 2020-2021, the scale of which is disputed. The unmistakable fact is that we had no ‘Zero-Covid’ policy but let the virus spread at will, we let re-infections happen too, and we have far more effective vaccines. Omicron (known sub-variants) cannot do much harm in India in 2023. The advice of the experts is: be cautious, not anxious. Be alert, not panic.

That’s as good as it can get for 2023. It is advisable to be masked up in crowded areas. The practice helps prevent other infections, and puts in place civic discipline as a simple and easy layer of protection that can be made mandatory should the situation turn out different.