Hyderabad: The Omicron variant has been driving the current third wave of Covid-19 infections, but data should not be extrapolated from other countries to explain trends in India, Centre for Cellular and Molecular Biology (CCMB) director Vinay K. Nandicoori has said.
In an interview to ThePrint, the chief of the Hyderabad-based institute, under the Council of Scientific And Industrial Research (CSIR), said data extrapolation would not be effective as it reacts differently from one population to another.
A lot of factors — such as population, infection rate and the number of people vaccinated — are different in every country, Nandicoori said.
He also spoke about the need for ‘hybrid immunity’ studies to assess the exact level of protection against Covid variants among the population, and stressed that the population must learn to live with the virus, which is likely to stay around, similar to the virus from the Spanish Flu pandemic from 1918-1921.
Surge ‘completely because of Omicron’
The Omicron variant was first identified in South Africa. It resulted in a massive surge across several countries, including the United Kingdom, but is said to have been a ‘milder’ infection resulting in fewer hospitalisations.
India has seen a big jump seen in infections over the last three weeks. On Wednesday, the country reported 2.5 lakh cases in the biggest single-day jump since the pandemic began.
Nandicoori highlighted that the Omicron variant is five times more infectious than the Delta variant, adding that it is crucial right now to figure out how new waves are coming.
“The Omicron as a variant spreads five-fold faster than Delta. It is not that easy to avoid it. Spread is inevitable anytime a wave comes,” he said.
“I think the surge seems to be coming because of Omicron. So, right now, figuring out whether it is Omicron or not is not as important as figuring out how new surges are coming. What kind of additional mutations Omicron may have acquired,” he said.
“Genome sequencing efforts should continue to track the variants that may emerge at a later point of time. As far as Omicron sequencing, that may not be very essential because Omicron is almost there in all of India right now. I think the surge is completely because of Omicron,” Nandicoori added.
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CCMB, in collaboration with CSIR-Indian Institute of Chemical Technology, also in Hyderabad, is working on an mRNA vaccine. Amid talks around these vaccines, the CCMB director said the institute’s vaccine will “take time” and won’t help immediately. But the learning in the process of making it will help in the future.
“At this point, we know how to produce mRNA, how to package it into lipids. But these are all done at a laboratory level. They are not done at anything bigger than that. First thing is to be successful in injecting this into the mice and getting an immune response. This process of learning of mRNA vaccine with respect to SARS-CoV-2 would help us for the future, not immediately for now,” Nandicoori said.
According to Nandicoori, studies on ‘hybrid immunity’ — protection in people who got infected with the virus and then got vaccinated — is the only way to detect the kind of population getting infected in every wave.
Quite a lot of people in India have hybrid immunity, the CCMB director said.
Asked about the pattern of people getting infected in each wave and those who escaped the first two waves but have been infected in the third, Nandicoori said it would only be possible to assess the pattern using the hybrid immunity study.
“Without a proper hybrid immunity study where you actually divide the population into four parts — unvaccinated, vaccinated, infected, infected and vaccinated — it is difficult to pinpoint and say which gives better protection,” he added.
“So, an infected and vaccinated person actually has three doses in one sense. Infection, followed by two rounds of vaccination. Hybrid immunity, three rounds of vaccination versus two rounds of vaccination — these studies have to be done and in a systematic way,” he said.
“For the study, the patient’s metadata has to be taken into consideration. Their age, comorbidities etc. Once we get the data, we can look into the antibody response,” Nandicoori added.
Omicron and vaccination
Despite lower reported hospitalisations due to the Omicron variant, the CCMB director advised caution, asking people not to take the variant lightly as the infections are high and “people are still dying of Omicron”.
Allaying fears of whether vaccination would ensure protection against Omicron or other variants in the future, Nandicoori said the existing vaccination may not be very effective in neutralising Omicron, but it would definitely reduce the severity of the illness.
He also stressed that vaccination is extremely important at this stage and booster shots are just another layer of protection.
“Consider the UK’s case. When Delta came to India, our vaccination numbers were quite low. But the UK already had higher vaccinated people, so the wave that came last year in the UK, the death rate was lower compared to before. Which was not the case in our country,” he said.
Vaccination is very important because even though antibodies in vaccines that are against the spike protein of the virus may not be as effective in neutralising Omicron as in case of other strains, what’s important is there is T-cell immunity. So, in future, if your body has seen one form of spike protein, it will eventually be able to lower the severity of illness. So, people should get vaccinated, he said.
Citing research papers from South Africa and other countries, the CCMB director pointed out how the studies show “death rate, oxygen dependency, ventilator requirement” among those hospitalised due to Omicron is lower compared to the Delta variant-infected people.
“At the end of the day, some of our population is elderly, with comorbidities. Given all these things, it will take a toll on the population. Death percentage seems to be lower compared to Delta, but people are still dying of Omicron. Also, the number of infections is higher this time,” he said.
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On learning to live with the virus
Stressing the idea of “learning to live with the virus”, Nandicoori said it would be difficult to predict how many more waves the country could see in the future.
Asked if the third wave would be the last such, he ruled out the possibility.
“Flu pandemic was between 1918 and 1920 (1921) and even now we get flu. It is likely that over a period of time, the pandemic will take shape and it will start appearing in different parts of the world at different times. It is ultimately going to get converted into something like a flu but the virus is not going anywhere,” he said.
“It is going to be around and it is constantly going to evolve… If we are vaccinated, the virus that gets selected for it is the one that can actually evade the antibody response and immune response,” he said. “If we have drugs that are treating the virus, it will try to evolve mutations such that it can overcome the inhibition by the drug. That’s the way evolution works.”
What the CCMB is doing
Ever since the pandemic broke out in 2020, CCMB has been at the forefront of genome sequencing, drug testing, validating testing methods and diagnostic kits, said the institute director.
In an earlier interview to ThePrint in December 2020, its then-director Rakesh Mishra had predicted that India might make its own variant, sooner or later, given the population. This was at a time when the Alpha variant cases were on the rise in the UK, where it was first found. The Delta variant that emerged later was once known as the ‘Indian variant’.
About 13 per cent of sequencing in India has been done from CCMB.
The facility, which is one of the national laboratories for genome sequencing, is still trying to culture Omicron. The institute has also developed a “primer” that can specifically recognise Omicron, but it is yet to test it on a lot more samples, according to Nandicoori.
“Omicron actually has quite a lot of mutations in spike protein — around 32 to 36 mutations, which is used by the virus to enter us. Because of these mutations, the existing antibodies don’t effectively recognise the virus that is coming in. It is not replicating as efficiently, wildly as the previous Delta strain, but if you have other comorbidities, even this much can cause problems,” he said.
CCMB is currently also working on different studies, particularly on viral infections, such as a study on various aspects of SARS-CoV-2 virus, what happens when it infects the cells, etc.
Asked about suggestions to escape the virus, Nandicoori stressed the usual — mask up, avoid gatherings and get vaccinated. “The only way to protect ourselves from viruses is shutting ourselves completely but that is not possible. So, these precautions are the only way out,” he said.
(Edited by Amit Upadhyaya)
Also read: 115 deaths reported due to Omicron globally, including one in India, health ministry says
Source: The Print