Reason for concern: India must comb for variants, step up vaccine innovation efforts

Preliminary findings of an AIIMS study, as per news reports last week, show that the Delta (D) variant of SARS CoV-2 beats Covid-19 vaccines approved for use in India, in recipients of both just one dose and two doses. The variant was first reported by India in October 2020, and the WHO declared it a variant of concern (VoC) on May 11. The WHO lists “decrease in effectiveness of … available diagnostics, vaccines, therapeutics” among the three conditions that qualify a variant to be designated VoC. Another criteria is “increase in transmissibility…”.

On Friday, Public Health England (PHE) noted that the variant carries a 60% higher risk of household transmission than the wild type, and is nearly 45-50% more transmissible than the Alpha (A) variant detected in the UK . Indeed, while the A variant, itself a VoC, was responsible for 98% of the cases in the UK till March, now, the D variant accounts for 90%. Indeed, it is likely to have been behind India’s deadly second wave; a recent study by the National Centre for Disease Control and Insacog (the lab-consortium carrying out genomic analysis of SARS CoV-2 in India) suggests Delhi’s second-wave surge, despite earlier estimates of 56% seropositivity in its population, was because of this variant. PHE has shown that the D variant significantly reduces the efficacy of vaccines with different underlying technologies, adding to the concern.

Against this backdrop, there is a need to rigorously comb infections for emergence of variants. To that end, the Insacog mechanism must be strengthened. Last week, the government said that Insacog had so far processed 30,000 samples—for perspective, the 10 laboratories that made the consortium at its launch, as per Down to Earth, have the capacity to process this number in just one month.

Seventeen new labs getting added to the consortium is good news, but only if the capacity of each is fully utilised, supported with commensurate government funding. The government also must let science have the final say. It can’t afford to ignore scientific advice; citing an Insacog insider, Reuters had reported the government had done this during the second wave. Indeed, eminent virologist Dr Shahid Jameel, who resigned as chair of the scientific advisory committee to Insacog, had written in The New York Times: “All of these measures (increased testing, isolation, etc) have wide support among my fellow scientists in India. But they are facing stubborn resistance to evidence-based policymaking.”

The government must also facilitate access to Covid data; 800 Indian scientists had appealed to the PM in April on this. This can only happen with rigorous data collection; as far as possible, cases and deaths need to be recorded correctly. States will have to step up their act on this.

The government needs to roll out support programmes for vaccine and therapeutic innovation, say, US-style funding of Covid-vaccine research. With a large population of immunocompromised individuals—this, among other conditions, fosters viral evolution—India can’t afford to drop its guard again.