India faces 520% surge in new COVID-19 cases in one month, WHO perturbed over global rise

India became a focal point with a staggering 520 per cent surge in new COVID-19 cases from November 20 to December 17, 2023, as per the World Health Organization's (WHO) epidemiological update released on Friday.  

The South-East Asia Region, including India, reported a concerning 388 per cent increase. Notable proportional rises were observed in India, Sri Lanka, and Thailand. Indonesia led with 3,725 new cases, marking a significant uptick.  

Contrasting the global 8 per cent decrease in deaths, India recorded a severe 425 per cent increase, along with Thailand (220 per cent) and Indonesia (317 per cent). On December 18, WHO designated JN.1, a sub-lineage of the BA.2.86 Omicron variant, as a separate Variant of Interest, constituting 27.1 per cent of global sequences in week 48. 

The report also highlighted a global rise in hospitalizations and ICU admissions, with India recording over 3,241 new cases and 21 deaths in the 28-day period, stressing the strain on the healthcare system.  

As the world shifts from emergency to long-term disease management, WHO emphasized sustained efforts in testing, sequencing, and reporting. WHO called for increased surveillance and protective measures in response to rising respiratory diseases, including COVID-19 and the JN.1 sub-variant, urging South-East Asia countries to take preventive actions. 

“The COVID-19 virus continues to evolve, change, and circulate in all countries globally. While current evidence suggests the additional public health risk posed by JN.1 is low, we must continue to track the evolution of these viruses to tailor our response. For this, countries must strengthen surveillance and sequencing, and ensure sharing of data,” said Dr. Poonam Khetrapal Singh, Regional Director, WHO South-East Asia. 

While JN.1 is currently classified as a variant of interest with a low global public health risk, its rapid spread raises concerns, particularly as countries enter the winter season. Dr. Khetrapal Singh urged people to take precautions during holiday gatherings, emphasizing the importance of vaccination against COVID-19 and influenza, especially for high-risk individuals. 

“As people travel and gather for festivities during the holiday season, spending a lot of time together indoors where poor ventilation facilitates transmission of viruses that cause respiratory diseases, they must take protective measures and seek timely clinical care when unwell,” said Dr. Khetrapal Singh. 

As testing and reporting of COVID-19 cases have decreased, the WHO stressed the necessity for countries to enhance surveillance, sequencing, and reporting to effectively manage respiratory diseases and safeguard public health. 

How prepared is India? 

The central government has said that it is implementing a comprehensive approach to combat the persisting challenges posed by the COVID-19 pandemic, with a primary emphasis on vaccination. With the goal of achieving 70 per cent coverage by March 2024, the government is prioritizing booster doses as a crucial component of its strategy. 

To bolster vaccine uptake, special campaigns are underway in rural areas and among vulnerable populations. The government is also actively involved in ongoing research and development efforts for indigenous nasal and mRNA vaccines, aiming to diversify the vaccine portfolio. 

Highlighting the significance of surveillance and monitoring, the government is conducting continuous genomic sequencing to identify potential threats from circulating variants, according to a recent statement from the union health ministry. The strategy places a strong emphasis on community-level disease surveillance and the prompt isolation of cases. Pilot projects monitoring wastewater are being implemented to detect outbreaks early, adding an innovative dimension to the overall approach, the government said in a recent statement. 

On the healthcare infrastructure front, the government said that it is proactively increasing ICU beds, oxygen supplies, and ventilators across hospitals to prepare for potential surges in cases. Regular training programs for healthcare workers on case management and infection prevention protocols are being conducted to ensure a skilled and prepared workforce. 

The government is also expanding telemedicine services and utilizing digital platforms for contact tracing and remote consultations, reflecting the integration of technology into the healthcare response. Clear advisories and guidelines are regularly issued to the public, emphasizing preventive measures such as mask-wearing and social distancing. 

“The recent surge in COVID-19 infections caused by the JN.1 subvariant in the USA and China has raised concerns, particularly with cases rising in Singapore and now Kerala and Tamil Nadu. While the current variant appears to have low transmissibility and fatality rates, the single reported death serves as a reminder that it could still mutate and cause serious problems on the scale of the previous pandemic,” said Dr Rajeev Gupta, Director - Internal Medicine at the CK Birla Hospital, Delhi. 

The global scenario 

The WHO has issued a call for countries worldwide to enhance surveillance and implement protective measures. The 28-day period from November 20 to December 17, 2023, witnessed a notable surge in reported cases, with 105 countries reporting a collective increase of 52 per cent, resulting in over 850,000 new cases. However, a contrasting trend was observed in deaths, which decreased by 8 per cent, totaling over 3,000 new deaths compared to the preceding period. 

Despite the emergence of the JN.1 sub-variant of the BA.2.86 Omicron variant, classified as a variant of interest by the WHO, the global public health risk is currently assessed as low. JN.1 accounted for 27.1 per cent of sequences in week 48, reflecting a substantial rise from 3.3 per cent in week 44. This underscores the imperative for sustained surveillance and sequencing efforts to tailor responses effectively. 

The South-East Asia Region reported a staggering 388 per cent increase in new cases, with India, Sri Lanka, and Thailand experiencing significant proportional rises. While the number of new deaths in the region surged by 317 per cent, the WHO highlighted a decreasing ICU-to-hospitalization ratio,  suggesting a lower proportion of new hospitalizations requiring intensive care. The death-to-hospitalization ratio has exhibited a general decline since July 2021, indicating a reduced mortality risk among hospitalized individuals, as noted by the apex global health agency. 

Also Read: COVID-19 in India: Active cases cross 4,000-mark, 5 JN.1 infections reported from Maharashtra's Thane