India faces surge in fresh COVID cases; govt on high alert

India initially saw a decline in Covid-19 cases and fatalities from October to November, but in recent weeks, there has been a surge, especially in Kerala, said the government. It has attributed this to an increased number of samples from Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) referred for testing.

According to the World Health Organization’s (WHO’s) recent epidemiological update released on November 24, from October 23 to November 19, India showed a downturn in both Covid-19 cases and related fatalities. India reported 523 new Covid-19 cases during the 28-day period, marking an impressive 79% decrease compared to the preceding month. 

Additionally, the country reported four new deaths during the period, representing a 100% decrease compared to the previous month, as several countries experienced fluctuations.

Despite these positive trends, the report emphasised the importance of cautious interpretation, considering factors such as testing variations, reporting delays, and changes in reporting frequency. 

Also read: 'Wear mask at airports': Singapore issues travel advisory as Covid cases surge due to JN.1

Dr. Rajiv Bahl, Director-General of the Indian Council of Medical Research (ICMR), last week said a case of the JN.1 sub-variant of Covid-19 was identified in Kerala during the routine surveillance conducted by INSACOG.

INSACOG, a network of Genomic Laboratories, has been actively monitoring Covid-19 in India from a genomic perspective, with ICMR being a part of this consortium. According to the revised surveillance guidelines for Covid-19, patients with ILI and SARI are tested for Covid-19, and positive cases are referred for Whole Genome Sequencing (WGS).

The WHO has urged member states, including India, to maintain their established Covid-19 infrastructure to sustain early warning, surveillance, reporting, variant tracking, clinical care, vaccination, and communication efforts.

The Union health ministry said the identified case of JN.1 sub-variant was from a RT-PCR positive sample collected in Karakulam, Thiruvananthapuram, on December 8. The sample had tested RT-PCR positive on November 18. The patient exhibited mild symptoms of ILI and has since recovered from Covid-19.

The majority of these cases are clinically mild, and individuals are recovering at home without requiring treatment, the government said. As part of the routine activities of the Union Health Ministry, a mock drill is currently underway in all health facilities across states to assess their public health and hospital preparedness measures. This exercise, initiated on December 13, is supervised by district collectors and is expected to conclude by December 18, the government said in a statement.

The Union Ministry of Health further said that it is maintaining regular communication with the State Department of Health in Kerala, which is actively monitoring various points of entry.

JN.1 emerged from the BA.2.86 sub-variant first identified in July. Since then, cases have been reported in several countries, including Luxembourg, the United States, and now India. While its prevalence remains low compared to dominant variants like XBB.1.5, health officials have said that it should be cautiously watched.

“While still relatively rare, JN.1 sub-variant warrants close monitoring due to its unique mutations and unknown characteristics. Concerns arise due to India's large population and potential for rapid outbreaks. Additionally, the country’s vaccination coverage, while improving, still leaves room for vulnerability,” said Dr Jugal Kishore, Director Professor, department of community medicine, Safdarjung Hospital

“JN.1 carries specific mutations in the spike protein, the part of the virus that attaches to human cells. These mutations could potentially increase its transmissibility and ability to evade the immune response provided by prior infection or vaccination. However, further research is needed to confirm these possibilities,” he said.