Omicron variant: India to see a large wave of infections, says Brown University’s Dr Ashish Jha

Brown University’s Dr Ashish Jha forecast that India is likely to witness a steep rise in cases in the coming weeks. “India is in a different place than where it was a year ago. Here’s what I think people should expect. What we’re seeing in country after country is a very sharp rise in cases. I think that will happen in India in the upcoming weeks. India will probably see a large wave of infections,” he said.

Dr Jha added that tens of millions or maybe hundreds of millions of Indians can get infected and that the consequences of this wave will be much milder than the Delta wave that India witnessed in March-May this year. He also noted that natural immunity or infection-induced immunity from the Delta wave and record vaccination numbers in India are the big reasons that the outcome of this wave will be much milder.

“Things will look very different from the Delta wave that India had earlier in this year. That’s for two reasons – one is of course there is a lot of natural immunity [or] infection-induced immunity from the Delta wave but the second big reason is India has [done] an extraordinary job of vaccinating its population. Really, really amazing where India is today compared to where it was 10-11 months ago,” Dr Jha said.

He also added that the end to the pandemic is nowhere near in sight. “There isn’t one day or one moment where we all get together and say, okay pandemic is over. Pandemics fade into the background.” He also added that after Omicron is over, so many people will be infected that we will build up even more population immunity, adding there may likely be other variants in the future but they are likely to have lesser impact compared to the Delta wave.

He also highlighted that “vaccine escape” or “immunity escape” is the biggest issue with Omicron and this is causing infections in the vaccinated population. Dr Jha said that vaccines are working at preventing severe illness and this infection is not very severe in vaccinated people. “For me, the data on this is quite clear looking at the data coming out of the UK, out of Europe, the US and South Africa, I think high-risk people need a booster. So if I were advising the Indian government, I would say identify your high-risk people: people over 60, people with significant chronic disease and get them a booster,” Dr Jha said on the issue of booster doses.

He further explained this is important because if a 70-year old with a heart disease has a breakthrough infection that can be quite serious. He also advocated boosters for healthcare workers because if many healthcare workers get sick very quickly, it will increase the burden on the healthcare infrastructure, adding the remaining population besides healthcare workers and high-risk people can get boosters at a later stage when the vaccine supply inequity is bridged.

This is in line with what Director of Center for Infection and Immunity at Columbia University and scientific advisor for the film Contagion Dr Ian Lipkin has to say. Dr Lipkin said that if one is not vaccinated or don’t have any infection, then there is a probability of getting a severe disease if you get infected with the Omicron variant of the novel coronavirus. This probability goes up if you suffer from comorbidities.

“If you are not vaccinated and if you’ve never seen the virus with a previous infection, then, the chances are that if you become infected with Omicron, you are going to have severe disease particularly if you fall into the categories that we’ve already known are associated with more disease,” Dr Lipkin told Business Today.

He, however, said that those who are fully vaccinated and/or have received booster shots are likely to have milder disease compared to those who still haven’t been vaccinated.  “On the other hand, if you’ve been previously infected or you’ve been fully vaccinated particularly you’ve been boosted with either the adenovirus fixed vaccines such as Covishield which is made in India or you’re receiving an RNA vaccine, the chances are that if you become infected you’re going to have milder disease,” the Director of Center for Infection and Immunity at Columbia University noted.

But how and why is Omicron different than Delta? Omicron has mutations in variety of regions in the genome primarily in the portion of the virus that attaches to the outside of cells. He further said, “Think of it like velcro but with more teeth. It’s able to attach more efficiently and then get into cells. It also has some substitutions and other portions of the genome that may make it more capable of reproducing itself in the nose and in the upper respiratory tract as opposed to in the lungs.”

He also called it a sort of “mixed blessing” implying that even though it is easier to generate and transmit the virus, it also reduces the possibility that the virus is going to cause severe disease in case one has had an exposure to the vaccine or to the virus itself.

Dr Lipkin also explained how one can protect themselves. He said that people need to be more mindful of large gatherings and the types of masks we use. He noted that any mask is better than no mask at all and one should go for the mask that covers your nose and mouth properly and prevents you from breathing around the sides. In case one doesn’t have access to the N-95 masks, Dr Lipkin suggested that you should double-mask.

Also read: Is Delmicron a new COVID-19 variant? Here’s what you need to know