Mumbai: Experts fear complicated Covid-19 cases in winter

One of the experts also urged the government to bring back the mask mandate. File pic

With the onset of winter a few weeks away, the emerging Omicron sub-variants of COVID-19 could trigger multiple symptoms and the existing antiviral medicines might not work on them, health experts have said, advising the masses to follow COVID-appropriate behaviour. Their concerns stem from the rise of sub-variants BQ.1 and BQ.1.1, which increase the severity of infection, seen in parts of Europe and the US since the end of September and the beginning of October.

mid-day's report on Friday - Expectant mother? Mask up, especially in trimester! - also pointed to potential challenges for healthcare authorities. It highlighted a growing number of newborns succumbing to Multisystem Inflammatory Syndrome-Neonates (MIS-N) without their mothers having any symptoms.

Confirming the present situation in the US and Europe, Dr Subhash Hira, Professor of Global Health at the University of Washington-Seattle and advisor to WHO-TDR-Geneva, said the new Omicron sub-variants have led to an increase in patient inflow including neonates and children suffering from MIS-N. "The sub-variants of Omicron will not only be a challenge to the existing health systems but also the public at large, which will be vulnerable to a tsunami of post-COVID disabilities like weak heart, weak lungs, cloudy brain function, mental illnesses, kidney, pancreas, liver diseases, etc."

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Dr Hira said sub-variant BA.5 has so far been prevalent in the US and spreading in India but that could change in the coming weeks. He said BQ.1 and BQ.1.1 are doubling every week in parts of Europe. "Worse, emerging studies show that prior exposure to BA.5, vaccines, and monoclonal antibody drugs may not be able to stop a BQ.1 and BQ.1.1 spread. That kind of exponential growth can make it the dominant strain globally in an ultra-short time," he said.

The expert added, "As colder weather sets in and facilitates airborne transmission, public health experts are keeping a close eye on COVID-19 variants that could spell doom and gloom this winter…"

Dr Hira expressed concerns over new strains BA.2.75.2, which seems to be spreading quickly in Singapore, India and regions of Europe, and XBB, which is the most antibody-evasive strain tested. "Recent reports from the UK suggest that a sore throat is now the dominant symptom of COVID infection, rather than fever or loss of smell," he said.

‘Resort to strict measures'

Dr Wiqar Shaikh, Professor of Medicine, Grant Medical College and Sir J J Group of Hospitals, said the new sub-variants could spark a fresh wave in India as well as the rest of the world similar to Delta and Omicron. Quoting a study published in the journal Nature this month, he said that past infections and medications are not enough to stop BQ.1 and BQ.1.1 infections.

Citing research pointing to a spike in infections caused by BQ.1, BQ.1.1, BA 2.75.2 and XBB variants, Dr Shaikh urged the Centre and Maharashtra government to bring back the mask mandate, ensure social distancing and restrict all public gatherings.

He also expressed surprise at the comments of US President Joe Biden who said that the pandemic is coming to a close and the WHO Chief - "we are seeing the end of the pandemic". As per global data, the number of per day cases is 80,000 (United States), Italy (44,000), Taiwan (46,000) and France (66,000) and on Thursday the consolidated global number of fresh cases stood at 4.5 lakh. This is enough evidence that "the pandemic is far from over", said Dr Shaikh.

Testing has gone down

According to Dr Santosh Bansode, HoD, Emergency Medicine, Wockhardt hospital, "BA.2.75.2 is quickly spreading in Singapore, India and some regions of Europe along with the XBB variant. Some research suggests that both these are antibody-evasive strains. That means infection caused by these variants will be antibody and drug-resistant and we won't get much protection from our vaccines against these variants," he said.

"It's also seen that currently all governments are doing less surveillance and less testing compared to 2020 and 2021. There is a high chance that such variants can easily spread if we don't take precautions. Better to continue wearing masks when in crowded places and follow COVID-protective protocols till we see absolutely zero cases. Such variants will keep on coming as viruses keep on mutating. Therefore, we must always be careful," added Dr Bansode.