Kerala banks on genomic surveillance data
As anxiousness over a doable third wave of COVID-19 escalates, Kerala is banking on actual time genomic surveillance data to be careful for the emergence of doable new SARS-CoV-2 variants or any modifications in illness patterns amongst numerous teams in the neighborhood which may sign a possible change in illness transmission.
The first wave of COVID by no means actually ended and transmission continued at low ranges — 2,500 day by day instances — until March this 12 months when relaxations in COVID protocols, election campaigning, and primarily the arrival of latest virus variants within the State led to a sudden and large surge within the epidemic curve.
While getting ready the well being system forward for managing a 3rd wave could possibly be a chance to enhance the State’s well being infrastructure, the third wave is neither inevitable neither is it anticipated to be extra vicious than the second wave.
“The second wave peaked mid-May and we expect that the curve will remain on a higher plateau than before, at perhaps 5,000-6,000 new cases per day. Some surge in transmission is inevitable when the unlock happens but unless a more transmissible virus variant emerges, the circulating dominant strain, Delta (B.1.617.2) will continue to maintain the equilibrium it has found,” feels Rakhal Gaitonde, public well being knowledgeable and Professor, Achutha Menon Centre for Health Science Studies.
The “unlocking” must be a extra scheduled and managed affair as a result of, given the excessive transmissibility of the Delta variant, even small errors may be expensive, he warns.
Since mid-April 2021, after the extraordinarily transmissible Delta variant emerged because the dominant circulating virus within the State, the Rajiv Gandhi Centre for Biotechnology (RGCB) and the multidisciplinary analysis lab on the Medical College Hospital, Kozhikode, have been doing focused genetic sequencing research.
As a part of this initiative, viral RNA samples are being collected from throughout districts beneath 5 classes. Representative samples are being collected from locations which recorded a excessive check positivity price; from areas the place case clusters have been reported; samples from individuals who had re-infections; samples from individuals who contracted COVID after receiving one/two doses of the vaccine; and samples from individuals who had no comorbidities however had severe COVID and required ICU care.
“We are regularly checking out existing mutations (L452R, Delta, Kappa) as well as random mutations in the virus. Our effort is to detect any patterns in mutations and if it correlates with any particular category of samples. If so, we can identify the sample location, study the clinical profile of cases and plan further interventions,” says E. Sreekumar, senior scientist on the RGCB.
While that is anticipated to be a steady exercise, public well being consultants level out that except the State takes a aware effort to transcend laboratory findings and combine the genomic surveillance data obtained every now and then into appropriate coverage choices on the bottom, these are prone to stay mere educational workout routines.
“We now have people who derived natural immunity through infection with the virus before it mutated, those who have vaccine-derived immunity as well as those achieved natural immunity through infection by the mutant strain. Right now, we have no idea how long this protection lasts or how strong it is because we have seen re-infections in those who got infected by the original strain, as well as breakthrough infections in those who got vaccinated. It is highly unlikely, but we need to watch if a new new variant will emerge, leading to re-infections in those who were infected by the Delta variant,” says Dr. Sreekumar.
“We thought that vaccines will bring us herd immunity but we now know that while vaccines can reduce the severity of disease and prevent deaths, it cannot stop disease transmission. COVID will eventually become endemic, occasionally creating outbreaks in communities. The only strategy going forward will be to prime the health system, while investing in good genomic and disease surveillance measures,” he says.