In a period of only two months, the new variant of SARS-CoV-2 that was first detected in South Africa, has triggered a new wave of Covid-19 in many countries including UK, France, Italy and now some regions in India. Omicron variant which is known to be at least three times more transmissible than Delta, was also designated as a ‘variant of concern’ by World Health Organization (WHO). Therefore, tracing the virus and monitoring its spread are key to deploy effective counter measures. As per the recent data, India has already recorded 650+ confirmed Omicron cases with Maharashtra alone recording more than 165+ cases of the new variant. However, three separate teams of scientists have found that omicron infections more often result in mild illness than earlier variants of the coronavirus, offering hope that the current surge may not be quite as catastrophic as feared despite steeply rising caseloads. As the cases surge in India, extensive testing, vaccination and wearing masks remain the key weapons in our arsenal against the new variant.

Looking at the increasing cases, to quickly detect Covid-19 positive cases and slow the virus' spread, India must increase its use of Rapid Antigen Tests (RAT) in addition to the "gold standard" RT-PCR tests. RATs can help improve access to testing, without ramping up RT-PCR capacity, and help identify more positive cases, at a lower cost, and help better handle a possible third wave. Using this strategy in localised hotspots and in rural areas where RT-PCR testing capacity is lower, or when testing capacity is overwhelmed, can help India control a surge quickly. Whereas, flyers at the airports can opt for rapid nucleic acid test (NAT).

A hybrid model

India could rely on a hybrid model – a combination of all these tests to combat the virus. However, the strategy should be based on infection intensity and disease spread in the country. For example, if the case load and the positivity is low, RT-PCR tests would suffice. But in case of a surge, such as during the second wave, a combination of both testing techniques would help contact tracing and disease containment. Given the scale of the challenge and the danger to human lives, the efforts of the Indian government should be applauded widely. India has taken all the necessary steps to prepare for the possible third wave yet we need to be cautiously optimistic based on our previous experience. Currently, the only method to detect the new variant is genome sequencing. At a time when the threat of the third wave is looming, there’s a need for government to involve the private players with capabilities to conduct genome sequencing so that more samples can be processed at the earliest. At SRL, we have established an advanced centre for genomics at our Mumbai reference laboratory that can provide solutions to clinicians through precision diagnostics in the areas of Oncology, reproductive health, infectious diseases, and inherited disorders. We are completely equipped to conduct genome sequencing tests in our labs.

The second wave

While previously, Delta variant in India fuelled a deadly second wave that overwhelmed our country’s healthcare infrastructure, our government was quick enough to vaccinate its people and issue necessary travel advisories to contain the virus. It’s encouraging to see India achieve a milestone in the nationwide vaccination drive against the coronavirus disease (Covid-19) with 60 percent of its population fully vaccinated and about 90 percent vaccinated with at least one dose of vaccine. As per the government data a total of 34,208,926 people across the country have so far recovered from the infectious disease, which puts the nationwide recovery rate at 98.40 per cent, the highest since March 2020. When in the US people who were fully vaccinated against Covid began testing positive for the virus in greater numbers during the rise of the Delta variant, it was clear that the pandemic was not merely “a pandemic of the unvaccinated”.

The role of vaccines

Breakthrough infections were seen amongst the vaccinated population as well, however, it was also found that those people were less likely to be hospitalized. Most of the healthcare workers in India were vaccinated in the month of February and March 2020. Which could mean that their immunity levels would be all time low as of now. Therefore, it is very critical for our nation to start the booster dose vaccination program for health worker, senior citizens and immune compromised individuals. The good news is that in the wake of the rising cases of the Omicron variant, on 25th December, Prime Minister Narendra Modi announced booster dose of Covid-19 vaccine, for healthcare and frontline workers and people above 60 years of age with co-morbidities. Teenagers aged 15 to 18, will also be eligible for vaccination from January 3.

With more than 2000 government and private RT PCR testing laboratories in the country, I am sure we will be able to navigate away from this rapidly evolving situation, where testing is absolutely critical and would play a pivotal role in combating it.