Omicron less likely to be severe but can stress healthcare systems, says top biologist

Another potential problem is that healthcare workers may get infected and available manpower may reduce at critical periods, Agarwal noted

A physician turned researcher, Anurag Agarwal is one of India’s leading biologists who heads CSIR’s Institute of Genomics and Integrative Biology, Delhi. He is a key member of the INSACOG and heads a WHO advisory group that recommends the Variants of Concern. Agarwal talks to DH’s Kalyan Ray on the Omicron variant and the third wave of Covid-19 in India. Excerpts:

Has the third wave started in India?

Yes, genetic sequencing has shown clear community transmission in Delhi, Mumbai and other metros. Omicron is rising in bigger metros. Then it will rise in smaller places and rural areas.

What could be the size of the peak?

The size of the peak depends on how much you test. In the South African wave, the number looks smaller than the UK wave because the UK is very different from South Africa in terms of testing. The size itself doesn’t have much meaning but in terms of total number of cases, the current wave should exceed the previous one. But since we are not testing the asymptomatic patients now, the numbers would not be immediately comparable.

Also Read | India's Covid-19 hospitalisation rate at 5-10%, says Centre

What’s your opinion on the new testing strategy?

There is no point in testing the asymptomatic as you really can’t stop this virus from transmitting. That's why we have decided not to test the low-risk asymptomatic people.

What percent of infected persons would require hospitalisation? Is there a chance of the healthcare system getting overwhelmed?

Severe disease seems 60-80 per cent less likely for Omicron. Many people are previously infected, vaccinated, or both which additionally reduces risk of severe disease. However, infections are rising very fast and that can cause stress to healthcare systems. Another potential problem is that healthcare workers may get infected and available manpower may reduce at critical periods. So, yes healthcare systems can get overwhelmed in Omicron waves, and we should take measures to reduce transmission and severe disease.

Can the existing vaccines offer protection against Omicron?

Yes, they do. Two doses give adequate protection against severe disease by Omicron. It seems that a third dose raises it further, based on UK data, but as of now, such precautionary use is being restricted to elderly and high-exposure professions such as healthcare. Once local data is available, the best strategy will become clearer.

What type of vaccine has a better chance to succeed as a booster dose?

The best vaccine to use as a booster is not fully known for India, but based on the available evidence, protein subunit vaccines such as Novovax/Covovax or Corbevax seem like excellent choices, once they are ready. Given that nearly 90 per cent of eligible people have been vaccinated with Covishield, one must have the availability and supply of any other possibility before a decision is taken. In my mind, the protein subunit vaccine, Covovax, is the best third dose, as per available data.

Is there a possibility of the Omicron variant evolving further, picking up some of the attributes of Delta to emerge as a more dangerous variant?

It can certainly evolve further. Other variants may also come. Recombination is unusual for this virus, but not impossible of course.

Do you foresee a lockdown once again?

No one wants a lockdown. Everyone must do what they can to avert a lockdown – proper use of the N95/FFP masks should be the top priority.

Check out latest DH videos here