We've no precedence for the BF.7 variant but it won’t be a flash flood: Karnataka TAC Chairman M K Sudarshan

As Covid-19 cases surge in China and elsewhere, India is on alert and has issued guidelines. Karnataka’s Covid Technical Advisory Committee (TAC) held its 189th meeting on December 25 to discuss and formulate recommendations to handle the current Covid scenario. In an interview with DH’s Navya P K, TAC chairman Dr M K Sudarshan discusses why the current measures are important and when there may be cause for greater concern.

Should there be cause for concern in Karnataka when there are no Covid clusters or a large number of cases? While the government is scaling up measures, experts say there’s no cause for concern as BF.7 is an Omicron sub-variant.

The Government of India has issued guidelines in the context of the surge in five to six countries, and there are no restrictions locally or on international arrivals. Under these circumstances, we need to consider that there may be a chance of cases coming in. So in that context, we need to gear up. People’s health, lives, and livelihoods should all be assessed in the context of the local situation and the perceived risk of infection. Then a commensurate decision should be taken, and continuous monitoring should be done. If required, there should be an in-built mechanism to scale up facilities. We are planning for all of these.

Theoretically, BF.7 is an Omicron sub-variant. It has been detected in routine genomic sequencing in at least three cases in India, but this has not resulted in any clusters or outbreaks.

Nevertheless, China has now officially declared that they will not publish or share data, and the US is seeing increased hospitalisations during a severe winter. So we need to be cautious and responsible. We can’t say that it will not happen here and continue as usual. Prime Minister Modi presided over a meeting, indicating that the threat perception is at the highest level. Our actions should be commensurate with the perceived risk.

BF.7 has been present in India and other countries for months but has not shown any specific trend.

A variant circulating in one country may not behave in the same way in another country for various reasons, such as human factors, services like clinical facilities and vaccination, and social and political structures. We have detected BF.7 in the regular INSACOG testing, but now we will look for it very specifically since it’s the dominant variant in China as far as we know. We will also look for any new variants of concern.

We are only doing some finetuning to see that there is no spread of infection. We are not closing down or restricting anything.

Other countries have not ramped up Covid precautions as much, and there has been no specific alert from the WHO. So is the response from India proportionate to the situation?

Why can’t a country be proactive and take measures before an advisory comes from WHO? Our recommendations are very preliminary. It will not have an impact on people’s livelihoods. Masking and vaccinations will only protect the health and lives of individuals. The public is welcoming our decisions.

When are more restrictions likely?

The state government has asked us to give projections of case numbers in the next few months. Mathematicians and statisticians from the IISc and Indian Statistical Institute, who have been working with us since 2020, said that when there is no clear scientific data and numbers available from China, it is difficult to predict or project. So we have requested that they give us at least some estimates so that we can plan for drugs, beds, etc. I think they will get back to us within a week.

Is there a certain benchmark after which there will be a need for greater concern?

In the last five days, there have been no Covid patients in Bengaluru city hospitals. If the number of daily cases increases and then any cluster forms or any outbreak (more than 15 cases) happens, those will be early warning signs. We will also look at the test positivity rate, home isolations, and hospitalisations. This is an emerging situation, and we have no precedence for the BF.7 variant. But it won’t be a flash flood; cases will start trickling in, so accordingly, facilities can be ramped up.

Is there a specific testing target now?

We revised the testing guidelines yesterday to 5,000 per day for Bengaluru, of which 30% can be Rapid Antigen Tests. This will take at least a week, as currently there are only around 1,500 samples per day. As of now, testing for the entire state is around 3,500 per day, and our recommendation is 10,000. We will review these guidelines next week.

The previous target for the state was 20,000, but this was not achieved. We also hadn’t insisted on it because even when people removed masks and the situation returned to pre-Covid levels, there was a downward trend in cases.