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India's COVID-19 variant worsens country's critical health situation

India's variant is now present in ten countries and has the potential to become more virulent, worrying health experts
Los nuevos contagios se han disparado en el último mes e India ha registrado ya más de 13,6 millones de casos, superando a Brasil y situándose en segundo lugar después de Estados Unidos

AP/CHANNI ANAND  -   New infections have soared in the last month and India has now registered more than 13.6 million cases, surpassing Brazil and ranking second only to the United States

First identified in India in March, the new COVID-19 variant is believed to be "double mutant". Experts are concerned about the strain, as these two mutations in the herringbone protein may make it more capable of evading the body's immune response, which includes those produced by some COVID-19 vaccines.

The spike protein is the part of the virus that it uses to invade human cells. The variant, like those first detected in the UK, South Africa and Brazil, also has differences in the genetic code of the virus, which is thought to make it more infectious. Last month, virologist Shahid Jameel said a double mutation in key areas of the virus's spike protein may increase the risks of it becoming more infectious, potentially more deadly and evading the body's immune response. More research is still needed to examine the role of the mutations and the impact they might have.

El cuerpo de una víctima del COVID 19 a la espera a ser incinerado en Nueva Delhi, India, el lunes 19 de abril de 2021
AP/MNISH SWARUP - The body of a COVID-19 victim awaits cremation in New Delhi, India, on Monday 19 April 2021

The new variant, called B.1.617, was initially detected in India with two mutations -- the E484Q and L452R. Viruses mutate all the time, as part of evolutionary biology. Some mutations weaken the virus while others may make it stronger, enabling it to proliferate faster or cause more infections. But if the virus can use reinfection to spread, then it would be "penetrating" herd immunity, says Dr Jeremy Kamil, a virologist at Louisiana State University Health Sciences Center Shreveport. Herd immunity occurs when a large part of a community becomes immune to a disease through vaccination or mass spread of the disease, he adds.

The degree of lethality of the strain is one of the unknowns that researchers are still trying to figure out. The characteristics of the double mutant variant are under investigation, but the L452R mutation is well characterised in US studies. It increases viral transmission by about 20 percent and reduces antibody efficacy by more than 50 percent according to these reports.

En esta imagen aérea tomada el 16 de abril de 2021, familiares y amigos se reúnen para enterrar los cadáveres de las víctimas del coronavirus COVID-19 en un cementerio de Nueva Delhi
AFP/ARCHANA THIYAGARAJAN - In this aerial image taken on 16 April 2021, family and friends gather to bury the bodies of COVID-19 coronavirus victims at a cemetery in New Delhi

This variant has been detected in at least 10 other countries, including the US, the UK, Australia and New Zealand, according to the situation report on outbreak.info. As of April 16, 408 sequences in the B.1.617 lineage have been detected of which 265 were found in India, the report shows. A surveillance report by the U.K. government said it has found 77 cases in England and Scotland so far, designating it as a “Variant Under Investigation."

This double mutant strain, first found in India, is believed to be fuelling India's deadliest new wave of cases that has made it the second most affected country in the world, again overtaking Brazil, and has already begun to overwhelm its hospitals and crematoria.

Mapa que muestra el número de casos activos de COVID-19 por cada 100.000 habitantes por estado en India, según datos de las autoridades sanitarias del 19 de abril
AFP/AFP - Map showing the number of active COVID-19 cases per 100,000 population by state in India, based on 19 April data from health authorities

The Indian government denies that the increase in cases is linked to the mutations. "Though VOCs and a new double mutant variant have been found in India, these have not been detected in numbers sufficient to either establish or direct relationship or explain the rapid increase in cases in some States," the health ministry said in a statement.

The report comes after several experts called on the government to step up genome sequencing efforts. "We need to constantly monitor and make sure none of the variants of concern are spreading in the population. The fact that it is not happening now doesn't mean it will not happen in the future. And we have to make sure that we get the evidence early enough," Dr Jameel told the BBC's Soutik Biswas earlier this month.

La gente espera en la cola para recibir la dosis de la vacuna contra el coronavirus COVID-19 en un centro de salud en Nueva Delhi el 10 de abril de 2021
AFP/PRAKASH SINGH - People wait in line to receive a dose of COVID-19 coronavirus vaccine at a health centre in New Delhi on April 10, 2021

India has currently licensed three vaccines. Two of them are already in use, while the third, Russia's Sputnik V, was approved this week. India also fast-tracked the approval of other foreign vaccines this week. All these efforts risk being compromised if the injections prove less effective against this double-mutant variant.

La gente se agolpa en una estación de autobuses para llegar a sus lugares de origen horas antes de que entre en vigor el bloqueo de una semana ordenado por el Gobierno de Delhi en Nueva Delhi el 19 de abril de 2021
AFP/JALEES ANDRABI - People crowd at a bus station to reach their places of origin hours before the week-long blockade ordered by the Delhi government comes into effect in New Delhi on April 19, 2021

More than 11.7 million cases and 160,000 deaths later, efforts are continuing to identify mutations. The latest surge - which began this month - comes during what some experts have called a "delicate phase" for India - the healthcare system is already exhausted from a year-long battle against the coronavirus. Indian States have already begun re-introducing restrictions, including curfews and intermittent lockdowns. Two major cities, Delhi and Mumbai, have also ordered randomised rapid tests at airports, railway stations and crowded areas such as shopping malls.