The new Covid-19 XBB sub-variant has arrived in India. How worried should you be?

Emerging Covid sub-variants have been predicted for some time and have been reported in various pockets across the country, primarily in Maharashtra. With winter approaching, it will be interesting to see if there is a new wave of Covid-19 infections. Based on the Singapore experience, Dr. Sanjay Pujari, an infectious diseases expert and member of the Indian Council of Medical Research (ICMR), believes vaccines may be effective in preventing severe illness associated with the new XBB sub-variant.

About Omicron sub-variants XBB

Omicron subvariants XBB and BQ.1 have been identified. XBB is the result of the recombination of two Omicron BA.2 sub-variants (BA.2.10.1 and BA.2.75). A large number of mutations on the virus’s surface are responsible for immune escape from neutralizing antibodies targeting the spike protein. According to WHO (as of October 12, 2022), Omicron is the dominant variant currently circulating globally, accounting for more than 98 percent of sequences shared on GISAID since February.

Omicron sub-variants XBB- Spread In India and Worldwide

The WHO weekly epidemiology update on COVID-19 identified 390 Omicron-descendent lineages and 48 recombinants. 35 countries have reported XBB and XBB.1 with 1,453 genomic sequences, including Singapore, India, Bangladesh, Australia, and the United States. It has been linked to an increase in COVID-19 cases in Singapore, though cases have begun to decline since last week.

The SARS-CoV2 virus, like other viruses, is expected to mutate and change over time. The XBB sub-variant is possibly the most immune-evasive variant known to date, particularly for evading neutralizing antibody responses induced by vaccinations or previous infections. This could result in an increase in infections. However, there is no evidence that it is linked to more severe illnesses. Based on the Singapore experience, vaccines appear to be effective in preventing severe illness caused by this sub-variant. This sub-variant has also shown resistance to monoclonal antibodies that prevent the progression of severe illness in high-risk individuals.

Omicron sub-variants XBB-Cases, Symptoms and Vaccine

35 countries have reported XBB and XBB.1 with 1,453 genomic sequences. Re-infections and breakthrough infections can occur due to immune evasion properties, but they are usually mild, causing upper respiratory symptoms. Preliminary evidence suggests that vaccines may be effective in preventing severe illness.

People should get a booster shot because it may still be useful in preventing serious illness and hospitalization. Vaccines (including precautionary doses) may aid in the prevention of serious illness. As a result, taking boosters is critical, especially for people who are at high risk of severe illness. mRNA vaccines are currently unavailable in India.

Omicron sub-variants XBB- Precautions

• Catch-up precaution doses are critical for the elderly, especially those with chronic co-morbidities and immune suppression.
• Masking must continue, especially in enclosed, congregated areas with insufficient ventilation.
• It is also important to stay at home when suffering from acute respiratory illness.
• Surveillance must be increased, including genomic sequencing.

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