No point focusing on airports, keep close watch on clinical samples from ICU: Experts

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With INSACOG stating that Omicron is in community transmission and has become dominant in multiple metros, experts have said that focus should be on sequencing clinical samples of those who are severely ill and keep a close watch on clusters.

“We should change the strategy of sample collection for genome sequencing. There is no point in focusing on airports. A close watch should be kept on clinical samples from the ICU or those with serious symptoms to check if there is further mutation of the SARS-CoV2 virus and whether it is changing a bit. There is a need to keep an eye on clusters at localities or parties or any gathering in case there is a sudden eruption of cases and also ensure a randomised sampling in large areas,” Dr Rakesh Mishra, former director of Centre for Cellular and Molecular Biology, said.

Only testing and tracking cannot prevent spread of the Omicron variant which is a fast spreading one, experts said. “While testing, of course, is of priority, every primary contact need not be tested. The focus should also be on hospitalised cases,” Dr Mishra, who is Director of Tata Institute for Genetics and Society, said. “Masking slows down the rate of infection and appropriate social behaviour remains crucial to tame this virus,” he added.

Maharashtra has reported close to 3,000 patients with Omicron variant in the past few weeks. Of these, more than 1,000 each have been reported in Mumbai and Pune cities itself.

According to Dr Shashank Joshi, member of state Covid-19 task force, with community transmission of Omicron variant, the focus is on saving lives. “What is known from the current wave is that it has come in a very explosive and tsunami-like proportion. Some geographies like Mumbai and Delhi are showing a decline while Pune and Bengaluru are in the peaking stage. We have shifted our strategy (as 80 to 90 per cent people are asymptomatic) to symptomatic patients, People who are totally or partially unvaccinated, are in high-risk category with diseases due to which their immunity does not work… the focus is to save lives and ensure health systems are prepared,” Dr Joshi told The Indian Express.

“Compared to the second Delta wave, the current one is clearly showing less severity of disease with less proportion of hospitalisation, oxygen need and ventilator care. There is also that occasional 5 to 10 per cent Delta, which is in geographies like Maharashtra, South India and the North East. Here, a clinical decision is to be taken in order to save lives. There will be a need to distinguish Delta (from Omicron), which may deteriorate,” Dr Joshi said.

“Those with the Omicron variant, especially the vulnerable group, will be needed to be taken care of. Today, a large proportion of hospitalisation is of people with Covid and not patients of other illnesses who have incidentally tested positive. Hence, the numbers are not representative of the true burden of the disease. However, the strain on health care infrastructure is much less than anticipated,” Dr Joshi added.

State surveillance officer Dr Pradeep Awate said that as per the ICMR, there has been a shift in strategy as part of which tracking each patient is not required if the index case is Covid positive. “We are already moving on to the endemic stage. Genomic sequencing, however, will be necessary as Omicron may not be the last variant,” Dr Awate said. “Already in Mumbai, cases are on the decline. Pune, Nashik and Nagpur were late in the surge but, like Mumbai, will stabilise and cases are bound to decline soon,” Dr Awate added.

While BA.2, a sub lineage of Omicron, is the variant under investigation, Dr Pradeep Vyas, state’s additional chief secretary for health, said the authorities were tracking it. “It is showing up in samples sent for genome sequencing but, as of now, it is a variant of interest and not of concern. Managing cases is just the same,” Dr Vyas said.

Until now, 6,328 samples have been sent for genome sequencing, out of which results of 6,223 patients have been received. Results of 105 samples are awaited. In all, 2,845 persons have been detected with Omicron variant in Maharashtra.

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