Variant B.1.617.2 dominant in Gujarat during the second Covid wave
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B.1.617 Covid-19 variant, of which B.1.617.2 is a subline, has now been found in 53 countries around the world, according to WHO
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The second wave of Covid saw a continuous flow of ambulances transporting critical patients to the civil hospital in Ahmedabad every day
Preliminary results of SARS-CoV-2 genome sequencing in Gujarat revealed that B.1.617.2 – the variant of concern – had proliferated in the state at least since March of this year, when the second wave of Covid hit state and country. The deadliest second wave to sweep through Gujarat saw queues of patients outside hospitals, people dying at home, critical patients not receiving ambulances, a shortage of oxygen and people who have struggling to buy steroids for those battling the pandemic.
B.1.617.2 found in 35% of samples from March to April
Mirror discovered, after going through reams of genome sequencing data on the government website, that of the 200 Covid samples recently sequenced by the GBRC through May 10, 2021, 70 patients were infected with the B.1.617 variant. .2 of
SARS-CoV-2, which represents 35% of the samples.
Then come 30 cases of B.1.1.7 (15%), exactly 25 cases of variant B.1.153 (12.5%), 20 cases of variant B.1.36 (10%) and 15 cases of B.1.617.1 variant which represented 7.5%.
It was not until May 24 that Union Health Minister Dr Harsh Vardhan, speaking at the Group of Ministers meeting, said INSACOG found that the Covid B variant. 1.617 was predominant in India which included three sublines: B.1.617.1, B.1.617.2 and B.1.617.3.
Earlier, a MoHFW press release dated May 5 said 102 samples from Gujarat were found to be variant B.1.617. There were 60 of the B.1.1.7 variant and two of the B.1.351 variant. However, there was no mention of the B.1.617.2 subline in this Center document.
It is the genome sequencing of Covid samples that can help experts determine whether new variants are associated with particular symptom patterns or the severity of the disease. This can make it easier to design therapies and vaccines for the same.
“Sample size too small”
Dr Atul Patel, leading infectious disease expert from Gujarat, a member of the ICMR Covid-19 Research Committee as well as the Gujarat Covid-19 task force, told Mirror: ‘Although this information shows that B .1.617.2 could be the dominant Covid. Variant in Gujarat, as is the case across the country, the sample size of 200 is too small to be representative of the whole. We need at least 10,000 to 20,000 samples, if not 5%, to get correct results and we are sorely lacking in this regard. Besides a larger sample size, we need a more diverse sample from all parts of the state to make this assessment conclusively. “
Timeline: genome sequencing
Gujarat already had results that it was mostly the B.1.1.7 (Kent / UK) variant which was seen in the state in December 2020 and January 2021 from the results sent by NIV. Mirror had reported the same on April 2, 2021.
On April 2, Mirror also reported that the state government commissioned the Gujarat Biotechnology Research Center (GBRC) in Gandhinagar in mid-March to carry out unofficial genome sequencing of Covid samples. This was done because the state was in the dark about the proliferation of various variants of the coronavirus, as it took a long time for the designated INSACOG laboratory of the National Institute of Virology (NIV) in Pune to give results.
By the end of April 2021, scientists at the GBRC had an idea of what they had found in the samples from March and April. Sources then told Mirror they had seen an unreported variant in Gujarat earlier. We now know that this variant was B.1.617.2.
However, the picture became clearer when it was confirmed in early May that many of the March samples sequenced also had the B.1.617.2 variant. However, there is still no confirmed whole genome sequencing (WGS) data for January 2021.
Where is the data to analyze?
The next step after identifying a variant of Covid is to examine its characteristics and clinical outcomes in patients to analyze its behavior. Reliable sources familiar with the developments have said that samples sent for whole genome sequencing to the GBRC often do not contain complete information to fully analyze the patterns and reach reasonable conclusions.
Speaking about the need to analyze clinical data to discover the implications of a dominant variant on the population, Dr Patel said: “Evaluations in the UK indicate that the B.1.617.2 variant could be up to ‘66% more infectious than variant B.1.617.2. Variant B.1.1.7 which prevailed there previously. We need a similar study scale conducted in India with clinical presentations, medical history, vaccination history and patient outcome to analyze the characteristics as well as the implications of this variant on our population. It is then that we can formulate a strategy for early detection, treatment protocols and vaccine efficacy and, most importantly, the chances of re-infection.
Why was this data not shared on May 10?
While Gujarat is one of the few states to have launched its own genome sequencing program, albeit unofficially and without waiting for the results of INSACOG, the question arises as to why the results of this work have not were made public at that time.
On May 10, a high-profile central committee meeting chaired by CM Vijay Rupani brought together senior officials from the health department, members of the Covid-19 state task force, and scientists from the GBRC. Sources confirmed that a presentation on the Covid variants prevalent in Gujarat was then discussed in detail. However, the same was not discussed in the press conference immediately following this meeting.
A senior health department official said: “We are trying to verify the information available and will let the public know when we are sure.” But even now, over a fortnight later, there has been no announcement from the state government.
GBRC director Dr Chaitanya Joshi was not available for comment.