Experts advise to redirect focus from airports to ICU’s clinical samples

India’s Covid-19 consortium, INSACOG (Indian SARS-CoV-2 Consortium on Genomics or Indian SARS-CoV-2 Genetics Consortium) has recently said that highly transmissible variant of coronavirus Omicron is now in community transmission. Citing the current stage, experts have stressed that the focus should now be directed on genomic sequencing of clinical samples of severely ill people and authorities must keep a close watch on case clusters in communities.

“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 a 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 randomized sampling in large areas,” said Dr. Rakesh Mishra, former director of Centre for Cellular and Molecular Biology.

Experts have added that just testing and tracking will not alone be able to curb and prevent the spread of rapidly transmitting Omicron variants.

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“While testing, of course, is of priority, every primary contact need not be tested. The focus should also be on hospitalized cases,” Dr. Mishra, who is Director of Tata Institute for Genetics and Society, said. “Masking slows down the rate of infection and appropriate social behavior remains crucial to tame this virus,” he added.

Dr. Shashank Joshi, a member of the Maharashtra state Covid-19 task force, has said that as the Omicron variant is now in community transmission, the focus should be on ensuring lives are saved. “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 percent of people are asymptomatic) to symptomatic patients, People who are totally or partially unvaccinated, are in a 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 said.

“Those with the Omicron variant, especially the vulnerable group, will be needed to be taken care of. Today, a large proportion of hospitalization 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.

“We are already moving on to the endemic stage. Genomic sequencing, however, will be necessary as Omicron may not be the last variant,” state surveillance officer Dr. Awate said. “Already in Mumbai, cases are on the decline. Pune, Nashik, and Nagpur were late in the surge but, like Mumbai, will stabilize and cases are bound to decline soon,” Dr Awate added.