What to know about COVID variant JN.1 that triggered nationwide alert in India. Should you be worried?

According to the Indian government data, of the 142 fresh COVID cases reported on Monday, 115 were from Kerala.

State Health Minister Veena George, however, said there is no reason to panic as the “situation is under control”.

Masks have been recommended for all those visiting the hospitals and with Thiruvananthapuram and Kochi recording higher number of cases, extra caution has been advised at these two places.

The Indian government advisory said: “Considering the upcoming festive season, there is a need to put in place requisite public health measures and other arrangements to minimise the risk of increase in transmission of the disease by adherence to the maintenance of respiratory hygiene.”

The government also directed the states to monitor the occurrence of respiratory diseases district-wise.

The state administrations are further told to ensure COVID testing according to the set guidelines. “Ensure a higher number of RT-PCR tests and send the positive samples for genome sequencing to the Indian SARS COV-2 Genomics Consortium (INSACOG) laboratories so as to enable timely detection of new variants, if any,” the advisory said.

“Promote community awareness to seek their continued support in managing COVID-19, including adherence to respiratory hygiene,” it added.

With 142 new COVID infections on Monday, the number of cases reached 1,970. Saturday and Sunday recorded 260 and 335 cases respectively, while a death was reported in Kerala and another in the neighbouring state of Karnataka, India’s health ministry said.

The ministry is in regular touch with Kerala Health department which is monitoring various points of entry.

So what’s JN.1 subvariant?

JN.1 is closely related to BA.2.86, a fellow Omicron descendent that first surfaced up in the US in September. The two variants are nearly identical, according to the Centers for Disease Control and Prevention (CDC), except for a single difference in their spike proteins, the part of the virus that allows it to invade human cells.

The fact that JN.1 is responsible for a growing portion of infections in the US suggests it is either more contagious or better at getting past our bodies’ immune defences than previous iterations of the virus, the CDC says.

But there is no evidence that it causes more severe disease.

Right now, there’s nothing that suggests JN.1 is any more dangerous than other viral strains, even though it may cause a bump in transmission, the CDC says.

What are the symptoms of new variant?

Primary symptoms are likely to be the same as those from previous variants: a sore or scratchy throat, fatigue, headache, congestion, coughing, and fever.

Do vaccines, tests, and treatments work against JN.1?

So far, the signs are positive, the CDC says. COVID-19 tests and treatments are expected to be effective against JN.1. And even though the latest COVID-19 booster shot was designed to target the XBB.1.5 variant, preliminary research suggests it also generates antibodies that work against JN.1, albeit fewer of them. (As ever, vaccines will not totally block JN.1 infections, but should reduce the likelihood of death and severe disease.)

In a December 13 statement, WHO’s expert COVID-19 vaccine advisory group recommended sticking with the current XBB.1.5 vaccines, since they seem to provide at least some cross protection.

What does WHO say?

The World Health Organisation (WHO) has not labelled JN.1 a variant of concern — that is, a new strain of the SARS-CoV-2 virus with potential for increased severity; decreased vaccine effectiveness; or substantial impacts on health care delivery.

In the wake of the surge in respiratory diseases and the new JN.1 COVID sub-variant, WHO said that the virus is evolving and changing and urged the member states to continue with strong surveillance and sequence sharing.

Is there a cause for concern?

Kerala Health Minister Veena George has assured the people that there is no need to worry. Veena however appealed to the people to stay vigilant.

“No need for any worry. That is a sub-variant (COVID-19 sub-strain JN.1). Two or three months ago it was detected in Indians when they were tested at Singapore airport,” George said.

“As Kerala’s health system is so good, we could detect it through genomic sequencing. No need to worry. We are keenly monitoring the situation. But we should be alert. People with comorbidities should be taken care of,” she added.

While the majority of cases in Kerala are reported to be clinically mild, the health authorities emphasise the importance of ongoing vigilance and preparedness to effectively manage the evolving situation related to COVID-19 variants.

What are the neighbouring states doing?

As a result of the increase in the number of COVID cases in Kerala and Tamil Nadu, the Commissionerate of Health and Family Welfare Services on Tuesday issued an advisory with multiple guidelines amid fears of a fresh surge during Christmas and New Year celebrations.

All elderly persons aged 60 years and above, those with comorbiditied (kidney, heart, liver ailments), pregnant woman, lactating mothers, have been advised to wear face masks compulsorily when outdoors and to also strictly avoid visiting closed, poorly ventilated spaces and crowded areas, according to the guidelines.

Telangana reported four COVID-19 cases on Tuesday and the people are urged to remain cautious and avoid travel.

Children below 10 years, pregnant mothers and elders above 60 years are advised to avoid going outdoors unless necessary.

Why are Uttarakhand hospitals on high alert?

The Uttarakhand government is on high alert and the health secretary has instructed all district magistrates and chief medical officers (CMOs) to adhere to the guidelines for COVID prevention in hospitals. Additionally, respiratory, lung, and heart patients should be closely monitored, and individuals with influeza cases should be tested, the advisory said.

How about India’s readiness?

A mock drill has just been concluded in all health facilities across states that evaluated public health and hospital readiness. This exercise was overseen by district collectors.

The India SARS-CoV-2 Genomics Consortium (INSACOG), a network of Genomic Laboratories, has been actively monitoring the genomic aspects of COVID-19 in India.

The detection of the JN.1 subvariant is in line with revised surveillance guidelines that involve testing patients with Influenza-Like Illness (ILI) and Severe Acute Respiratory Infection (SARI) for COVID-19. Positive cases are then referred for Whole Genome Sequencing (WGS).

The specific case of JN.1 was identified in an RT-PCR positive sample from Karakulam, Thiruvananthapuram, Kerala, on December 8.

Why did Singapore issue travel advisory?

After a sharp rise in COVID cases to 56,043 in the first week of December, Singapore issued a travel advisory. The island country saw a jump of about 24,000 cases from December 3 and 9 compared to 32,035 reported in the previous week.

The average daily COVID hospitalisations also rose to 350 from 225 the week before, and the average daily Intensive Care Unit (ICU) cases increased to nine cases compared to four cases in the previous week, Singapore’s Ministry of Health in an update.

According to the ministry, the vast majority of new cases are due to JN.1 variant.

Singapore has urged the public to “exercise personal and social responsibility”. They have asked individuals who are unwell with acute respiratory infection symptoms to stay at home until symptoms resolve and avoid contact with others. “If they have to come into contact while unwell, they need to exercise social responsibility by wearing a mask, minimising their social interactions, and avoiding crowded places.”