Even at the peak of the second wave in India last year, when no contact tracing was done or was possible, not a word was said about the Delta variant being in community transmission — where the source of infection cannot be traced. But with extremely transmissible Omicron becoming the dominant variant across major cities, INSACOG, the consortium meant to monitor the genomic variations in the SARS-CoV-2 virus, has for the first time officially mentioned that India has entered community transmission; daily fresh cases have been over 0.3 million since January 19. Even as on June 15 last year, when the second wave had peaked here, India claimed to have only a ‘cluster of cases’ as reflected in WHO’s last epidemiological report (weekly) mentioning the stage of transmission in member-States. In contrast, the U.S. declared community transmission in February 2020 when the source of infection was untraceable in one instance; only 15 cases were detected then. The closest India came to admitting community transmission was in October 2020, when then Health Minister Dr. Harsh Vardhan said it was restricted to “certain districts in limited States”. The deep reluctance to acknowledge community transmission was based on the premise that it marked the Government’s inability to control the virus spread and the failure of the harsh national lockdown. As the Government tried in vain to obfuscate the stage of transmission, it only reflected its resistance to acknowledge reality and an unwillingness to be transparent.
INSACOG’s weekly bulletin also mentions that the BA.2 sub-lineage of Omicron forms a substantial fraction of cases detected in India. This sub-lineage was detected a month after WHO had designated Omicron to be a variant of concern on November 26, 2021. Though the Omicron variant causes less disease severity intrinsically and most of those who are fully vaccinated have only mild disease, the number of people hospitalised and requiring intensive care has been increasing in the third wave in India. As WHO recently warned, people infected with Omicron can display the “full spectrum of disease” — from asymptomatic infection to severe disease and death. This is especially true in older people, those with comorbidities, and people not fully vaccinated. Though over 67% of adults have been fully vaccinated, and nearly 8.2 million booster doses administered as on January 23, nearly 5.5% of health-care workers, 6.8% of frontline workers, and 16.2% of those older than 60 years have not received their second dose. Fully vaccinating these vulnerable groups should be a high priority. Meanwhile, the need for strict adherence to COVID-appropriate behaviour cannot be overemphasised.
