COVID-19 deaths cannot directly be attributed to the new variant, say experts
Illustration: iStock Another surge of COVID-19, attributed to the sub-variant JN.1, appears to have hit India. JN.1 appears to be more contagious than other circulating variants.
India reported 594 fresh COVID-19 cases and six deaths on December 20. Kerala recorded 514 of these cases and three deaths. Two deaths were reported in Karnataka. One was reported in Punjab.
Some 2,341 of the 2,669 active cases on December 20 were in Kerala, up by 300 cases from the previous day. This is the highest number of active cases since June 7 in India and since May 23 in Kerala.
A film festival in Goa turned out to be a spreader, with 20 cases of JN.1 in the state being traced back to it. Maharashtra reported one case and Kerala reported another. Two other JN.1 cases have been reported in Ghaziabad near the national capital.
The Karnataka health ministry reported two COVID-19-related deaths — of men aged 44 and 76 who died on December 16 and 17 respectively. While one was asymptomatic, the other had breathlessness.
Rajeev Jayadevan, co-chairman of the National Indian Medical Association COVID Task Force, told Down to Earth (DTE): “We can say with reasonable certainty that the new wave is being fuelled by the new COVID-19 sub-variant JN.1.”
However, despite a few people dying, he said the deaths cannot directly be attributed to the new variant.
“As testing is minimal, we cannot comment on the death rate in a situation where all patients have not been tested, cases are not classified and the causes of death are systematically sorted out. Based on reports that a few people who died were COVID-positive, we can however reasonably infer it was from worsening of their existing medical conditions,” Jayadevan said.
“We do not know the true number of people who have COVID-19, and we do not know the true number of people who have died following COVID. If the numerator and denominator are inaccurate, these numbers cannot paint the correct death rate,” he added.
JN.1 is rising simultaneously around the world, according to the World Health Organization (WHO). It is rapidly spreading across three WHO regions — the Americas (AMR), the Western Pacific (WPR), and the European regions (EUR) — where testing has been high.
The largest increase was seen in the Western Pacific Region — from 1.1 per cent to 65.6 per cent in four weeks.
Healthcare systems worldwide are not yet feeling the pressure despite wastewater data from multiple countries approaching the winter season revealing a significant rise in COVID-19 infections.
There has been a rapid increase in the global proportion of JN.1 from epidemiological week 44 (October 30 to November 5, 2023) to 48 (November 27 to December 3, 2023) — from 3.3 per cent to 27.1 per cent.
During the same period and for countries with the highest proportion of JN.1 sequences, the WHO found that the prevalence of JN.1 in these countries rose:
The JN.1 variant can evade the immune system more easily compared to other circulating variants, certain studies suggest.
According to a study, individuals who experienced breakthrough infections with an XBB variant were able to neutralise XBB.1, EG.5.1, and BA.2.86.1. However, JN.1 displayed higher immune evasion properties compared to BA.2.86.1, its parent lineage.
JN.1 carries the additional spike mutation L455S in comparison with the parent BA.2.86 lineage. This increases its immune evasion capacity. Besides this difference, the variants are almost identical.
Similar variants such as HK.3 carry the L455F mutation, are more transmissible, and escape immunity as compared to the parental EG.5.1 variant.
While the WHO said current vaccines will protect against severe disease from JN.1, it also appears that JN.1 was 2.9-to-4.3-fold resistant to antibodies from individuals vaccinated with an XBB.1.5 mRNA vaccine booster according to one pre-print study, paediatrician Vipin M Vashishtha wrote on X (formerly Twitter).
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