Take precautions, stay safe as respiratory illnesses including COVID-19 doing the rounds

This is the season for all viral diseases but do not panic. Take precautions to stay safe and if ill seek medical advice, says an expert, while a senior Virologist allays fears about the coronavirus’s latest ‘variant of interest’ JN.1.

“Many respiratory illnesses such as Influenza A and B as well as parainfluenza are doing the rounds along with COVID-19,” says the President of the Sri Lanka College of Pulmonologists, Dr. Bodhika Samarasekera, reiterating that basic precautions taken by the vulnerable and those in high-risk groups would help keep viral diseases at bay.

The vulnerable groups who should be extra careful are the elderly (over 60s); those with Chronic Obstructive Pulmonary Disease (COPD); those with asthma; and those who are immuno-compromised such as cancer or kidney patients.

While the symptoms include fever, cough, a runny nose and body aches and pains, Dr. Samarasekera strongly advises anyone who experiences shortness of breath to seek immediate medical attention.

Prof. Neelika Malavige, Professor, Department of Immunology and Molecular Medicine of the University of Sri Jayewardenepura, told the Sunday Times that they had been conducting research at the National Institute of Infectious Diseases (NIID or IDH) for the last 15 years or so, in collaboration with Dr. Ananda Wijewickrama and other physicians.

“As a part of this ongoing research, we have sequenced not only SARSCoV-2 but also the influenza virus and the dengue virus, in patients presenting with respiratory symptoms and fever to the hospital. In December, we did a limited number of sequencing of SARS-CoV-2 viruses from patient samples obtained from this hospital. We are unable to comment on the SARS-CoV-2 variants currently circulating in Colombo or Sri Lanka, as we are no longer sent samples for sequencing,” Prof. Malavige said, confirming that they had all the resources to do sequencing for SARSCoV-2, if samples were received.

Focusing on JN.1, Prof. Malik Peiris, Chair of Virology at the School of Public Health, University of Hong Kong, Hong Kong, meanwhile said that it is a derivate of the BA.2.86 variant with an additional amino acid change. This appears to give it even “greater” capacity for immune evasion compared to its parent BA.2.86 or other recent variants such as EG.5.

JN.1 is one of the Omicron family of variants and a descendant of BA.2.86 (with one amino acid change in the spike protein). As the name indicates, BA.2.86 is itself a descendent from Omicron BA.2, it is learnt.

Prof. Peiris explains that JN.1 appears to be rapidly increasing in many parts of the world (including India, China, the United Kingdom and the United States of America), an indication that its immune evasion is giving it some advantage in transmission.

“However, there is no indication that it is having a major impact of severity or increase in admissions to Intensive Care Units (ICUs). But admissions in some countries (eg. Singapore) are filling up hospitals,” he said, pointing out that the bottom line is that JN.1 may not have a major impact on well-vaccinated populations who also have “hybrid immunity” as a result of a combination of vaccination and infection.

But it would contribute to a lot of “flu like illness” in the community, Prof. Peiris says, adding that people do not seem to be testing for COVID-19 anymore, but they report “nasty” respiratory illnesses. Some of this is likely to be influenza but a lot of this is likely to be COVID-19, the newer variants including JN.1. “The emergence of new variants of SARS-CoV-2 is something that will be with us in the foreseeable future.”

Elaborating on why those who experience shortness of breath during the course of a viral disease should seek immediate medical attention, Dr. Samarasekera says it could be an indication of pneumonia or worsening of pneumonia and even exacerbation of asthma or COPD, leading to a dangerous situation. Then oxygen saturation (levels of oxygen in the blood) in such patients need to be monitored and X-rays taken to check out their lung health. Usually, viral diseases have to take their course but there is the antiviral medication, oseltamivir (given on prescription), to treat Influenza A and B.

The preventive measures for any respiratory viral illness, according to this Respiratory Physician, include good hand hygiene (washing of hands thoroughly or using sanitizer after venturing out of the home); not touching one’s face as viruses usually enter the body when fingers transmit them through the nose, mouth and eyes; and wearing face masks if in a congested, crowded space.

Dr. Samarasekera advises all those in high-risk categories, if possible, to take the influenza vaccine which is available in the country.