India points to a variant as outbreak keeps raging
2nd wave gets worse as deaths, infections soar, authorities say
NEW DELHI — At Sir Ganga Ram Hospital, a huge facility in the middle of India’s capital, 37 fully vaccinated doctors came down with COVID-19 this month.
The infections left most with mild symptoms, but it added to their growing fears that the virus behind India’s catastrophic second wave is different. They wonder if a more contagious variant that dodges the immune system could be fueling the epidemic inside the world’s hardest-hit nation.
So far the evidence is inconclusive, and researchers caution that other factors could explain the viciousness of the outbreak, which has overwhelmed India’s capital so quickly that hospitals are entirely overrun and crematoriums burn nonstop.
“The current wave of COVID has a different clinical behavior,” said Dr. Sujay Shad, a senior cardiac surgeon at Sir Ganga Ram Hospital, where two of the doctors needed supplemental oxygen to recover.
“It’s affecting young adults. It’s affecting families. It’s a new thing altogether. Two-month-old babies are getting infected.”
India’s outbreak worsened even further Wednesday, as authorities reported nearly 3,300 daily deaths. That brings the official total to more than 201,000 people lost, though experts believe the true figure is much higher. Daily new infections also surged to nearly 357,700, another record.
As supplies run dangerously low and hospitals are forced to turn away the sick, scientists are trying to determine what role variants of the virus might be playing. They are working with precious little data. India, like many other countries, has not built up a robust system to track viruses.
India’s worries have focused on a homegrown variant called B.1.617. The public, the press and many doctors have concluded that it is responsible for the severity of the second wave.
Researchers outside India say the limited data so far suggests instead that a better-known variant called B.1.1.7 may be a more considerable factor. That variant walloped Britain late last year, hit much of Europe and is now the most common source of new infection in the United States
“While it’s almost certainly true B.1.617 is playing a role, it’s unclear how much it’s contributing directly to the surge and how that compares to other circulating variants, especially B.1.1.7,” said Kristian Andersen, a virologist at the Scripps Research Institute in San Diego.
Beyond the variants, scientists believe there are other, possibly more obvious factors that could be powering India’s deadly second wave.
India has just scraped the surface in terms of vaccinating its population, with less than 2% fully vaccinated. Experts also blame lax public behavior after last year’s first wave and missteps by Prime Minister Narendra Modi, such as recently holding large political rallies that may have spread the disease and sent a message to the people that the worst was over.
“There is a lot of jumping to conclusions that B.1.167 is the explanation for what’s happening,” said Jeffrey Barrett, director of the COVID-19 genomics initiative at the Wellcome Sanger Institute in Britain. “These other things are probably more likely to be the explanation.”
Preliminary evidence
suggests that the variant is still responsive to vaccines, although slightly less so. India relies heavily on the Oxford-AstraZeneca vaccine, which clinical trials show is less powerful than the vaccines made by Pfizer-BioNTech and Moderna and could perhaps be more easily thwarted by mutations.
“For now the vaccines remain effective, but there is a trend toward less effectiveness,” said Dr. Celine Gounder, an infectious disease physician and epidemiologist at Bellevue Hospital in New York.
In India, a number of doctors point to anecdotal evidence that people who have been fully vaccinated
are getting sick. Those doctors also say they are seeing children with serious symptoms, such as severe diarrhea, acidosis and falling blood pressure, even among otherwise healthy patients.
“This is very different from what we saw last year,” said Dr. Soonu Udani, head of critical care services at the SRCC Children’s Hospital in Mumbai.
Researchers say other factors could lead to more infections among young people, such as India’s schools, which had started reopening in recent months after the country’s first wave.
Scientists say that different variants seem to dominate specific parts of India. For instance, the B.1.617
variant has been detected in a large number of samples from the central state of Maharashtra.
By contrast, the B.1.1.7 variant is rising quickly in New Delhi, said Dr. Sujeet Singh, director of India’s National Centre for Disease Control. It was prevalent in half of samples evaluated at the end of March, up from 28% just two weeks before. The B.1.617 variant is also circulating in New Delhi, he added.
But ultimately, the data from India is too thin to parse the distribution of variants around the country. Despite the huge number of new infections, India is performing very little genomic sequencing.