Can JN.1 COVID variant play partypooper in India this holiday season?

After a lull in infections, India is suddenly seeing an uptick in COVID cases, playing party-pooper ahead of the festive season. As of Tuesday (19 December), the country reported 260 new cases of COVID-19, taking the overall active case tally to 1,828.

The rise in COVID cases coincides with the discovery of the first JN.1 subvariant in an elderly woman in Kerala, prompting fears amid the public and medical authorities. States across the country are already ramping up their testing capabilities and the question that people are asking is will this affect their Christmas and New Year’s plans.

JN.1 subvariant in India

Early on 8 December, a 79-year-old woman was detected positive for carrying the JN.1 COVID variant. The patient, according to the doctors, had mild symptoms of Influenza Like Illness (ILI) and has since recovered.

For the unaware, the JN.1 subvariant is a sub-lineage of the BA.2.86 Omicron variant (Pirola) and was first detected in Luxembourg. Since then, it has been spotted in more than 38 countries. According to experts, JN.1 carries an additional spike mutation, L455S, and this mutation is suspected to have the potential to escape immunity.

In the US, the JN.1 subvariant has become prominent with 15 and 29 per cent of infections being caused by it, as per data released by the Centers for Disease Control and Prevention.

Besides, the woman in Kerala, the Indian Express reports that 15 new cases of the JN.1 variant have now been detected in samples from Goa. However, there is no official confirmation on this development yet.

India on high alert

Following the detection of the JN.1 subvariant in Kerala and the rise in overall infections across the nation, the health ministry has written to states and Union Territories, asking them to monitor cases of influenza-like illnesses, conduct adequate testing, and send all positive samples for whole genome sequencing.

The Ministry of Health and Family Welfare (MoHFW) said the Union health secretary has sent a letter to states/UTs, highlighting the need for maintaining a state of constant vigil over the COVID-19 situation in the country.

The health ministry has also listed some strategies for the upcoming Christmas and New Year holidays. “Considering the upcoming festive season, states were advised to put in place requisite public health measures and other arrangements to minimise risk of increase in transmission of the disease by adherence to maintenance of respiratory hygiene,” it said.

States have taken cognisance of the situation. For instance, Maharashtra has stepped up its surveillance and directed district health authorities to evaluate hospital readiness. Dr Pratapsingh Sarnikar, Joint Director of Health, Communicable Diseases, Maharashtra, told the Indian Express that health officers have been urged to conduct regular surveillance of COVID as well as flu cases. Moreover, isolation wards have been established in government hospitals and mandatory medical audit of influenza deaths has been advised.

The state of Karnataka has also stepped up its health measures. Chief Minister Siddaramaiah-led government has made it mandatory for people above the age of 60, and those with comorbidities, to wear masks.

The state’s health minister Dinesh Gundu Rao on Monday said that they have increased tests among people reporting symptoms of COVID-19 subvariant JN.1. The minister also informed that the state government has increased surveillance in border districts with Kerala.

“Those above 60 years of age and those with comorbidities like issues related to heart, and kidney among others, and those with cough, phlegm and fever should mandatorily wear masks. We are communicating this to the public. Also, we have asked our hospitals and health centres to be prepared. There should be more surveillance in border districts like – Kodagu, Dakshina Kannada, Chamarajanagara – which share a border with Kerala,” he was quoted as saying.

Earlier, the state of Kerala, which first recorded the JN.1 variant, also asked people to stay cautious but urged them not to panic. Health Minister Veena George said there was no need to worry and the situation was under control. She added that the variant already existed in other parts of the country.

“Months ago, this variant was detected in a few Indians who were screened at the Singapore airport,” she told reporters on Sunday.

Experts speak on JN.1

With the rise in infections across the nation, there is a concern that COVID is making a comeback. However, experts have urged people not to panic. Chief of Indian SARS-COV-2 Genomics Consortium (INSACOG) Dr NK Arora said, “No cause for panic (over JN.1 subvariant). The number of samples is less but these are being collected from all the states. INSACOG is closely monitoring the situation, studying the epidemiology and clinical behaviour of the virus.”

He was quoted as telling news agency ANI, “This variant has been isolated and reported in November; this is a subvariant of BA.2.86. We have some cases of JN.1. India is keeping a vigil and that’s the reason no hospitalisation or severe disease has been reported so far.”

And when asked about the surge in cases, Dr Rajeev Jayadevan, former president of the Kochi wing of the Indian Medical Association (IMA) said that it was “expected.” “As we know, COVID-19 is a cyclical disease, it will keep coming back. It was in April this year when we last saw a spike, as per the INSACOG database, which was caused by XBB sublineages,” he told News18.

Senior virologist Dr Shahid Jameel, a fellow at the Green Templeton College, University of Oxford, and a visiting professor at Ashoka University, also expressed his view that there wasn’t any reason to panic. “With JN.1, it’s going to be no different. So unless people start showing up in hospitals, I wouldn’t worry,” he said.

Quick spread of JN.1 variant

With symptoms of fever, sore throat, runny nose, headaches, and, in certain instances, mild gastrointestinal symptoms, doctors believe that there isn’t any real threat from the JN.1 virus.

But owing to the additional spike mutation, this subvariant is easily transmissible. In the United States, it has accounted for a growing percentage of test samples and according to some projections, will be responsible for at least half of the new infections before December ends.

Singapore too has seen a jump in COVID cases, with experts blaming the JN.1 subvariant for the surge. The Singapore Ministry of Health (MOH) said the estimated number of cases from 3 to 9 December increased to 56,043, a 75 per cent jump compared with 32,035 cases in the previous week.

Malaysia, China and other southeast Asian nations have also seen an uptick in COVID infections, with many of them being infected by the JN.1 subvariant.

Tips to save yourself from JN.1

Doctors and medical experts have noted that while JN.1 is not life-threatening, it is fast spreading and hence, the public should take appropriate measures to protect themselves. Doctors are calling for precautions such as frequent handwashing, wearing masks, and maintaining social distance.

Doctors have also called on people to take their vaccines. Pulmonologist Dr Neeraj Gupta, Marengo Asia Hospitals, Gurugram told India Today that vaccination remains a critical defence, as vaccines have proven effective against serious infections from various strains of the virus.

With inputs from agencies