he World Health OrganiZation has classified the SARS-CoV-2 sub-variant JN.1 as a separate variant of interest (VOI) from its parent lineage BA.2.86, due to its rapidly increasing spread. This new variant was recently found in Kerala. In this episode of businesslines News Explained, Anjana PV and Jyothi Datta discuss the emergence of the JN.1 variant, the potential implications of this new variant, its origins, and the ongoing surge in Covid-19 cases.
Jyothi explains that the JN.1 variant is a sub-variant of the SARS-CoV-2, which initially caused the pandemic. The variant is considered a part of a lineage that includes well-known variants like omicron. Currently, health authorities such as the Union Health Ministry of India, WHO, and CDC suggest that there is no significant increase in public health risk from the variant based on available evidence.
The classification of JN.1 as a variant of interest rather than as part of a larger family of variants is highlighted in this podcast. This change in classification is attributed to a spike in cases linked to the JN.1 variant. The discussion moves on to the situation in India, where the first case of the JN.1 variant was detected in Kerala.
Jyothi emphasises the need for surveillance and precautionary measures in response to the detection of the variant in India, despite the absence of a call for panic. She also states that current vaccines are seen to protect against severe disease and death, and there is no widespread call for booster shots at the moment. However, she acknowledges that vulnerable populations, such as those with weakened immune systems, may need to consult their doctors regarding booster shots.
The podcast also dives into the possibility of future variants and the importance of continuing basic public health measures. Jyothi emphasises the need for common sense in navigating the upcoming festive season, advocating for handwashing, mask-wearing, and other preventive measures.
Tune in to know more about the JN.1 Variant.
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Published on December 21, 2023
Malcolm Brabant:
Twenty miles to the south are sheer drops, where, over the years, several people have leapt to their deaths. The cliffs no longer have such a grim reputation, thanks in part to a neighborhood regeneration scheme, including the benches.
I have come to Ramsgate, a seaside town some 80 miles southeast of London. This is a chatty bench. It's a glorious sunny day, a real change from the miserable winter that Britain's having. People are out and about. Let's see if anybody wants to talk.
The sad truth is, I was studiously ignored, until David Barber turned up. He's one of the community leaders behind this chatty bench project.
India saw a single-day rise of 656 COVID infections while the active cases have increased to 3,742, according to Union health ministry data updated on Sunday.
The death toll was recorded at 5,33,333 with one new death reported from Kerala in 24 hours, the data updated at 8 am showed.
The countrys COVID case tally is 45 million (4,50,08,620).
The number of people who have recuperated from the disease has increased to 44.47 million and the national recovery rate stands at 98.81%, according to the health ministrys website.
The case fatality rate stands at 1.19%.
According to the ministrys website, 2.2 billion doses of COVID vaccines have been administered in the country so far.
WHO defines long COVID as continuing or new symptoms at least 3 months from start of COVID
EG.5 or the Eris COVID variant is dominant in parts of Australia. Eris, along with other circulating strains, are descendants of Omicron.
While these strains appear less severe than the original Alpha and Delta variants, the risk of long COVID remains.
So what does the latest data say about the chance of long COVID? What symptoms should you look out for? And what can be done to support people with long COVID?
For most people, long COVID means not getting better after a COVID infection.
The World Health Organization defines long COVID as continuing or new symptoms at least three months from the start of a COVID infection that last at least two months and cannot be explained by an alternative diagnosis.
The most common symptoms include fatigue, brain fog, breathlessness, headaches and abdominal pain. But people with long COVID can experience a wide range of problems including cardiovascular issues, mental health problems such as depression and anxiety, insomnia, muscle and joint pain, and gastrointestinal problems.
Australian data on long COVID remains limited compared to international data, and estimates of its prevalence have varied. A report from Australia's parliamentary inquiry into long COVID, published in April, suggested 2%-20% of people may develop long COVID following an infection.
A recent Australian study conducted when vaccines were widely available indicates earlier Omicron variants saw 10% of people who caught COVID develop long COVID.
Another recent study, yet to be peer-reviewed, found 18.2% of those infected went on to have long COVID. The wide-ranging estimates are likely to be because of different COVID variants, differences in vaccination, and different long COVID definitions and assessment methods.
The risk is lower in children. One Australian study indicated persistent symptoms in 8% of children who had COVID in 2020, while preliminary research points to a slightly lower risk among children infected in 2021.
But more research is needed, especially as the virus continues to evolve. This can be complicated because typical long COVID symptoms are common to many other health problems. As in other countries, more research is now underway in Australia to determine the accurate prevalence of the condition using a definition and methods that carefully exclude other causes.
Although research on long COVID risk factors with new variants is ongoing, we expect being female, having more severe initial disease and having other health conditions will increase a person's chance of getting long COVID.
Research shows COVID vaccines offer protection against long COVID. As well as vaccinations, immunity from previous COVID infections and antiviral treatments are contributing to less severe COVID and potentially less long COVID than we saw earlier in the pandemic.
But while the Omicron waves may lead to fewer cases of long COVID than the earlier Alpha and Delta variants, because so many Australians are contracting COVID, this will still result in a large number of people with long COVID. And each repeat infection presents a new risk of prolonged symptoms.
Long COVID can impact a person's life in many ways. Fatigue following exertion, brain fog and other symptoms can reduce capacity to perform tasks such as concentrating at a computer, manual labour, and even normal household tasks.
Many people with long COVID submitted evidence to the recent parliamentary inquiry that they were unsupported, stigmatised, isolated, and not taken seriously by health professionals.
Evidence suggests many symptoms will improve in most people over 12 to 18 months, although recovery time can differ between symptoms. Some, including gastrointestinal and respiratory symptoms, tend to resolve sooner than others, such as cognitive symptoms.
Long COVID is the kind of challenge Australia's health system finds most difficult. GPs are stretched and the small number of specialist long COVID clinics are struggling to maintain funding.
Australia has trailed behind the US, the UK and Europe in rolling out care for long COVID, and in collecting data on the condition.
As a result, support for long COVID in Australia is hard to access, expensive and patchy.
However, there is consensus on what constitutes good care. Clinicians seeing patients with possible long COVID should:
validate the person's experience of symptoms and the impact their symptoms are having on their functioning, particularly when the cause is not clear
diagnose and treat any other health conditions that are part of the picture
support people to minimise the impairment their symptoms cause by pacing of physical and cognitive activities. Importantly, this doesn't involve pushing through fatigue.
These steps are not a cure but they may improve a person's ability to function in their day-to-day life, at work and to fulfil their caring responsibilities.
The best way to prevent long COVID is to avoid contracting and spreading COVID. This means:
getting vaccinated or boosted, if you're eligible
staying home if you feel unwell
wearing a mask to protect yourself and vulnerable community members
testing for COVID if you have symptoms and if you test positive, taking antivirals (if eligible) and isolating until your symptoms resolve.
Long COVID is not going away, but we all have a role to play in preventing and responding to it.
Ruby Biezen from the APPRISE Network and the University of Melbourne and Andrew Lloyd from the Kirby Institute at UNSW contributed to this article.
(Authors:Andrew Baillie, Professor of Allied Health, University of Sydney; Amelia Gulliver, Senior Research Fellow, ANU College of Health and Medicine, Australian National University; Lena Sanci, Professor, Department of General Practice and Primary Care, The University of Melbourne; Lucette Cysique, Senior Research Fellow, Viral Immunology Systems Program, The Kirby Institute, UNSW Sydney, and Philip Britton, Associate Professor, Child and Adolescent Health, University of Sydney)
(Disclosure Statement:Andrew Baillie is a Conjoint Professor of Allied Health at Sydney Local Health District, a Member of the Australian Psychological Society (APS) and a Fellow of the Clinical College of the APS.
Amelia Gulliver is a senior research fellow at the Centre for Mental Health Research, National Centre for Epidemiology and Population Health, ANU College of Health & Medicine, and has lived experience of Long COVID.
Lena Sanci is the co-lead of the APPRISE initiative which has received commonwealth funding. She is the Chief GP advisor for the state department of health and the president of the Australasian School Based Health Association.
Lucette Cysique is a Senior Research Fellow based at the Kirby Institute, UNSW, and manages the DoHAC-funded APPRISE Long COVID initiative. Lucette Cysique receives support from the Peter Duncan Neuroscience Unit at the St. Vincent's Applied Medical Research Centre which contributed to her involvement in the neurological substudy of the St. Vincent's Hospital COVID-19 ADAPT study.
Philip Britton is Conjoint Associate Professor in Child Health at the University of Sydney. He has received funding from the NHMRC, MRFF and Royal Australasian College of Physicians)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)
The World Health Organization (WHO) has said that the number of new COVID cases increased by 52 per cent during the past four-odd weeks, with over 850,000 new cases reported during the period.
The number of new deaths decreased by 8 per cent as compared to the previous 28-day period, with over 3,000 new fatalities reported, the World Health Organization (WHO) said in its latest press release.
As per WHO, as of December 17, over 772 million confirmed cases and nearly seven million deaths have been reported globally since the onset of COVID-19.
Further, the WHO said over 118,000 new COVID-19 hospitalisations and over 1600 new intensive care unit (ICU) admissions have been recorded, with an overall increase of 23 per cent and 51 per cent, respectively, globally.
As of December 18, 2023, JN.1, a sub-lineage of BA.2.86 Omicron variant has been designated a separate variant of interest (VOI) apart from its parent lineage BA.2.86 due to its rapid increase in prevalence in recent weeks. Globally, EG.5 remains the most reported variant of interest.
Due to its rapidly increasing spread, WHO is classifying the variant JN.1 as a separate variant of interest (VOI) from the parent lineage BA.2.86. It was previously classified as VOI as part of BA.2.86 sublineages.
Based on the available evidence, the additional global public health risk posed by JN.1 is currently evaluated as low. Despite this, with the onset of winter in the Northern Hemisphere, JN.1 could increase the burden of respiratory infections in many countries.
The WHO had earlier said it was continuously monitoring the evidence and would update the JN.1 risk evaluation as needed.
Current vaccines continue to protect against severe disease and death from JN.1 and other circulating variants of SARS-CoV-2, the virus that causes COVID-19, it noted.
COVID-19 is not the only respiratory disease circulating. Influenza, RSV, and common childhood pneumonia are also on the rise.
The WHO advises people to take measures to prevent infections and severe disease using all available tools. These include wearing a mask when in crowded, enclosed, or poorly ventilated areas, keeping a safe distance from others, practicing respiratory etiquette (covering coughs and sneezes), cleaning hands regularly, and getting tested if one has any symptoms or if you might have been exposed to someone with COVID-19 or influenza.
(With inputs from ANI)
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Published: 23 Dec 2023, 12:36 PM IST
This is the year that the COVID-19 pandemic was declared to be no longer a global health emergency.
But even though case counts are down in 2023, it's not as if everything is back to normal. There is, for example, a new omicron variant that was first detected in late summer and has spread significantly in recent weeks. It's called JN.1, and health officials have now classified it as a variant of interest. And a frequently asked question is:
Health officials are not sounding the alarm. The World Health Organization says the overall risk is low.
Based on the limited evidence, JN.1 seems comparable to other circulating omicron variants and doesn't appear to cause more severe disease.
COVID vaccines, including the updated booster, continue to provide protection against severe illness and death. In the U.S., hospital admissions for COVID-19 have been climbing since early November.
There have been other pressing COVID questions in 2023. Here are some of the topics we tackled, starting with a quandary about this new phase of the pandemic:
'Emergency' over! Do we unmask and grin? Or adjust our worries?
Is it OK to get a COVID shot and a flu shot and even an RSV shot at the same time?
How do I avoid catching COVID while flying in 2023?
Why do some people get a COVID infection yet show no symptoms?
A few posts from years past drew a lot of readers in 2023 as well:
Can you test positive for COVID from getting a vaccine/booster?
Does a faint line on a self-test mean I'm barely contagious?
Is paxlovid the best treatment?
On Saturday, India reported 752 new infections, marking the highest daily count since May 21. Four deaths were also recorded, bringing the nationwide death toll to 5,33,333.
India reported 656 new Covid-19 cases in the past 24 hours, raising concerns amidst the looming threat of the JN.1 subvariant. While the number of new cases remains relatively low compared to previous peaks, the slight increase in the active caseload, which now stands at 3,742 from 3,420, has put authorities on alert.
In the last 24 hours, one new death was reported in Kerala, bringing the total death toll in the country to 5,33,333, according to the data updated at 8 am. The case fatality rate remains at 1.18 per cent.
Kerala, the state where the Covid sub-variant JN.1 was initially identified, witnessed the highest surge in active cases, recording 126 new cases in a single day, as per the Ministry of Health and Family Welfare. Other states experiencing an increase in daily active cases include Karnataka (96), Maharashtra (35), Delhi (16), Telangana (11), and Gujarat (10).
In the last 24 hours, 333 people have recovered from Covid-19, bringing the total number of recoveries to 4,44,71,545. The national recovery rate remains at an impressive 98.81 per cent, as reported by the Health Ministry.
The total number of Covid-19 cases in the country has reached 4.50 crore (4,50,08,620). On Saturday, India reported 752 new infections, marking the highest daily count since May 21. Four deaths were also recorded, bringing the nationwide death toll to 5,33,333.
The active cases have crossed the 3,000-mark, reaching 3,420. The Health Ministry reported that on Friday, India recorded 640 fresh Covid-19 infections and one death, with the active caseload increasing from 2,669 to 2,997. The total number of Covid vaccine doses administered in the country stands at 220.67 crore.
The recent uptick in Covid-19 cases, particularly associated with the JN.1 sub-variant of Omicron, has prompted the central government to advise caution, especially for individuals with comorbidities, urging them to wear face masks as a precautionary measure. Although the government has reassured the public that the current spike is not a cause for concern, it remains vigilant against emerging strains of the virus.
As of December 21, a total of 22 cases of the JN.1 sub-variant have been reported across the country. The majority of these cases, 19 in total, were identified in Goa, with one case each reported in Kerala and Maharashtra.
The JN.1 variant, classified as a 'variant of interest' by the World Health Organisation, has gained attention for its rapid spread in recent weeks. Despite the rise in cases, health officials have emphasised that no clustering of cases related to the JN.1 variant has been observed in India, and the reported cases have been mild, with patients recovering without complications.
According to officials, there has been no clustering of cases in India attributable to the JN.1 variant. They stated that all of the cases were found to be minor, and the patients healed without any consequences.
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India saw a single-day rise of 752 coronavirus infections, the highest since May 21, 2023, while the active cases have increased to 3,420, according to Union health ministry data updated on Saturday.
The death toll was recorded at 5,33,332 with four new deaths -- two from Kerala, one each in Rajasthan and Karnataka -- reported in 24 hours, the data updated at 8 am stated.
The country's Covid case tally stood at 4.50 crore (4,50,07,964).
The number of people recuperated from the disease has increased to 4,44,71,212, and the national recovery rate stands at 98.81%, according to the health ministry's website. The fatality rate stands at 1.19%
The ministry's website stated that 220.67 crore doses of the Covid vaccine have been administered in the country so far.
(Edited by : Sudarsanan Mani)
Current evidence, including randomized controlled trial and observational data, suggests that SARS-CoV-2 rebound occurs initially as a mild illness 37 days after resolution of the initial acute illness, occurs in both treated and untreated patients, and is not associated specifically with receiving nirmatrelvir/ritonavir. Moreover, rebound occurs when there is variable, host-mounted immune response to infection during the course of illness. Finally, no hospitalizations or deaths were reported among outpatients who experienced rebound.
Some observational studies demonstrated a higher frequency of rebound among treated persons (10%14%) (11,14,22) than reported by the randomized controlled trial, EPIC-HR (8,10) (Supplementary Table, https://stacks.cdc.gov/view/cdc/137156). Viral rebound might occur in persons on antiviral treatment because they are at high risk for severe disease and might have host factors, such as immunosuppression, that contribute to the natural variability in viral dynamics (21). Risk factors for rebound appear to be similar to risk for severe disease, but further studies are needed to understand whether persons with certain characteristics or underlying medical conditions are predisposed to experiencing rebound. Another important consideration is that persons receiving antiviral treatment might be at higher risk for experiencing rebound given the viral suppression related to use of treatment early in the disease course and resumption of viral replication after completion of treatment because of delayed viral clearance. This elevated risk could be due to early discontinuation of antiviral treatment or the need for longer courses of treatment among certain persons, such as those who are immunocompromised (14). Two ongoing clinical trials of nirmatrelvir/ritonavir will further characterize the frequency of rebound after different durations of nirmatrelvir/ritonavir treatment among immunocompromised subjects and the potential benefit of nirmatrelvir/ritonavir retreatment among subjects with posttreatment rebound.***
Rebound does not likely represent reinfection or resistance to treatment (12); however, further studies are needed to confirm this finding. The FDA analysis identified potential treatment-associated mutations that were not clinically relevant among two treated patients because rebound symptoms resolved without hospitalization (8). It is important to ensure that use of antivirals does not accelerate viral evolution and result in resistant mutations, such as through counseling patients to complete antiviral treatment and monitoring for resistance using molecular analyses. Two studies demonstrated shedding of infectious virus during rebound (8,11). Comparisons of genomic strains present in both acute and rebound episodes and viral culture to determine infectiousness are important to understanding the clinical implications of rebound. In addition, a large assessment of innate and adaptive immunity and monitoring biomarkers of inflammation and cytokine storm would contribute to understanding of the underlying pathophysiology of recurrence.
The findings in this report are subject to at least five limitations. First, standardized definitions for symptom, viral, and clinical rebound were not used across studies. Using standard definitions to accurately reflect outcomes could improve interpretability and comparisons of data across studies and settings. Most studies examined symptom or viral rebound. A definition that requires reemergence of virus after complete resolution of illness, which takes 710 days for a healthy adult, and a negative viral test result after resolution of initial symptoms would allow for examination of clinical implications of rebound or recrudescence, such as a dysregulated immune response (23). Second, publications about recurrences and viral kinetics might have been missed given the narrow search. Third, a major limitation of observational studies is the difficulty in verifying whether antiviral treatment courses were completed and whether vaccination status and previous infection were documented accurately. Fourth, few studies correlated symptoms with viral load, which makes the significance of recurrence of mild symptoms difficult to understand because symptoms are subjective and might not represent viral reactivation. Finally, ascertainment bias is also possible given that persons receiving antiviral treatment are closely followed, and more likely to report recurrent symptoms, which would explain the early case reports being associated with nirmatrelvir/ritonavir, the most commonly used oral antiviral in the United States.
Viral rebound can occur in persons who do and do not receive antiviral treatment and might reflect viral fluctuation that is part of the natural disease process early in the course of illness. Risk for experiencing rebound could be related to many factors, such as immunosuppression, delayed viral clearance, and overall immune response. The current literature review, along with a recently published randomized trial (8), suggests the substantial benefit of antiviral treatment among persons at risk for severe disease outweighs the risk for rebound, because rebound resolves quickly and is not associated with an increase in severity of recurring signs and symptoms. Increased education and awareness among practitioners and patients about rebound not increasing risk for hospitalization or death might increase use of COVID-19 treatment. According to NIH COVID-19 Treatment Guidelines, rebound should not deter providers from prescribing life-saving antiviral treatments when indicated to prevent morbidity and mortality from COVID-19 (1).
"What Covid taught us is never to take anything for granted," says Dr Ashok Seth, Chairman, Fortis Escort Hospital, while talking to The Times of India. India on Thursday recorded 594 fresh Covid-19 infections while the number of active cases increased to 2,669 from 2,311 the previous day, according to Union health ministry data. The country's Covid-19 tally stands at 4.50 crore (4,50,06,572). The death toll climbed to 5,33,327 with six more people -- three from Kerala, two from Karnataka and one from Punjab -- succumbing to the viral disease.
