Patients in Delhi who tested positive for BA.5 did not have severe symptoms

Both BA.4 and BA.5 are sub-variants of Covid-19’s Omicron variant and have been declared as variants of concern by the World Health Organisation (WHO) and the European Centre for Disease Control and Prevention because of their high transmissibility.

As Delhi reported the first cases of the Omicron BA.5 variant of coronavirus, doctors from the hospitals where those infected with the new sub-lineage have been admitted said the patients did not exhibit any unique symptoms, and the disease was not severe.

Since mid-June, the city has reported cases of BA.5 from the All India Institute of Medical Sciences (AIIMS), Lok Nayak Hospital and Institute of Liver and Biliary Sciences (ILBS), according to scientists privy to genome sequencing data of Delhi. (REUTERS (PIC FOR REPRESENTATION))

There is no need to panic as this sub-lineage, even though more transmissible, is not known to cause severe infection, increased hospitalisations or deaths, they said.

Since mid-June, the city has reported cases of BA.5 from the All India Institute of Medical Sciences (AIIMS), Lok Nayak Hospital and Institute of Liver and Biliary Sciences (ILBS), according to scientists privy to genome sequencing data of Delhi.

There are no clusters of this sub-lineage reported yet and it is not spreading at an alarming rate, they stressed.

A patient admitted to Lok Nayak Hospital, the city’s largest Covid facility, tested positive for BA.5 but exhibited moderate symptoms and was discharged without any complications, medical director Dr Suresh Kumar said.

“There were no symptoms that were unique to this patient. The patient has been discharged. Currently, we have 26 patients admitted with Covid at our hospital, and all have moderate to mild symptoms. Three patients are on ventilator,” said Dr Kumar.

Two cases of BA.5 were reported from ILBS and one from AIIMS over the past fortnight, doctors said.

Both BA.4 and BA.5 are sub-variants of Covid-19’s Omicron variant and have been declared as variants of concern by the World Health Organisation (WHO) and the European Centre for Disease Control and Prevention because of their high transmissibility.

These were first identified in South Africa in January, and in a matter of two months, BA.4 and BA.5 became the dominant variants in the country. BA.4 and BA.5 in four months since the first infection collectively replaced 55% of the other Covid-19 variants, according to the National Institute of Communicable Disease, South Africa,

Since then, the two sub-lineages been detected in the UK and the US.

In India, 120 cases of BA.4 and BA.5 have been reported since May 1. Cases have been reported from Telangana, Tamil Nadu, Maharashtra, and Gujarat before Delhi.

While the two sub-lineages of Omicron are known to have a greater immune escape, which makes patients more susceptible to getting infected despite vaccination and past infection, there is no proof of it being more deadly or causing more severe symptoms, according to Dr Lalit Kant, former head of the epidemiology and communicable diseases department in the Indian Council of Medical Research (ICMR).

“Omicron’s BA.4 and BA.5 sub-variants are known to be around 13% more transmissible than the previous BA.1 and BA.2, and are slowly becoming the dominant sub-strains in Europe and US,” Dr Kant said. “However, there is no proof of these being more dangerous. Since we have seen cases of BA.4 and BA.5 in Tamil Nadu and Maharashtra, this could become a dominant strain in Delhi as well. Since genome sequencing is a long process, we might get confirmations on the trend maybe two-three weeks from now.”

The L452R mutation in BA.4 and BA.5, previously found in the Delta variant, is known to enhance the virus’ ability to enter human cells, experts said. Even if a person has acquired immunity through prior infection or vaccination, they do not have confirmed immunity against these sub-lineages, they said.

Currently patients are coming in with symptoms such as abdominal pain, diarrhoea and nausea along with cough, fever and body ache, said Dr Sandeep Budhiraja, group medical director of Max Healthcare Group. Most patients are recovering in 5-7 days, he said.

“What we have been seeing is that it usually takes 6-8 weeks for a new variant to become the dominant one in the community. The introduction of a new variant or sub-variant is usually characterised by spike in numbers and after that, it takes around 6 weeks to become dominant,” said Dr Budhiraja. “So logically, the cases under the new sub-lineage should peak by July in India and start declining by September.”

In Delhi, among the Covid-19 samples sent for genome sequencing till June 5, the dominant sub-variants were BA.2, BA.2.10 and BA.2.38, according to a scientist from INSACOG, a pan-India consortium to monitor genomic variations in the SARS-CoV-2 virus.

It was around the middle of June that BA.5 was seen among some samples, the scientist said, requesting anonymity. It was highly unlikely that this sub-strain was causing a spike in deaths or hospitalisations in the city, the scientist said.

Delhi on Monday had reported three Covid deaths and on Saturday—the last comparable data as the health bulletin for Sunday was not released by the Delhi government—six Covid deaths were reported.

“There is no proof of this sub-lineage creating severe infection or deaths. The spike in deaths over the last two days could be a coincidence,” the scientist said.