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COVID: Are Next 40 Days Crucial for India? What's Happening in South Asia?

What do experts think? Does India need to consider a fourth dose?

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There is still no clarity on what is happening in China, with experts raising alarm that the country is witnessing a steep increase in the number of COVID-19 cases due to coronavirus variant BF.7.

The Union Health Ministry has, however, said that the next 40 days will be crucial in India – with the country likely to witness a surge in January.

What's the rationale behind the next 40 days being crucial? What do experts think? Does India need to consider a fourth dose? Here's all you need to know.
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Why are the next 40 days crucial for India?

“In the past, whenever a COVID-19 wave was reported in India, it used to hit us in 30-35 days, starting from East Asia, it used to hit Europe in 10 days, moving towards America and the Pacific region, and then finally hitting India which would normally take 30 days," a senior health ministry official told media, requesting anonymity.

The official added that the number of deaths and hospitalisations is likely to be low this time, even if India is hit by a COVID wave by the end of January.

“We have developed hybrid immunity (from vaccine plus natural infection), so COVID-19 wave may not affect us the same way as it is being reported in countries like China, Japan, etc."

But what is happening in South Asia?

According to the World Health Organisation, over the past seven days, Japan has had the world's largest confirmed COVID-19 infections and the second-most deaths after the United States.

Japan said it recorded 216,219 newly confirmed coronavirus cases on Wednesday, which marks an up 4 percent from a week earlier. The number is close to the record high of some 260,000 a day in August. 

As of 28 December, some countries near China have witnessed a surge in both the number of cases and deaths.

  • South Korea - 69 deaths, 87,517 new cases

  • Hong Kong- 59 deaths, 20,865 new cases

  • Taiwan: 25 deaths, 28,168 new cases

However, experts point that the Omicron-induced spike in these countries has been on and off since August 2022.

Why is this?

As per reports, BF.7 Omicron variant is quicker to transmit, has a short incubation period, and infects people easily, even those who have had COVID before.

In a statement released back in June, Dr Tulio de Oliveira, Director, Centre for Epidemic Response & innovation (CERI) said that prior infection with other Omicron variants, particularly the original BA.1 does not protect against the BA.5 subvariant.

Not just this, the easing of COVID lockdown and travel restrictions could also be the reason for the spike, experts added.

What do we know about Omicron subvariants and vaccination?

Previous studies have found that the BA.5 Omicron subvariant is able to circumvent vaccine protection. This is true for BF.7 too.

In fact, a recent study found that BF.7 was able to infect even triple vaccinated people, and those who have hybrid immunity (vaccinated and have had prior COVID infection).

But, the good news is that vaccines are still able to protect from severe illness and death, particularly the mRNA vaccines, say experts.

Should India start thinking about the fourth dose?

There is no clarity on this yet.

"We should be looking at what the frequency of boosting ought to be and what we should be boosting with. For example, with mRNA vaccines, you get a really high antibody response and then it crashes. You inject again and antibodies go up to a high level and then it crashes. By the time you get to the fourth dose, your boosts are getting lower and lower each time," said Dr Gagandeep Kang, one of India's leading virologists.

"However, with some of the adenovirus, vector vaccine, you actually see that the immune response takes a longer time to mature. It takes six months. So, assessing which combination of vaccine gives us the best immune response, both antibodies as well as cellular response, that last for a long time is really important," she added.

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Does this mean India should be worried?

Experts are continuing to maintain that there is no reason for India to worry.

In an earlier interview with FIT, Dr Chandrakant Lahariya, one of India's leading public health policy experts, said:

"In India, there have been three waves – and in the Delta wave, a majority of the population – be it elderly or younger people – were exposed to the virus. India has also achieved 97 percent vaccination coverage with at least one dose of vaccine."
Dr Chandrakant Lahariya to The Quint

"But what also matters is when a person is inoculated. If the person gets the vaccine after the infection, they are protected both by natural immunity and the vaccine – giving them hybrid immunity. This has protected a lot of Indians," he added.

Dr Kang, in an elaborate thread on Twitter, reiterated this.

"At the moment, India is doing fine. We have few cases, we have had the XBB & BF.7 for a while and they have not driven an upsurge in India. In the absence of an even more highly infectious variant, I do not expect a surge," she added.

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