Should You Be Worried About the XE Variant? ‘Calm Down,’ Says Dr Gagandeep Kang

Is the XE COVID Variant more transmissible than others? Can it lead to a 4th wave in India? A virologist explains

4 min read

The Indian SARS-CoV2 Genomics Sequencing Consortium in its latest bulletin has confirmed that they have detected the XE COVID subvariant in India.

Recombinant sub-variant XE is the latest COVID Variant to take the news cycle by storm, especially as confusion surrounding reports of two unconfirmed cases in Gujarat and Maharashtra emerged just weeks ago.

As China reels from record high COVID cases and stringent lockdown measures, and cases in parts of India surge, the fear of new emerging variants XE, BA.2 and so forth leading to a full blown 4th wave is palpable.

Should we be worries about the XE variant?

FIT caught up with one of India's Top Virologists, Dr Gagandeep Kang, to get to the bottom of the XE variant and the level of threat it poses.


What Do We Know About XE?

XE is a recombinant variant, like Deltacron, which means it is subvariant formed out of a combination of two other strains (BA.1 and BA.2).

XE was first detected in the UK on 19 January, and since then hundreds of cases of the strain have been sequenced there.

A possible case of XE was also reported in India on 6 April, although it has since been denied by the Union Health Ministry,

On 6 April, the World Health Organization issued a statement saying that XE is being tracked as part of the Omicron variant is not being considered a separate variant.

The WHO also added that, "early estimates based on limited preliminary data suggest that XE has a community growth rate advantage of about 10 percent as compared to BA.2, however this finding requires further confirmation."

Speaking to FIT, Dr Gagandeep Kang, Virologist and Professor at CMC Vellore, says, "This (XE) is not behaving currently like a significant threat. So, calm down."

More Transmissible? More Virulent?

Yes, the subvariant is more transmissible than Omicron's BA.1 and BA.2 strains, but that doesn't automatically mean it's more dangerous, says Dr Kang.

"The next question to ask is, is it causing more severe disease? Doesn't look like it,"she says.

"It has higher transmissibility. If there was ever a variant perfect for causing infections, this would be the one. But, fortunately for us, not severe symptoms."

"We were worried about BA.2, but it didn't cause more serious disease than BA.1. XE doesnt cause more serious disease than BA.1 or BA.2. Does a 10 percent faster spread really matter? In a vaccinated population, no."
Dr Gagandeep Kang, Virologist

"BA.1 was fine, BA.2 was fine. When the parents are fine, how bad can the child (XE) be?" she quips.

'Variants Are Inevitable'

"Variants will come. The country is opening up, everyone is travelling all over, so we will get variants sooner or later. Why are we getting obsessed with XE?"

Dr Kang goes on to explain that the COVID-19 virus has a peculiar way of replicating.

"Even though it is a virus that has a proof reading mechanism, it has a kind of way of jumping genes and reading different sections differently so the idea that recombinance will arise is something that we should be expecting."
Dr Gagandeep Kang, Virologist

"We've seen it with the common cold coronavirus as well. We are seeing it with SARS-CoV-2,"she adds.

Dr Kang goes on to reiterate that new sequencing data will tell us that there are variants. What matters is the consequence of that variation."

The question is what is the behaviour of the variant going to be like?

"Quite frankly, from everything I've heard about XE, I'm not too excited about it at this time," she says.


Fully Vaccinated? Rest Easy

Another question that repeatedly comes up with each new variant is, does it infect people who have already been vaccinated?

To this, Dr Kang says, "All the omicron subvariants infect people who have been vaccinated."

Explaining this further, she adds, "this seems to be because Omicron is behaving biologically very different from other variants. It is infecting a different part of the respiratory tract, and it's causing a much milder disease and has a shorter incubation period."

"But, the higher rates of infection have not translated into higher cases of severe illnesses and deaths."
Dr Gagandeep Kang, Virologist

Moreover, she echoes what many health experts are saying, that the population in India also has the advantage of 'hybrid immunity' on their side.

The fact that India had such high rates of infection in the previous waves turned out to be a double-edged sword, many experts have reiterated. "The biggest advantage we have was that such a large part of our population was infected, so we really have hybrid immunity in spades,"Dr Kang says.

In contrast, speaking of the situation in China, she adds, "They didn't see the kind of cases many other countries saw earlier."

However, to get a clearer picture of this, India needs to generate more granular data, particularly, according to Dr Kang, real world data of hospitalisations in vaccinated and unvaccinated individuals.


More Data Means More Clarity

Speaking during a panel discussion at the launch of the Johns Hopkins Gupta-Klinsky India Institute on 7 April, Dr Kang brought up the need for better communication between systems of data collection.

"You want to be able to link the sequenced data (International and Indian) with the clinical information. When was the sample collected? Was there a cluster of cases going on there? Then you can understand the consequence of that sequence,"she tells FIT.

"XE spreads 10 percent faster than Omicron. If you don't have a humungous database, you're not going to be able to pick up that 10 percent. For example, in India would we have even been able to say that XE spreads 10 percent faster? We couldn't. Could the US have done it? Maybe,"she says.

"It's only because the UK has such strong sequencing information, that they were very quickly able to tell us that this spreads at 10 percent faster."
Dr Gagandeep Kang, Virologist

"The sequence in isolation only tells you that this is a variant that is related to another variant of a virus."

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