Four JN.1 cases reported in Tamil Nadu in Nov; all recovered

CHENNAI: Of the 56 COVID-19 samples sent to the National Institute of Virology for genomic sequencing to determine the presence of the JN.1 variant, four samples have tested positive for the JN.1 variant in Tamil Nadu. The results of 30 samples have been received so far and the XBB variant has been identified as the dominant variant with 24 samples testing positive for the same.

The four cases tested positive for JN.1 were from Coimbatore, Tiruchy, Madurai and Tiruvallur and the patients were infected with COVID-19 in November. Of the 4 patients diagnosed with JN.1, two were treated as inpatients and the other two as outpatients. Two samples also tested positive for BA.1.

A senior health official said there is a mild viral infection which causes minimal morbidity and there is no need to panic about JN.1 in Tamil Nadu at present. “The individuals with symptoms including fever, cough and body aches are requested to approach the nearest government hospital for proper examination and treatment,” said the official.

Tamil Nadu reported 11 cases of COVID-19 on Monday with a Total Positivity Rate (TPR) of 8 per cent.

Even as the positivity rate stood at 20 per cent in Chennai on Sunday, and Chengalpattu recorded 21.1 per cent TPR on Monday, the testing is yet to be intensified. The TPR is above 10 per cent in several other districts, while the testing of samples remains below 400 on average. The samples tested dropped to 163 on Monday.

Cuddalore reported a TPR of 33.3 per cent, Chennai 12.4 per cent, Chengalpattu 21.1 per cent, Krishnagiri 16.7, Tiruvannamalai 14.3, Kancheepuram 13.3 per cent and Tiruvallur and Vellore 11.1 per cent TPR.

The number of samples tested in Chennai stood at around 100 cases on average, while the city reported 17 cases on Sunday and five on Monday. The city has been reporting about 15 cases of COVID-19 in the last week. There are a total of 139 cases of COVID-19 in the State.

The director of Public Health and Preventive Medicine Dr TS Selvavinayagam said there are no severe cases needing admissions. “Nothing to panic even if it is new variant,” he said.

The government hospitals, which recorded a steady inflow in December of 2022 and 2021, are now recording minimal footfall, he added.

Living with COVID the new normal: Experts

The paranoia over COVID-19 is raising its ugly head yet again, with the sharp spike in cases across the country. Public health experts and several virologists opine that the incidences of COVID-19 would continue to increase in the future and that the virus is here to stay.

However, from a medical standpoint, the challenge would be to keep pace with the changes in the structure and modifications of the virus that would impact people in different ways.

The urgent requirement in the advancements in vaccines and booster shots are intensified, as the changes in the virus can impact those with comorbidities in hitherto unforeseen and unheard of ways.

Infrastructure, drug-availability

“It’s more a flu-virus now but the impact depends on the variant. However, the risk of another outbreak and/or pandemic is low,” says former Director of Public Health Dr K Kolandaisamy.

He advised senior citizens and people with comorbid conditions to avoid enclosed places. “The hospital-acquired infections can be prevented by avoiding unnecessary hospital visits. Handwashing before and after hospital visits and use of masks is important. This prevents the unnecessary spread,” he added.

Dr Kolandaisamy emphasised on the need for isolation even in case of flu-like symptoms. “It’s important to self-isolate and avoid schools or offices. We have adequate availability of drugs, infrastructure and human resources to handle a surge. We’ve seen three waves and the right system for treatment and management of cases of COVID-19 is in place,” he explained.

Advancement in vaccines

Public health experts recall the influenza pandemic and how it has become normal to live with it. A major surge of H1N1 was reported in 2009 and Tamil Nadu continues to get cases of H1N1.

Dr R Madhumitha, senior consultant, Infectious Diseases and Infection Control at MGM Healthcare, said, “More number of advanced vaccinations will be developed for COVID-19 in the future. We do not have a monovalent vaccine for influenza and it changes over the years. Currently, there are only mild infections and there is timely recovery among patients. It’s possible that the mass spread would dip in the future.”

She pointed out the weakening immunity with age, which is why people with comorbidities may need booster doses. “If there are changes in the variant, there can be a change in the types of vaccines that can evolve in the future as well,” stated Dr Madhumitha.

Document, research

Virologists said that the spread of COVID would most likely become similar to the influenza trend soon.

“Variants besides Omicron kept diminishing over time and the cases reduced. Omicron is most likely to be the endemic variant in the future. Its sub-variants keep surfacing, unless there is a new variant that takes over,” pointed out senior virologist Jacob John. “Vaccination and immunity from previous infection is not robust enough to prevent a recurrence but the risk of infection is low.”

The data suggested several factors such as comorbid conditions that were responsible for the fatalities during the COVID wave. Tamil Nadu has not reported any recent COVID-induced deaths.

“Symptomatic cases have reduced since the last wave. Now the cases are fairly steady and showing a slight up-tick. It’s high in Kerala because of rampant testing by the health authorities,” he added.

Health experts claimed that JN.1 was not the dominant variant yet but it could become over time because of the ability to spread quickly. “There needs to be systematic documentation to understand the impact and how the nature of the virus progresses in the long run. This needs to be done for all kinds of illnesses to prevent outbreaks in the future. We need to define a mark to ensure that the numbers do not cross a certain specific margin. We should be more vigilant if there is a surge beyond that,” added Dr John.

‘Surge during winter months due to low immunity levels’

Ever since COVID began its impact in 2019, the cases spike during the winter months each year. The flu-like patterns that shoot up in winter suggest that a certain temperature and environmental factors hasten the risk of transmission. Let’s not forget that the surge in cases of Omicron in 2023 and Delta in 2021 during the winter.

Dr S Chandrashekhar, HoD-General Medicine, Stanley Medical College, explained, “It’s not different from other flu-like illnesses. When the temperatures dip, immunity levels of certain age groups lowers as well, and the replication of the virus becomes easier, and it spreads quickly.”

The acquired immunity and vaccinations have helped to prevent severity of cases but there can be an annual surge due to certain environmental factors. “However, several such viruses become locally endemic and we can expect the same with COVID-19 too,” he added.