Bring genomic sequencing into the pandemic fight
Why in News
If there is one tool in the COVID 19 pandemic response, which India has been slow in adoption and has used suboptimally, it is genome sequencing.
Background
- Effective COVID-19 pandemic response requires, inter alia, keeping track of emerging variants and then conducting further studies about their transmissibility, immune escape and potential to cause severe disease.
- Therefore, genomic sequencing becomes one of the first steps in this important process.
- Success of the United States and the United Kingdom in containing the virus is discussed, a lot of credit is being given to the increasing vaccination coverage; however, it is often forgotten that alongside, these countries have scaled up genomic sequencing, tracked the emerging variants and used that evidence for timely actions.
- India seems to be faltering on both expanding vaccination coverage and genomic sequencing.
- Though the procedural steps such as setting up the Indian SARS-CoV2 Genomic Consortia, or INSACOG have been taken, the sequencing has remained at a very low level of a few thousand cases only.
- We understand the Delta variant far less than the Alpha variant reported just a month before Delta.
- The challenge of insufficient genomic sequencing is further compounded by the pace at which data is being shared.
The Delta strains
- Release of findings of the Council of Scientific and Industrial Research-Institute of Genomics; Integrative Biology and National Centre for Disease Control and Academy of Scientific and Innovative Research study; tracking variants of SARS CoV-2 in Delhi, is a welcome change and provides new insights.
- The Delta variant became the most circulating variant in Delhi and was found in nearly 60% of the samples analyzed; is 50% more transmissible than the Alpha variant.
- Based upon these findings, the authors attribute the in April-May 2021.
- Public Health England (PHE) reported that the Delta variant has become the most common circulating strain in the U.K., replacing Alpha.
- Lancet published research findings from laboratory studies which examined the neutralizing capacity of antibodies from individuals vaccinated with two doses of Pfizer-BioNTech, which was nearly 5.8-fold lower against Delta variants and 2.6-fold less against the Alpha variant, when compared with the ancestor virus.
- Emerging variants — with early evidence of higher transmissibility, immune escape and breakthrough infections — demand continuous re-thinking and re-strategizing of the pandemic response by every country.
- Scientific research would make a difference only if it results in informed policy decisions.
The steps ahead
- India needs to scale up genomic sequencing, across all States. There should be sufficient and representative samples collected for genomic sequencing to track district-level trends in circulating variants.
- National-level analysis of collated genomic sequencing data should be done on a regular basis and findings shared publicly.
- Indian government needs to invest and support more scientific and operational research on vaccine effectiveness.
- The data should be analyzed on a regular basis and should include various stratifies such as age, gender and comorbid conditions, etc.
- The data from genomic sequencing has both policy and operational implications.
- The State and district officials should engage the epidemiologists in coming up with practical and operational implications and strategies.
- We should aim for far stricter adherence to COVID appropriate behaviour, in public places.
Use evidence for actions
- Continuation of many unproven and ineffective therapies in COVID-19 treatment guidelines is proof that India is not quick in adopting evidence to the practice.
- There is a need for rapidly expanding genomic sequencing, sharing related data in a timely and transparent manner, and understanding of the impact of new variants on transmissibility, severity and vaccine effectiveness.
Conclusion
- The only assured way to fight the pandemic is to use scientific evidence to decide policies, modify strategies and take corrective actions. As India prepares for the third wave, increasing genomic sequencing and use of scientific evidence for decision making are not a choice but an absolute essential.