Chandrakant Lahariya | New variant of Covid-19, JN.1, is here, but no need to panic…

Nearly four years since the reporting of the first case of SARS CoV2 -- the virus which causes Covid-19 – it is in the news again. This time, a new sub-variant of SARS CoV2, JN.1, is grabbing headlines. The JN.1 sub-variant has been reported from multiple countries and has been declared a “variant of interest” (VoI) by the World Health Organisation. Meetings at high levels in governments have started and a few states have issued masks-related advisories. This is causing some concern and worry. Should we worry or not? Shall we go ahead with planned holidays or cancel? Is a new Covid-19 wave coming? Do we need additional shots of Covid-19 vaccines? These are the questions many people are asking.

First, while Covid-19 is over as a pandemic, the SARS CoV2 virus hasn’t gone anywhere. It is circulating in all countries and all settings. Once a virus is reported in any setting, usually it keeps circulating for long. The genetic structure of circulating viruses -- especially of respiratory viruses -- keeps changing. These are called mutations in scientific language.

These changes in genetic structure (genome) are classified as new variants and sub-variants. There have been many variants and sub-variants, and every change does not matter. However, if mutations or genetic changes result in alternation in the characteristics of the virus, such as higher transmission, more severe disease or immune escape from vaccine induced or natural immunity, it merits attention.

First, people are getting worried because JN.1 has been designated as a “variant of interest” by WHO. However, this doesn’t automatically mean we should worry about it.  VoI simply means that there are some characteristics in circulating viruses, which need to be monitored by the health agencies and the government to track the mutations, and keep tracking for additional characteristics like clinical outcome and immune escape. Till now, there is no evidence that JN.1 causes more severe disease or causes immune escape, and thus isn’t a reason for worry for citizens.

Second, JN.1 is not a new virus but a sub-variant of BA.86, which itself is a subvariant of the Omicron variant of SARS CoV2. It is four years since SARS CoV2 was first reported. Most people in India, including children, have been exposed to the virus in this period around two to three times, and most adults in India have received at least two shots of the Covid-19 vaccines. Current scientific evidence supports that vaccines and natural infection continue to provide protection from any sub-variant; therefore, this is another reason not to worry. This is also a reason that currently no additional shot of Covid-19 vaccines for any age group is recommended.

Third, the reported rise in number of cases of Covid-19 is more artificial than real. Covid-19 testing in last many months has come down. Now, with the JN.1 variant being reported, testing is being ramped up. Thus, the increase in Covid-19 confirmed cases is proportional to the increase in the testing. Then, some deaths are attributed to Covid-19; however, those are not causally linked to SARS CoV2 but happens to be in individuals who happen to be sick and also had Covid-19.

Fourth, there is a possible scenario where reported Covid-19 cases may slightly increase in the coming days, as had happened in April 2023 when daily cases had spiked. However, for most circulating respiratory viruses including SARS CoV2, mere transmission or increase in cases is not an immediate concern. Whether those infections lead to a spike in hospitalisations remains the concern.  Currently, SARS CoV2 infections don’t appear to change the clinical outcome in any age groups.

Fifth, there might be some additional precaution needed if a new variant of concern (VoC) of SARS CoV2 emerges. In the last four years, there have been five variants of concern of SARS CoV2. The last variant of concern was Omicron, which was first reported in November 2021. It has been more than two years since then and all of us -- epidemiologically speaking -- have been exposed to the Omicron. Therefore, a sub-variant of Omicron JN.1 is unlikely to cause a fresh wave.

In short, a slight uptick in cases may happen, even that will be artificial because of increased testing. A fresh wave of Covid-19 is not coming. In fact, we are already in a stage where we should become accustomed to hearing about new variants and sub-variants and slight upticks once in a while.

How should we respond to the current news? If you have planned any travel, go ahead, and there is no need to change your New Year plans. Yes, if anyone has a cough, cold or flu-like illness, simply follow good respiratory etiquette: wear masks in public places, cover your nose and mouth when coughing or sneezing and handwashing, irrespective of whether it is a type of SARS CoV2 or any other respiratory illness. The air pollution in some cities is a bigger health concern than the SARS CoV2 at present. It is time we continue to treat SARS CoV2 or Covid-19 just like any other respiratory illness.

There is no need for additional Covid-19 vaccine shots, but the children should receive routine childhood vaccines (children younger than 12 years -- in India -- are not recommended for Covid-19 vaccines) and adults with any comorbidity should get recommended vaccines such as flu vaccine shots. People with pre-existing illnesses such as respiratory illnesses, kidney diseases, liver diseases, diabetes and heart diseases, should get regular treatment. We need to learn from our experience of the last four years and should act responsibly and not to share unverified social media messages or forwards. We all need to act responsibly.