The New Variant – The Emergence

All viruses in general go through mutations constantly. That is, their genetic code keeps changing and each significant change or mutation is called a variant. Further, each variant goes through additional mutations which are called sub-variants. Each variant or sub-variant has the ability to infect a person based on the immune system response. The immune system also needs some time to recognize a variant in the body and produce the desired antibodies to fight that.

Ever since its emergence in Sep 2019, the Sars Cov2 or Covid-19 virus has undergone thousands of mutations leading to innumerable variants and sub-variants. Of these, the most significant Variants of Concern (VOC) have been alpha, beta, delta and omicron. Each of these are actually a family of variants, and needless to say, they have their own sub-variants too. The latest variant in the news – BF7 – is a sub-variant or branch of the BA.5, which is one of the Omicron variants.

BF7 or B71 is the shorter name given to the variant BA.5.2.1.7 of Omicron. It first emerged in China in September 2022, and thereafter has been detected in Japan, South Korea, South Africa, US, Denmark, Brazil and India too. India has seen 4 cases so far (as of Dec 23, 2022), in the states of Gujarat and Odisha. It has created an epidemic-like situation in China, which has caused concern to millions of Indians monitoring the developments.

Also Read: All about the new mutant strain of Covid-19 virus

Symptoms and the Protocol

Symptoms of BF7 infection are very similar to that of earlier variants and sub-variants. There is no striking symptom that sets BF7 apart from earlier variants/sub-variants. This includes:

• Cold
• Cough
• Fever
• Sore throat
• Fatigue
• Runny nose
• Diarrhoea
• Vomiting

BF7 has a short incubation period. That is, infection happens, and symptoms show up – quickly. Further, the virus has a very high, or dominant transmissibility rate compared to other variants. While one person infected with the Omicron variant could infect 5 people around him/her, a person infected with BF7 subvariant can infect 16 people. This point alone, combined with the current situation in China, is what is causing concern. However, as elaborated in below sections, there is no need for concern or panic in India. One should just be aware of the virus and developments happening, through news sources. And, every one should follow Covid-appropriate protocol:

1. First and foremost – hand hygiene. We should wash our hands after touching any surface that could possibly be infected by droplets from one or more humans in the vicinity.
2. When one is in a crowded public or private place (as in family gatherings), one should wear a mask all the time. And keep a distance of 3 to 6 feet from people around.
3. If you have any signs of infection like fever, sore-throat and cold, please do not venture into public places, as that will spread the infection to others. You can undergo home-isolation, without waiting for others to give you solutions.
4. Finally and most important – If you have not taken the vaccine already, you must do so immediately. Further, those who are eligible for a booster dose (elderly, people with weak immune-system and people with pre-existing ailments or ‘co-morbidities’), must take the booster dose at the earliest.

Also Read: The Kauvery “smart” guide to “Fighting COVID with Confidence”

Impact in India vs the rest of the World

BF7 in China

News channels and journals are full of data on the Covid situation in China. As of 20th December 2022, there were 5241 deaths due to Covid (all variants, with majority being BF7) and these are official figures only. Unofficial figures could be much higher. So why is the new variant causing an epidemic situation there? There are multiple reasons for this:

1. Lockdowns: The Chinese Govt has adopted a policy of mandatory lockdown, forced lockdown and aggressive lockdown. Infected people are locked up in homes and not allowed to step outside. The downside of this is that, the virus is confined within the homes of infected people. The population outside is not exposed to the variant, so there is no possibility of their immune systems learning how to fight the variant, so people are denied the chance to develop herd immunity against it.
2. Vaccine efficacy: None of the 4 or 5 vaccines promoted by the Govt have been found to be effective in battling any variant of Sars Cov-2. As a result, there is enormous vaccine hesitancy in people.
3. Booster doses: The downside of vaccine hesitancy is that people are not voluntarily taking the 3rd booster dose (although the Govt is pushing for 4th and 5th doses as well). According to a report in Nature journal, out of 260 million people who are 60 years or older in China, only 70% in the age-group of 60-80 years and 40% in the age-group of 80+ years, have received a third dose.

BF7 in India

In contrast, India has done much better than its neighbour or rest of the world. The reasons being:

1. Hybrid immunity: BF7 is a sub-variant of the Omicron variant. While Omicron has been around for a year already, the new variant BF7 has been in circulation since July 2022. So, both vaccinated and unvaccinated people have been exposed to the virus. While the unvaccinated would have developed symptoms listed above, the vaccinated would have shown mild to no symptoms. Indians and Indian society in general have shown hybrid immunity. Where-in, the vaccine as well as exposure to the variants have helped Indians develop immunity against one or more variants.
2. Herd immunity: A large population of Indians have received double dose of the Covid vaccines. And many people who are eligible for the booster dose have received this as well.
3. Vaccine efficacy: Both the vaccine choices mandated by the Indian govt – Covaxin and CoviShield have been very effective in fighting the Covid virus and variants successfully. The booster dose has also been found to be effective. Further, the Govt has added another vaccine in to the mix, which is Bharat Biotech’s nasal drops. This has been added to the CoWIN portal for administration to those above 18 years of age. All this has helped India prepare better for the battle against Sars-Cov-2.

BF7 in Rest of the world

The rest of the world has fared somewhere between India and China. US, UK, Germany, France, Belgium, Denmark and some other countries have reported cases of BF7 infection. In October 2022, 5% and 7.26% of all Covid infections in the US and UK respectively were due to BF7. While there is not much data about number of deaths due to BF7 in the western world, all countries are on an alert.

Also Read: Monoclonal Antibodies and Covid-19 Treatment

Vaccination

Vaccination has been, by far, the most effective preventive measure against the Covid-19 virus and multiple variants including BF7. Unlike China where vaccination was forced, in India, people were encouraged to get vaccinated, with Industry also mandating vaccination for employees, vendors, partners and contractors. The elderly, people with weak immune systems and those with co-morbidities are all eligible for a booster dose and many have received them. If you or any of your near and dear ones have not received both doses of the vaccine, or the booster dose, please get the shot immediately. You can safeguard yourself and your family this way. The vaccine + booster will not only help fight BF7 effectively but also newer variants that will come up in the future.

Cause of Concern?

The World Health Organization is the overarching body in the world that tracks the emergence and spread of any virus or variant. The WHO then designates some of the variants as Variant of Concern (VOC), Variant of Interest (VOI) and Variant under Monitoring (VUM) based on a set of parameters. All other variants and sub-variants are regarded as minor or insignificant variant/sub-variant.

The WHO has not designated BF7 as a Virus of Concern (VOC), so there is no cause for panic in India. While it has caused a major outbreak in China since it was first detected in September 2022, it has not caused any outbreak in India, although its been in circulation since July 2022. The vaccine is surely keeping Indians safe. But its not advisable to get complacent. Covid-appropriate behaviour should become the new normal for Indians, as only that will protect us from newer and newer variants of Sars-Cov-2 virus that will keep emerging.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem and Bengaluru, the hospital also renders adult and pediatric trauma care.

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