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What is happening in China? Lockdown in India again?

Many countries relaxed covid curfews and started opening borders for international tourism assuming that the covid pandemic that started in 2019 come under control.

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Meanwhile, news that China is experiencing countless deaths as the Covid virus is rampant, started flooding in. What is happening in China? Did the BF.7 sub-variant originate from China? Countries around the world are starting to come up with strict rules again. Is BF.7 so dangerous?

Why Corona again in China?

At the end of 2019, after the celebrations of New Year in China, the first case of corona infection was confirmed in the city of Wuhan. Then in March 2020, the World Health Center declared Covid-19 a global pandemic after the number of cases in countries other than China rose 13-fold (1). After that, countries across the world made serious efforts to bring the disease under control through approaches such as lockdown, preparing hospitals, and “tracking, testing, treating”. But China has implemented a strict control system called Zero COVID policy to eliminate the coronavirus completely.

With zero COVID policy, the Chinese government engaged in severe lockdown, social quarantine, and human rights violations. Many times people who test negative are also taken to quarantine facilities, and children are separated from their parents. And even though only a few people in the city were diagnosed with the disease, a lockdown was announced for the entire city.

Countries around the world eased restrictions after vaccinations but China has not relaxed its Zero COVID policy for the past three years (2, 3). Following this, the people who were under the strict government for a long time started protesting against the human rights violations and the economic crisis that occurred due to the Zero COVID policy (4).

Nationwide Protest of Chinese People Against Chinese Government’s Covid-19 Restrictions (5)

In this case, the Chinese government announced at the beginning of this December that it would relax its restrictions. In addition to easing Covid testing and travel restrictions, the Chinese government has also announced for the first time that patients with mild symptoms will be able to self-isolate at their home rather than in quarantine facilities. Researchers have expressed concern that the sudden relaxation of restrictions will increase the impact of the disease and that millions of people in China may be affected by the disease in the coming days (6).

Modeling predictions said that if China were to lift strict restrictions now when a booster dose of the vaccine for the elderly is not properly available, and when herd immunity against Covid has not developed even after three years, 160 million to 280 million people could be affected by Omicron and 1.3 million to 2.1 million deaths to be faced. The report also stated that most of these are likely to be unvaccinated elderly people (7). The Chinese government did not take this seriously and relaxed its zero COVID policy directly without any transition stage.

The newly formed BF.7 began to spread very rapidly among the Chinese people due to the lack of a plan for people gathering together in a place to protest. As researchers predicted, China is currently in the grip of the third wave of Covid-19. Official data suggests that a maximum of 40,000 people are affected by the disease in a single day. However, China’s National Health Commission (NHC) has not released any official data on the number of Covid-19 deaths in China this December. Meanwhile, the NHC also announced last Sunday that it will stop publishing the daily number of cases (8).

Michael Ryan, Executive Director of WHO’s (World Health Organization) Health Emergencies Programme, pointed out that despite officials saying that the number of cases is “relatively low” in China, Intensive Care Units (ICU) across the country are busy. He also appealed to China for more information on the country’s Covid situation (9). Despite posts and heart-wrenching videos of intensive care units in China flooding social media, determining the severity of the disease is difficult in the absence of official data. The lack of data can also hinder predicting the spread of the disease in countries around the world.

Data from https://ourworldindata.org/coronavirus (10)

And on the one hand, the Chinese people are faced with severe political restrictions, economic crisis, and on the other hand, racist attacks in various countries due to the spread of the first wave of the SARS-CoV2 virus from China. In this situation, reports say that the BF.7 sub-variant also has evolved from China (11, 12). Portraying a single country as the source of the disease will only add a burden politically and on the people affected by the disease.

Did BF.7 originate from China?

The third wave of covid caused by the BF.7 variant in China has only started this December. But the BF.7 sub-variant has been developed as early as January 2022. It is updated in genome assembly and SARS-CoV2 genome mutation of the COVIDCG database (https://covidcg.org/?tab=report).

Data from COVIDCG

And when looking at the number and spread of BF.7 infection, it can be known that BF.7 started spreading in European countries and the United States around last June (https://nextstrain.org/ncov/open/global/6m).

It is a scientific fact that BF.7 did not originate in China based on data on disease prevalence rates and due to the high prevalence of Omicron we cannot control the emergence of new strains of CoV2 in the world. While the current BF.7 variant was also spread in European and American countries, China’s relaxation of its zero COVID policy caused excessive infection in the country, but BF.7 did not originate in China.

Is BF.7 dangerous?

While the infection of BF.7 type is increasing in China, and European countries, other countries including India have prepared themselves. Is BF.7 as dangerous as the government and people fear? What should we know about BF.7?

As far as Covid is concerned, if a new type of virus is created through genetic modification, the new type of virus will be classified as a dangerous variant of concern based on the rate of spread, the speed of spread, the severity of the disease caused by it, etc.

Based on this, the BF.7 sub-variant spread much faster than the alpha and delta sub-variants, which wreaked havoc in the first and second waves of Covid-19, respectively. On average the delta type spreads from one person to 5 people while the speed of spread of BF.7 is 18 people from one person. It is predicted that 60% of China’s population and 10% of the world’s population will be infected with Covid-19 within three months due to such rapid transmission (13).

Due to the nature of spread and the speed of spread, if we see whether this BF.7 infection will bring great destruction and deaths like the second wave that shook India, the delta type responsible for the second wave is capable of attacking the lower respiratory tract of humans, especially the lungs. Due to exposure to the delta virus, excessive damage to the lungs caused death due to lack of oxygen. A small piece of comforting news regarding Omicron and its sub-variants is that the virus most commonly infects the upper respiratory tract of humans (14). Thus, mild symptoms such as fever, sore throat, and cough are observed when the BF.7 sub-variant attacks a person with an average immune system. So unless the vaccine is received regularly and personal precautions are followed, the public will not be seriously affected.

Also, it is believed that BF.7 sub-variant will not cause severe disease due to the fact that Indians have a high level of hybrid immunity, which includes the immunity obtained through vaccination and the herd immunity obtained after being infected with the Covid disease.

People more likely to have an exacerbation of the disease:

Although exposure to the BF.7 strain in the general population is not fatal, the following individuals may develop severe disease.

  1. Unvaccinated
  2. Elderly people
  3. People suffering from other diseases like cancer, uncontrolled diabetes, heart or kidney diseases
  4. People with a weak immune system

Of the 2 million deaths predicted to be caused by BF.7 in China, most are of the above-mentioned types (6). Therefore, only when the anti-vaccination conspiracy, reluctance to vaccinate, etc. are abandoned and the vaccine and booster dose are made available to the entire society, the severity of the Covid-19 infection and deaths can be controlled.

Measures taken by the Government of India and Tamil Nadu to control BF.7

After millions of people were infected with BF.7 in China, countries all over the world started to tighten restrictions again. Prime Minister Narendra Modi on 24 December called on states and Union Territories to take appropriate measures to prevent the spread of BF.7 in India as a first step following the outbreak of the disease in neighboring countries (15). He also urged people to follow the Covid restrictions and get vaccinated as the Covid wave is not yet over (16).

Also the Union Govt. has taken the following actions:

  1. Training sessions for hospital preparedness are being conducted across the country (17).
  2. Mandatory RT-PCR test for travelers coming from abroad has been relaxed but has now been made mandatory again (18).
  3. Mandatory temperature screening for all passengers; It has been announced that 2% of passengers will be tested for Covid using random sampling (18).
  4. General public is advised to wear a face mask (18).

The Tamil Nadu government has also started taking preventive measures against the disease. In a meeting held on December 22, Tamil Nadu Chief Minister M.K.Stalin discussed ways to contain the impact of BF-7 in the state with Ma. Subramanian, Minister for Health and Family Welfare of Tamil Nadu, Chief Secretary Irai Anbu, DGP Sailendrababu, and health officials.

Since the spread of BF.7 in Tamil Nadu was already in June and July, the BF.7 strain is already being monitored by the state health ministry. And most importantly in Tamil Nadu, 97% of the population has received the first dose of the vaccine and 92% of the population has received the second dose of the vaccine (19). So the severity of BF.7 will not threaten Tamil Nadu.

And in the press conference held yesterday (28.12.2022), Ma Subramaniam said Tamil Nadu has three lakh vaccines in stock; He announced that the BF.7 sub-variant is being monitored continuously and if many restrictions are imposed when the disease is not serious, it will cause unnecessary panic among the people and restrictions can be fixed when the disease is serious.

Apart from these, if the third/fourth dose vaccines for the elderly are included, the Union and Tamil Nadu government can effectively control the BF.7 internal strain without causing any harm through measures such as monitoring the course of the disease and keeping anti-virus drugs ready.

What do we have to do?

The responsibility to control the disease is not solely that of the government. The cooperation and awareness of the public are essential for the successful functioning of the government. therefore,

  1. Vaccinate – Co-operating with the government and examining vaccination and booster doses is the greatest service we can do to the country during epidemics. Let’s act with social care, keeping in mind that not only our health is in our hands but also the health of our surroundings.
  2. Let us follow covid restrictions – continue following basic covid restrictions like personal distancing, wearing a face mask, and hand washing.
  3. NO NO to Rumors – Let’s avoid believing or sharing rumors that scare the public without knowing the truth.

Let’s hope that 2023 will be the year of recovery from covid and a healthy society through vaccination and personal control.

– Dr. Devi (Genetics)

Reference:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569573/
  2. https://www.hindustantimes.com/ht-insight/public-health/what-is-china-s-zero-covid-policy-101656065706406.html
  3. https://abcnews.go.com/Health/chinas-zero-covid-policy-back-protests-erupt-country/story?id=94086617
  4. https://www.cfr.org/blog/did-chinas-street-protests-end-harsh-covid-policies
  5. https://time.com/6238800/china-protests-reveal-about-the-country/
  6. https://www.nature.com/articles/d41586-022-04382-0
  7. https://www.nature.com/articles/d41586-022-04235-w
  8. https://www.npr.org/2022/12/25/1145472905/china-stops-publishing-daily-covid-data
  9. https://www.firstpost.com/world/who-says-chinas-hospitals-filling-up-fast-worried-about-real-impact-of-covi-11853441.html
  10. https://ourworldindata.org/coronavirus
  11. https://news.abplive.com/explainers/understanding-omicron-bf-7-the-new-covid-19-variant-from-china-and-how-india-should-prepare-1571821
  12. https://economictimes.indiatimes.com/news/india/a-made-in-china-covid-concern-for-india/articleshow/96505488.cms
  13. https://www.businesstoday.in/coronavirus/story/covid-variant-bf7-spreading-like-wildfire-in-china-how-worried-should-you-be-357236-2022-12-21
  14. https://www.livemint.com/science/news/which-covid-variant-affects-your-upper-lower-respiratory-tract-and-how-severe-it-can-get-11648113096228.html
  15. https://economictimes.indiatimes.com/news/new-updates/covid-bf-7-preparedness-in-india-all-you-need-to-know/articleshow/96497955.cms?from=mdr
  16. https://economictimes.indiatimes.com/news/india/bf-7-covid-variant-pm-modi-chairs-high-level-review-meeting-amid-surge-in-cases-in-china/videoshow/96430130.cms
  17. https://www.indiatvnews.com/news/india/covid-19-bf-7-variant-live-updates-virus-mock-drill-at-hospitals-across-states-daily-coronavirus-cases-health-minister-mansukh-mandaviya-2022-12-27-834335
  18. https://www.cntraveller.in/story/india-covid-guidelines-latest-china-bf7-airport-testing-rules/
  19. https://www.business-standard.com/article/current-affairs/covid-19-tn-health-deptt-issues-alert-against-new-omicron-variant-bf-7-122122200584_1.html

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