HomeTech PRVirus Variant in India Might Be More Infectious, W.H.O. Warns

Virus Variant in India Might Be More Infectious, W.H.O. Warns

Medical workers tending to a coronavirus patient in an emergency room in New Delhi last week.
Credit…Adnan Abidi/Reuters

A virus variant that has been spreading rapidly in India and designated a variant of concern by the World Health Organization might be more contagious than most versions of the coronavirus, the U.N. agency said in a report it published on Tuesday evening.

The W.H.O. emphasized in its report that it wasn’t yet clear how much the variant, known as B.1.617, had contributed to the devastating surge that has crushed India in recent weeks. It cautioned that India, like many countries, is only sequencing a tiny fraction of positive samples, and that with so little surveillance, it’s difficult to make firm conclusions about B.1.617.

The W.H.O. study comes amid growing condemnation of the Indian government’s response to its ferocious virus wave and calls for nationwide restrictions to try to limit the death toll, as hospitals are overrun and crematories burn nonstop.

India recorded more than 360,000 new cases on Wednesday and more than 4,200 deaths, the country’s highest daily death toll since the pandemic began. India has now reported more than 250,000 deaths from the virus, although experts believe that the true toll is far higher.

Experts also caution that it is not yet clear just how much of a factor B.1.617 has played in the explosion of cases in India. They point to a perfect storm of public health blunders, such as permitting enormous political rallies and religious festivals in recent months. It’s possible that the variant is being lifted up by the surge, rather than the other way around.

The W.H.O. speculated that another variant known as B.1.1.7, first identified in Britain and now dominant in the United States, might also be driving the swell in cases.

It’s not yet clear whether B.1.617 causes more severe Covid-19. Anecdotally, doctors in India are reporting higher numbers of young people and children testing positive for the virus and more patients with severe disease requiring oxygen support. But until more genetic sequencing is done, it’s impossible to know if the variant is to blame.

Stacia Wyman, a genomics scientist at the University of California, Berkeley, said that the W.H.O. had made the right decision. She pointed to the fact that the variant had already spread to at least 49 countries. “This appears to be posing the biggest threat right now in terms of transmissibility, with many countries reporting increasing trajectories of the B.1.617 variant,” she said.

B.1.617 is the fourth variant of concern recognized by the W.H.O. The others include B.1.1.7; B.1.351, which swept through South Africa; and P.1, which has devastated Brazil.

B.1.617 first came to light in October 2020. It had a number of mutations, some of which have been proved worrisome in other variants. Preliminary studies on the mutations suggest that some of them might give the coronavirus a tighter grip on cells, increasing their chances of a successful infection.

Other mutations could make it more difficult for antibodies produced by infections with other variants to stick to them. Studies on antibodies produced by vaccinated people also suggest that they work less successfully against B.1.617. Experts expect that most vaccines will remain effective against the variant.

W.H.O. researchers determined that B.1.617 is spreading fast in India, making up over 28 percent of samples from positive tests. The shift suggests that B.1.617 has a higher growth rate than other variants circulating in India, with the possible exception of B.1.1.7. And B.1.617 has been growing rapidly in Britain.

Gagandeep Kang, a pre-eminent Indian virologist, said there was not enough data to conclude whether either variant was contributing to India’s deadlier second wave.

“There is some conflicting data regarding the B.1.1.7 variant, which seems to indicate in some studies that it does cause more severe disease, in other studies not,” said Dr. Kang, the executive director of the Translational Health Science and Technology Institute in India.

Based on reports from hospitals, Dr. Kang said, it appeared that B.1.617 was causing more severe disease but that, again, there was insufficient data to draw conclusions. She said that real-time genetic information would be needed to determine whether B.1.617-infected people needed more oxygen.

Officials in India are trying to track how many fully vaccinated people have fallen ill. If an unusual number of these so-called breakthroughs are caused by a variant such as B.1.617, then that could point to the variant’s ability to evade a vaccine.

Governor Henry McMaster of South Carolina signing a bill on April 22 requiring schools to provide in-person classes five days a week starting on April 26, in Columbia, S.C. 
Credit…Jeffrey Collins/Associated Press

Parents in South Carolina will be able to opt their children out of mask requirements in public schools, effectively ending mask mandates for schools throughout the state, according to an executive order signed by the governor that defies Centers for Disease Control and Protection guidance.

The order signed on Tuesday by Gov. Henry McMaster, a Republican, also prevented South Carolina’s local governments from using previously issued orders or states of emergency to enforce mask mandates and barred the use of “vaccine passports” in the state. South Carolina was one of several states that never had a statewide mask mandate, though several counties and cities imposed their own.

At least one school district said its legal counsel was reviewing the order. Doing away with masks in schools conflicts with C.D.C. guidance, which recommends universal masking combined with at least three feet of social distancing.

“Everybody knows what we need to do to stay safe — including wearing a mask if you’re at risk of exposing others — but we must move past the time of governments dictating when and where South Carolinians are required to wear a mask,” Mr. McMaster said in a statement, noting the availability of vaccines and falling coronavirus cases. “Maintaining the status quo ignores all of the great progress we’ve made.”

Mr. McHenry’s announcement comes as leaders in other states and cities have announced a rollback of restrictions and vaccines have become available to any adult. Mayor Muriel Bowser of Washington said on Monday that most of the city’s restrictions, including capacity limits, time restrictions and limits on types of activities would be lifted on May 21. Capacity limits on bars, nightclubs, and large sports and entertainment venues would be lifted June 11.

Mayor Jim Kenney of Philadelphia announced on Tuesday that all restrictions except the mask mandate would be lifted on June 11. The announcement came a week after Governor Tom Wolfe of Pennsylvania said that all restrictions related to gatherings, businesses and restaurants would be lifted on May 31 and that the statewide mask mandate would be lifted when 70 percent of adults in the state had been vaccinated. But the announcement came with the caveat that municipalities and school districts could continue or implement stricter mitigation efforts, despite the state’s easing restrictions.

The governor directed the Department of Health and Environmental Control and the Department of Education to develop a standardized form for opting out, the statement said.

Unloading an oxygen cylinder as a patient lay outside the emergency ward of a hospital in Kathmandu, Nepal, on Monday.
Credit…Niranjan Shrestha/Associated Press

As hospitals in Nepal strain to cope with one of the world’s fastest-growing coronavirus outbreaks, relief groups in the Himalayan nation are asking mountain climbers to hand over their used oxygen cylinders so that they can be refilled for Covid-19 patients.

The unusual appeal reflects the strange duality in Nepal: While hundreds of foreign climbers are attempting costly expeditions to the summits of Mount Everest and other peaks, the impoverished nation down below is facing urgent shortages of hospital beds, medical oxygen, coronavirus test kits and other supplies.

Expedition operators are preparing to airlift thousands of cylinders from the Himalayas as expeditions are completed this month, the culmination of the climbing season. Kul Bahadur Gurung, general secretary of the Nepal Mountaineering Association, estimated that tour companies would be able to provide at least 4,000 cylinders by the first week of June.

“We are asking them not to leave even a single oxygen cylinder in the mountains,” Mr. Gurung said.

Climbers attempting to reach the top of Everest, the world’s tallest peak, and other mountains carry oxygen to help them breathe in the thin air. Although Nepal prohibits leaving equipment behind in the mountains, canisters are sometimes left buried in the snow by exhausted climbers or stashed by expedition companies for later use.

Cylinders used in mountaineering are smaller to those typically found in intensive-care wards, but Mahabir Pun, a prominent Nepali scientist who is helping to lead the cylinder drive, said that they could be used by patients who cannot find a hospital bed or who are being treated at home.

“I.C.U. beds are already filled with critical Covid patients, so we want to distribute these portable expedition cylinders with regulators for those patients staying in home isolation,” Mr. Pun said.

Nepal’s outbreak has surged in recent weeks, most likely fueled by the virus’s catastrophic surge in India, with which it shares a long, porous border. On May 1, Nepal reported 26 deaths from the virus. On Tuesday, the official death toll was 225.

Doctors say that a shortage of medical oxygen is a factor in many of the deaths. Many hospitals have stopped admitting new Covid-19 patients, citing a lack of oxygen. Wealthy families are airlifting their loved ones by chartered helicopter to cities where they can find intensive-care beds. Other patients are being treated in makeshift emergency facilities set up in parking lots and other open spaces.

With almost half of Nepal’s coronavirus tests coming back positive, health experts warn that the worst is yet to come.

China has pledged to provide Nepal with 20,000 oxygen cylinders and 100 ventilators, the first batch of which arrived on Tuesday.

Expedition companies are stepping in with smaller donations. Mr. Gurung’s group said that he was sending five dozen cylinders, along with a few more from a local mountaineering museum, to hospitals treating coronavirus patients.

Mingma Sherpa, chairman of Seven Summit Treks, Nepal’s largest expeditions operator, said that he planned to ship as many as 500 cylinders used in expeditions to Everest and other peaks soon after climbers descended to base camps.

“My only condition is that those cylinders should be used for poor and helpless people rather than V.I.P.s,” he said, adding: “It’s our responsibility to help the government during these trying times. We will do it happily.”

Marisol Gerardo, 9, is held by her mother as she gets a second dose of the Pfizer vaccine during a clinical trial for children at Duke Health in Durham, N.C., in April.
Credit…Shawn Rocco/Duke Health, via Reuters

On May 4, Dr. Hina Talib, who goes by the handle @teenhealthdoc on Instagram, asked the parents among her 33,000 followers if they were hesitant to get the coronavirus vaccine for their 12- to 15-year-olds, and if so, why. Dr. Talib, a physician in the adolescent medicine division at the Children’s Hospital at Montefiore in New York, got 600 messages in response.

More often than not, Dr. Talib said, the parents had already had the Covid-19 vaccine, and would preface their message with: “I’m not an anti-vaxxer or an anti-masker. I’m just worried.”

Although trials have shown no serious safety concerns for children thus far, some recent polls show that only about 30 percent of parents nationwide say they would get their children vaccinated right away. Parents of infants and preschoolers expressed even more anxiety about the vaccine than parents of teenagers.

These parents tend to be concerned about the vaccine affecting puberty and future fertility for their children, and its possible impact on allergies and side effects. Their fears are a key hurdle for U.S. efforts to expand vaccinations to younger teens.

Aurora Duran, 86, is hugged by her granddaughter during a visit from her family at a long-term-care nursing community in Fort Stockton, Tex.. in April.
Credit…Tamir Kalifa for The New York Times

Epidemiologists are starting to hug again, running errands, gathering outdoors with friends and getting haircuts.

In a new informal survey this month by The New York Times, 723 epidemiologists responded to questions about how they were navigating this in-between phase of the pandemic, when vaccines have become widespread and cases are declining but herd immunity is not assured and Covid-19 remains a threat.

More than at any time in the past year, most are feeling hopeful that Covid-19 will eventually become just another risk in daily life, but not one that paralyzes us.

Nevertheless, their advice was to hold on to most precautions just a bit longer.

“There is a strong likelihood that we will experience unexpected problems due to moving about as if the Covid pandemic was no longer a threat,” said Jana Mossey, an epidemiologist who retired from Drexel University.

“It is not ‘one size fits all,’” said Alicia Riley, a sociologist and epidemiologist at the University of California, San Francisco, expressing a version of the profession’s unofficial motto: It depends. “How safe it is depends on the local levels of community transmission.”

Buying protective face masks following a small outbreak of coronavirus disease in Taipei, Taiwan, on Wednesday.
Credit…Ann Wang/Reuters

Growing concerns in Taiwan about a small but worsening coronavirus outbreak drove a sharp intraday plunge in its stock market on Wednesday, as investors worried about new government restrictions on businesses in a place that has largely escaped the pandemic.

On Wednesday morning, Taiwan’s health minister, Chen Shih-chung, said that the island’s new outbreak has reached a “very severe stage” and that restrictions could be upgraded in “the coming days.” He spoke after the government reported 16 new cases on Wednesday and seven on Tuesday.

The Taiwan Stock Exchange weighted index slumped as much as 8.6 percent intraday following the news, a nearly 13 percent loss from its April peak. The market regained some ground later in the day and finished down 4.1 percent.

Taiwan has been a rare success story in a pandemic-stricken world. The island democracy threw up its borders when the pandemic first began to spread from mainland China and has heavily limited travel. It has recorded only 1,210 total cases, according to a tally by The New York Times.

But the authorities haven’t been able to trace the handful of cases that have popped up in recent days, raising questions about whether the government will limit the number of people who can gather within restaurants or other businesses.

Taiwan instituted some Covid-related restrictions on Tuesday, the first in a long time. It suspended large events, limiting outdoor gatherings to 500 people and indoor gatherings to 100 people. On Wednesday morning, the health minister said that the restrictions might be stiffened within days.

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