80-yr-old is Maharashtra’s first Delta plus victim

An 80-year-old woman from Ratnagiri became the first Covid-19 patient with Delta plus variant (AY

An 80-year-old woman from Ratnagiri became the first Covid-19 patient with Delta plus variant (AY.1) to succumb to the infection in the state. The senior citizen died on June 13 and her genome sequencing report, which identified her as infected with AY.1, was submitted to the state health department on June 20. Health experts have raised concerns over the delay in submission of genome sequencing reports, which is critical for early detection of Covid-19 variants.

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The Delta plus variant is a mutation of the highly transmissible Delta variant (B.1.617.2) of Sars-CoV-2 that was detected in Maharashtra during the second wave. The union health ministry on Tuesday categorised the Delta-plus variant of Covid-19, as a ‘variant of concern’.

The octogenarian patient along with her son contracted Covid-19 in the last week of May. She

was admitted to the district civil hospital on May 31 on testing positive. The deceased individual was a psychiatry patient who was also undergoing treatment at the civil hospital at Ratnagiri. Later, she was referred to a dedicated care hospital, where she was undergoing treatment for Covid-19 treatment in a separate psychiatric department.

“The patient died before we could get her genome sequencing report. She was declared dead on June 13 and her report that confirmed the presence of Delta-plus was submitted on June 20,” said Dr Sanghamitra Gawde, civil surgeon of Ratnagiri.

Dr Archana Patil, Maharashtra director of health service said that they are still collecting information about the deceased patient including if she had Covid-19 vaccines.

Following this, the state health department has instructed district officials to keep an eye on the remaining 20 recovered patients. As per the state health ministry, a total 21 number of Delta-plus variant cases have been found in the state. At Ratnagiri, nine samples were identified with the Delta-plus variant— the highest in the state, followed by Jalgaon, Mumbai, Palghar, Thane and Sindhudurg districts.

Concerns

This is not the first case where the genome sequencing reports of a Covid-19 positive patient have been submitted late. A 78-year-old female from the eastern suburb of Mumbai contracted Covid-19 along with her eight family members in April. Her blood samples were collected in the third week of April for genome sequencing. But the report was submitted to the Brihanmumbai Municipal Corporation (BMC) only on June 22. She was the first Covid-19 patient diagnosed with the Delta-plus variant in the city.

“The patient and her family members have recovered completely. But considering the samples were sent in April when the pandemic curve was at its peak, it was essential to submit the report at the earliest. It would have helped us to understand how transmissible the Delta-plus is and how much it contributed in the second wave,” said a senior officer from BMC’s health department.

Public health experts and doctors said sequencing and early detection of new variants are needed. It could provide essential information that can help in better planning of anti-Covid containment plans.

Suresh Kakani, additional municipal commissioner, BMC, had raised a similar issue. That’s when they decided to start genome sequencing in the civic-run Kasturba Hospital. “On a daily basis, we sent samples for genome sequencing through random selections. But often, the reports come after 20-30 days. So, to avoid such delays, we sought permission from the central government to start genome sequencing at Kasturba Hospital which will help us in getting the reports within days,” he said.

In view of the rise in infections across the state in March-April, the state in April signed a memorandum of understanding (MoU) with the Council of Scientific and Industrial Research-Institute of Genomics and Integrative Biology (CSIR-IGIB) to undertake genome sequencing of 4,000 positive swab samples.

Some private laboratories said they should also be allowed to do genome sequencing that may help in producing data in bulk which would help in providing information about mutation of the virus, possibly adaptation to the available vaccines, and the epidemiological characteristics of the new variants that are travelling across geographies.

“We have known how the Delta variant of Sars-Cov-2 was more transmissible that contributed to the sharp rise in Covid-19 cases across the country. So we need to generate data in bulk and share in real time to understand how it is influencing the spread of the virus among the population,” said a senior officer from a private laboratory in Mumbai.

As per the report submitted by the central government on Friday, a total of 45,000 samples have been sequenced in India. Of these, 48 of them have been found positive of Delta-Plus variant, 20 of them are from Maharashtra.