Rise in Delta variants, vaccine shortage main concerns amid relaxation in Maharashtra

While medical experts have described the relaxations as a ‘calibrated thought’, they are emphasising on robust mass immunisation which is lagging behind due to shortages of vials.

Even as Maharashtra government has relaxed Covid-related restrictions, officials from public health department are faced with two main concerns — rise in Delta and Delta Plus cases, and acute shortages of vaccines. Anticipating a third wave, public health experts said these two issues could contribute to aggravating Covid-19 cases.

Beneficiaries get inoculated against Covid-19 at a vaccination centre in Worli Seaface, Mumbai on Thursday. (Pratik Chorge/HT PHOTO)

While medical experts have described the relaxations as a ‘calibrated thought’, they are emphasising on robust mass immunisation which is lagging behind due to shortages of vials.

Since the start of the second wave in mid-February, the state has sent over 8,000 samples for genome sequencing to identify variants of Sars-CoV-2 — the virus that causes Covid-19. Almost 80% of the samples have tested positive for the Delta variant.

On the other hand, Delta Plus (AY.1), a mutation of the highly transmissible Delta variant (B.1.617.2), was detected in the state during the second wave. In June, the Union health ministry declared it as the variant of concern.

The number of Delta Plus variant cases increased from 21 in June to 65 in August.

At present, the positivity rate of Maharashtra stands at 2.11% which is higher than the national average of 1.34%. Six districts in the state — Beed, Pune, Sangli, Satara, Sindudhurg and Solapur — are still recording seven-day high positivity rates between 7% and 4.6% while the state’s average is 3.3%.

The Delta variant is more transmissible while the Delta Plus variant is believed to defeat vaccines and immunity against the infection. Dr Lancelot Pinto, epidemiologist and pulmonologist from Hinduja Hospital, said the Delta Plus variant, in addition to having mutations seen in the Delta variant that renders it potentially more transmissible than the Alpha variant, also possesses the K417N mutation (lysine-arginine in the spike protein).

“The concern now is that the presence of this mutation in the Delta Plus variant might render it immune to the antibodies produced by vaccine, past Covid-19 infection or new antibody cocktails used in treatment,” said Pinto. “However, this hasn’t yet been proven and might not necessarily be the case, and the rarity with which the Delta Plus variant has been reported makes it not a variant of concern yet. But we do need to be vigilant and monitor its spread closely.”

Priority should be on vaccination

Vaccine shortage across the state is hindering the immunisation process. An analysis of the data shows that in the past 11days, the number of inoculation dropped to 3,165,269 compared to 4,670,787 between July 20 and 30.

When HT inquired with peripheral civic-run hospitals, many said they do not have vials for the past two days. Dr Pratima Patil, medical superintendent of Shatabdi Hospital in Kandivli, said, “Though people are coming forward to get vaccinated, we can’t inoculate them as we don’t have the stock. We don’t know when we will get vials again.” The situation was similar with Bhagwati Hospital in Borivli and Bhabha Hospital in Kurla.

With relaxation in Covid-19 restrictions, medical experts said robust mass immunisation programme is the need of the hour which can help divert the third wave by increasing sero prevalence among citizens.

“The available vaccines in India have shown good response to the predominant variant, which is the Delta variant. Data from the United Kingdom also confirmed that Covishield offered them protection from getting severe cases and hospitalisation. So, it is essential that people take both the shots of vaccines for better immunity,” said Dr Rahul Pandit, director of critical care, Fortis Hospital, and member of state’s Covid-19 task force.

When asked if it is a reasonable idea to relax the restrictions in a state with over 140 million citizens amid rising cases of Delta variants, Pandit said “Governing bodies have put a lot of thought into this calibrated unlocking. We need to be cognisant, act as responsible citizens, and shoulder the responsibility of wearing double masks despite being vaccinated, and not host social gatherings that could turn into super spreader events. If we adhere to this, unlocking will be smooth.”