Omicron: What we know so far

Come Monday, India will enter its third week since the Omicron variant began pushing up cases, led by hotspot regions of Delhi and Mumbai. After a rise in infections in both cities, the optimistic presumption of the variant appears to have been borne out: The medical care infrastructure is unlikely to be overwhelmed as long as timely reinforcements are made and infection-control measures are put in place. Both cities have growing amounts of data on who is more likely to have severe disease, how the variant sickens those with one, two or no vaccine shots, and the critical comorbid diseases that could put people at risk of death.

Some of this data has been consistent with global experiences. For instance, in Delhi, close to 75% of the deaths were in unvaccinated people, and having two doses significantly lowered the odds of death. The state’s health minister also said that the death audit committee’s analyses showed most deaths were in those who came to a facility due to some other critical illness. This echoes the higher rate of deaths in unvaccinated people and the “incidental diagnosis” seen in other parts of the world. But Delhi showed other trends too: Almost 60% of the deaths occurred within 48 hours of admission, and almost all fatalities suffered from critical comorbidities instead of diabetes or hypertension — two diseases seen as big Covid-19 risk factors, but may now not be playing as big a role. A small subgroup analysis showed kidney disease might be a significant hazard.

These are still early trends, highlighting a crucial gap in India’s Covid-19 management: The lack of minute data. Authorities in Delhi and Mumbai have shared these analyses sporadically, releasing information in their own formats. But even these have not included data on how long ago the hospitalised or the deceased got their doses — information that could be critical to understanding the effect of vaccine waning. Outside of these two metropolises, the information gap worsens with hardly any data on comorbid conditions, age and gender distribution, vaccination status, and symptoms of serious cases. Understanding who needs what type of care will help determine who should be shielded the most. Without these, the scientific understanding of Covid-19 is incomplete. The government should consider a unified portal for states to feed data in a standardised format. This will be crucial in keeping India, as the prime minister implored on Thursday, ready for any variant.

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