The Landscape of Omicron Globally and in India

On 26^th November 2021, World Health organization designated the variant B.1.1.529 a variant of concern named OMICRON as a new variant of COVID 19. The new variant of COVID-19 was first detected in Botswana and South Africa at Lancet Laboratories in Pretoria, South Africa. Early assessments suggest the doubling time for the Omicron variant is approximately 2.5 to 3 days, which is much shorter than the Delta variant.

Both Covid-19 and the flu often cause symptoms such as fever, fatigue, body aches, sore throat, shortness of breath and vomiting or diarrhoea. However, headache and dry cough often go along with COVID-19 infection. Loss of taste and smell that has been the biggest warning sign of a COVID-19 infection is still a possible symptom, though it is less prevalent now. People who are feeling serious chest pain, particularly with a dry cough that has gotten worse, that’s when you really ought to seek medical attention.

It is best to wait five days after exposure before testing. A negative test doesn’t necessarily mean it’s not COVID. The best approach is to test and then maybe test again in 12 to 24 hours. If two negative tests, one can be more certain that it’s not COVID-19. The majority of the countries have diverged from the World Health Organization’s recommended 10-day isolation period. In the US, people can now leave isolation if they don’t have symptoms after five days, followed by five days in which they should wear a mask around others. The UK cut the period to seven days for people who produce two consecutive negative lateral flow tests. Germany requires up to 14 days in isolation.

Protocols like masking, sanitizing, distancing and reducing indoor gatherings are still believed to be effective in reducing spread. Vaccination is the best way to reduce the risk of disease severity and prevent hospitalization.

Omicron is a new variant and research is needed in the area to know more about this new variant.

GLOBAL SCENARIO

Hospitalization rate

South Africa reports showed a lower rate of hospitalization as a result of Omicron infections compared with infections caused by the Delta variant, which is currently responsible for most SARS-CoV-2 infections globally. Discovery Health in Johannesburg announced that hospitalization risk has been 29% lower among people infected with Omicron, compared with people infected with a previous variant. Another report released by Denmark showed that hospitalization rates for people infected with Omicron seemed to be on a par with those for people infected with other variants. But this comparison was based on only about 3,400 cases of Omicron infection and 37 hospitalizations. Similarly, a report from Imperial College London found no evidence of diminished hospitalizations from Omicron infections compared with Delta in England, although this was again based on relatively few cases. Researchers suggested that Omicron causes milder disease than previous variants, but it’s too early to be sure, and key methodological details of that study have not yet been published.

Morality due to Omicron

USA

First confirmed death related to Omicron variant the person was unvaccinated and had been infected before.

United Kingdom

The second death was confirmed, but the British Government has not revealed information regarding person vaccination status and underlying health conditions.

India

The first omicron death in India was 52years old person who had a travel history to Nigeria and was tested covid-19 positive. According to the National Institute of Virology Report revealed that he was infected with an omicron variant. The expired person has a past history of 13 years of Diagnosed Diabetes. The omicron positive person expired due to Cardiac Arrest. It has been reported out of 141 cases reported from 22 of the city’s 24 wards – 93 are fully vaccinated and 3 have taken one dose. 7 are moderately symptomatic and hospitalized, 39 are mildly symptomatic and 95 are asymptomatic. Across the state up to 46% of 450 confirmed omicron cases don’t have any international travel history, 198 cases confirmed travel history.

Travel Restrictions for India by other Country

Travel Guidelines for International Arrivals

Planning for Travel, the passenger should provide a self-declaration form on the online Air Suvidha portal before the scheduled travel, including last 14 days travel details and to upload a negative COVID-19 RT-PCR report which should be within 72 hrs prior boarding the flight.

Before boarding the flight Passengers originating or transiting from at-risk countries shall be informed by the airlines that they will undergo post arrival testing, quarantine if tested negative, stringent isolation protocols if tested positive etc. During Travel every passenger should follow Covid appropriate behaviour. If any passenger reports symptoms of COVID-19 during flight, he/she shall be isolated. On arrival if passengers found to be symptomatic during screening shall be immediately isolated and taken to medical facilityTravellers arriving from specified Countries “at risk” should submit a sample for post-arrival COVID-19 test at the point of arrival (self-paid). Such travellers will be required to wait for their test results at the arrival airport before leaving or taking a connecting flight. If tested negative they will follow home quarantine for 7 days. Re-test on the 8th day of arrival in India and if negative, further self-monitor of their health for next 7 days. However, if such travellers are tested positive, their samples should be sent for genomic testing at INSACOG laboratory network. They shall be managed at separate isolation facilities and treated as per standard protocol including contact tracing. The contacts of such a positive case should be kept under institutional quarantine or at home quarantine monitored strictly by the concerned State Government. Travellers from Countries excluding those Countries at – risk will be allowed to leave the airport and shall self-monitor their health for 14 days’ post arrival and shall undergo post-arrival testing at random at the airport on arrival.

Travel guidelines for different states of India

Delhi

Random sample collection will be done for passengers arriving from states where there has been a spurt in number for Covid-19 cases. Passengers will be allowed to exit only after their samples have been collected. Thermal screening will also be done for all passengers upon arrival. If someone is traveling on a connecting flight and not leaving the airport in transit station, the guidelines of the final destination would be applicable for them. Random sample collection will be done for passengers arriving from states where there has been a spurt in number for Covid-19 cases. Passengers will be allowed to exit only after their samples have been collected. Thermal screening will also be done for all passengers upon arrival. If someone is traveling on a connecting flight and not leaving the airport in transit station, the guidelines of the final destination would be applicable for them.

Maharashtra

For High-risk international travellers have to undergo RT-PCR tests on arrival at the respective international airports and shall undergo mandatory 7-day “institutional quarantine” with a second test to be carried out on the seventh day. If the test result is positive, they will be shifted to a hospital. If the test result is negative, the traveller should undergo 7 days of home quarantine. In the case of domestic air travellers, passengers will either have to be fully vaccinated or carry an RT-PCR negative certificate which should be not more than 72 hours old.

Mumbai

Mandate seven days of home quarantine mandatory for passengers arriving from Dubai. According to the guidelines, all arriving passengers from Dubai, who are Mumbai residents, will compulsorily undergo seven days of home quarantine.

There will be no need for an RT-PCR test on arrival if they are fully vaccinated. If the test is negative, the traveller needs to self-monitor for seven more days. “If the test is positive, they will be shifted to institutional quarantine as per the current guidelines for the international traveller. For travellers residing in cities other than Mumbai, the collector will arrange transportation for such passengers. Travellers will not be allowed to take public transport.

West Bengal

Travellers from other states must carry negative RT-PCR reports, which should not more than 72 hours old. Those arriving in the state from Omicron-hit nations have to spend seven days in isolation.

Karnataka

International flyers arriving in the state will have to mandatorily undergo RT-PCR tests and remain in home quarantine for seven days. If tested positive, the sample will be sent for genomic sequencing and they will be admitted to a separate isolation facility. They will be discharged at the discretion of the treating physician if the genomic sequencing is negative for the Omicron variant.

For travellers coming from countries excluding those enlisted as the “at-risk” ones, a random sample of 5% of travellers with negative results will undergo RT-PCR testing on arrival.

Jammu and Kashmir

Foreigners flying to Kashmir will have to undergo RT-PCR tests at the airport. Those testing positive would be shifted to a quarantine facility and their contacts will be traced and tested.

People from ‘at-risk’ nations who test negative will, have to be in home quarantine for seven days. They would be tested again on Day 8, and if negative, will be advised to self-monitor for at least two weeks. Travellers from other countries would also be asked to monitor themselves carefully for at least two weeks.