India steps up surveillance as covid-19 cases surge in Hong Kong and Singapore

The surge has raised concerns about potential clusters back home, where active covid-19 cases hit 257 as of 19 May, the highest count in the past year, according to the health ministry’s dashboard.

“There have been many spikes earlier as well. One has to keep a watch, no panic required," the scientist said, requesting anonymity.

A health ministry official said that as per preliminary information available the recent covid cases reported in Singapore and Hong Kong were mostly mild and not associated with unusual severity or mortality.

Government agencies, including the Indian Council of Medical Research (ICMR), the Department of Biotechnology, and the National Institute of Virology (NIV-Pune), are closely monitoring influenza-like illness (ILI), severe acute respiratory infection (SARI) cases, and clinical trends to track potential clusters. 

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The aim is to stay ahead of any escalation in cases, particularly given past surges, the scientist said.

While the government maintains that the vaccinated population is unlikely to experience severe illness, health officials are monitoring hospitalization data and genotyping samples to detect any emerging variants.

“The government is assessing potential actions and tracking clinical data across the country. If we notice a sudden rise in hospitalizations, we will closely examine the details," the senior government scientist said. “The Indian population is largely vaccinated, and breakthrough infections are unlikely to have a significant impact…However, caution is necessary."

The health ministry official added that a review meeting of experts from the National Centre for Disease Control, the Emergency Medical Relief division, Disaster Management Cell, ICMR, and Central government hospitals was convened under the chairpersonship of the Director General of Health Services (DGHS).

They concluded that the covid-19 situation in India was under control, with almost all of the current cases being mild, with no hospitalization required. India has a robust system for surveilling respiratory viral illnesses including covid-19 through the Integrated Disease Surveillance Programme (IDSP) and ICMR, the health ministry official said.

Dr. Soumya Swaminathan, former ICMR director general and ex-WHO chief scientist, said genotyping was in progress at the National Institute of Virology to identify circulating strains and detect any new variants.

“Countries with good surveillance are reporting a spike in SARSCov2 infections in recent weeks," Swaminathan said. “In India, the ICMR ILI and SARI surveillance network has shown a relative increase in the percentage of SARSCoV2 as a cause of both mild and severe respiratory infections...Cities like Bengaluru that are doing waste water surveillance in collaboration with institutions like Tata Institute for Genetics and Society (TIGS), are also seeing a spike"

Swaminathan noted that despite widespread vaccination, covid-19 continues to cause respiratory infections, severe disease, and deaths worldwide. She advised the public to continue wearing masks in crowded places, maintain hand hygiene, and seek medical advice if experiencing symptoms like breathlessness or high fever.

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New variants, regional spread

The rise in cases in India coincides with increasing covid-19 cases in Hong Kong, where sewage samples have shown a rise in the viral load of SARS-CoV-2. As of 15 May, the percentage of respiratory samples testing positive for the virus reached 13.66%, compared to 6.21% four weeks earlier. Hong Kong authorities reported 81 severe cases in the past month, including 30 fatalities.

According to Hong Kong's health department, covid-19 activity levels have remained high since mid-April, following two earlier active periods in 2023 and early 2024. The government expects the elevated level of cases to continue for several weeks.

Dr. Sujeet Singh, former director of the National Centre for Disease Control (NCDC), emphasized the importance of genome sequencing to assess whether the rising trend in India is linked to new covid-19 variants LF.7 and NB.1.8, identified in Singapore and Hong Kong.

“These new variants, offshoots of Omicron’s JN.1 strain, have driven up transmission rates in Southeast Asia," Singh said. 

He added that if these variants are circulating in India, health authorities need to closely monitor transmission patterns and identify which regions are affected. “We must remain vigilant, particularly with sewage samples. Past trends indicate that a spike in viral load is often followed by a rise in cases two weeks later," he said.

Singh noted that areas showing higher viral loads should be closely monitored for increases in respiratory cases and hospitalizations to assess severity and any similarities with the patterns seen in Singapore and Hong Kong.

Also read | Mint Explainer: The official ‘data fog’ on India’s covid toll has finally cleared up. Here’s what we know now.

India is likely to have lost 533,665 people to the coronavirus pandemic, according to official estimates. However, Mint calculations from the demographic survey Sample Registration System (SRS), whose report the government published on 7 May, show that these deaths were undercounted and likely ran into millions.