The fight against the SARS COV 2 is not yet over and any complacency on our part towards combating the virus , will meet with serious consequences and this is true not just for India but everyone inhabiting the highly connected planet earth .

Recent example is Israel , which was riding high after near total success of their vaccination program , had even opened up their streets for people without wearing masks for about three weeks . Now due to the recently detected Delta variant , even in those who were vaccinated with mRNA vaccine , it has created a very unpleasant state . Now they have withdrawn relaxations and have gone back on a cautious note . Now it is becoming clearer that the most important defence against this evil SARS COV 2 virus even now besides vaccines , is protection of our breathing portal by covering our face with proper mask , adequate distancing ,hand hygiene and using only open spaces - for small meetings only if urgently required . One should understand that the vaccine is of paramount value as it protects death and serious illness but it must be supplemented with the above mentioned self protection practices even today .

Indian mythology is full of such Demons who could change their face, forms and behaviour under threat and could attack with greater ferocity and strength such as Mahishasur in Sanatan dharm scriptures and concept of satans in Abrahamic religions .

Currently we are facing something very similar , SARS COV2 , a novel coronavirus of controversial origin , emerged from Chinese city of wuhan officially on December 19 , 2019 and since then it has brought the whole world on to it’s knees , and continues to do so even after eighteen months of suspended life.

When virus SARS COV2 enters the respiratory tract , it is the viral crown with spikes present on it’s surface protein, S1 and S2 which joins the host’s epithelial ACE 2 receptors and enters into cells.

This RNA virus with 30,000 base pairs , acquires 2 mutations every month but only half as fast as influenza virus and only one fourth as fast as virus causing HIV -AIDS . Every time it passes through the body there is some change in the viral antigen and the more it cycles through human body cells the more are the changes . Eventually such antigenic drifts make mutations and get further aggregated onto one place . Subsequently it changes it’s functionality and behaviour qualifying it’s recognition as a “variant of interest “ and subsequently may be upgraded to “variant of concern “ if found significantly dangerous !

Delta plus variant with increasing in numbers every day , has been upgraded and accepted in it’s derogatory value as variant of concern from it’s earlier status of variant of concern.

Everyday more Indian states are confirming its presence and yesterday Tamilnadu and Karnataka have joined the trio of Maharashtra ,Kerala and Madhya Pradesh and very soon others will join!

Added to the fact that the earlier variant of Delta ~ B.1. 617.2 has been joined with a mutation K417 N and now this Delta plus variant is newly christened as B.1. 617.2 .AY1 !

It will be interesting to mention that (South Africa variant ) B.1. 351. has three important mutations, K 417 B E 484 K, and N 501 Y of which K 417N ( a lysine to asparagine substitute at amino acid position 417 ) has found a new addition in earlier Delta variant ( first seen in Maharashtra,India) and now this is known as Delta Plus variant B.1.617.2 .AY 1 .

There is increasing fear that this attachment in the Delta variant might allow an easy immune escape route to the vaccine generated antibodies and similar monoclonal antibodies created against the viral spike proteins and may pose yet another challenge !

Currently It’s the parent awatar Delta which is sweeping the United Kingdom and Europe after it’s murderous run in India and has almost replaced (~90%)the earlier dominant alpha (Uk or kent )variant due it’s increased infectiousness.

If it is confirmed that some immune escape properties of gamma(South Africa origin )variant , is being added to Delta variant which is also very infectious then this Delta plus variant must be taken quite seriously even if one is vaccinated. If we recall Astrazenica covishield vaccine in particular had not done well in their phase three trial which took place in South Africa . This does not auger well for our country where Astrazenica’s covishield has been the most used vaccine. And we do not know much about covaxin which is yet to submit it’s efficacy data in public domain . Therefore , we must continue to take all possible precautions.

Good news is that all vaccine producers have already started working on production of an updated version of their vaccines which will take care of all possible variants in sight and offer a booster in a few months from now . 

There is very encouraging information that Indian company EMCURE’s vaccine arm Gennova, is in second phase of it’s mRNA vaccine creation since April 2021 and should be available hopefully in few months from now besides World’s first made in India DNA vaccine from Zydus Cadila, is about to be launched giving us more options to cover the entire population by the end of the year hopefully and contain the pandemic.

(The Author is former Professor and Head of Medicine, RIMS, Jharkhand).