Union Health Minister Mansukh Mandaviya on Tuesday held a meeting with his department’s top officials to discuss the new emerging variants of the coronavirus disease.

Although the fresh load of Covid-19 remains low, India’s daily new cases have shown a haphazard trend over the last one week, rising from 1,900 on October 11 to over 2,600 by October 14 and falling down to 1,500 on October 18.

Few states have begun identifying newer variants as they witness a simultaneous rise in cases. The symptoms, doctors said, include flu-like illness, with cough, cold, fever, body ache and weakness most common.

The high-level meeting on Tuesday was to discuss preparedness and whether a fresh set of guidelines are required for states to curb the spread of new Covid-19 variants.

Niti Aayog member VK Paul, head of national expert group on vaccination Dr NK Arora, Indian Council of Medical Research Director-General Rajiv Bahl, members of National Expert Group on Vaccine Administration for Covid-19, and health officials attended this meeting.

Across India, Kerala has seen a steep spike in Covid-19 cases – from 510 cases recorded between October 3-10 to 3,727 cases between October 11-18 week. The southern state has issued an alert over XBB and XBB.1 variants of Omicron.

XBB and XBB.1 have witnessed a surge globally. Countries like Singapore, Australia, Japan, Bangladesh, Denmark, USA have also reported this variant.

On Monday, Kerala Health Minister Veena George held a high-level meeting and directed all districts to remain on alert about new variants. Kerala is also noting influenza-like illnesses similar to Covid-19.

Maharashtra too has reported a rise in daily Covid-19 cases. On Tuesday, it reported 358 Covid-19 cases, up from 201 on Monday. Weekly comparison from October 3-9 and October 10-16 showed cases rose from 2,502 to 2,945, a 17.7% rise.

The state also released data stating XBB variant had a growth advantage over its parent lineage, the BA.2.75, and had far greater immune evasive nature. Whether it is more severe than existing Omicron variants in circulation is yet to be known.

Data from Maharashtra suggests that BA.2.75, which comprised 95% of total genetically sequenced Covid-19 samples, has come down to 75% over last few weeks, said state epidemiologist Dr Pradeep Awate. XBB seems to be replacing BA.2.75. The state also warned of other newer variants found for the first time in India – BQ.1 and BA.2.3.20, both sub-lineages of Omicron.

Experts have warned that with lower temperatures during approaching winters and festivity in the country, Covid-19 cases may further spike in absence of adequate masking.

What is XBB variant?

The Omicron variant of coronavirus first made appearance in South Africa in November 2021. Since then, Omicron has diversified into a family of sub-lineages. Its first two main sub-lineages were BA.1 and BA.2. Both have further branched out.

XBB has originated – or formed as a mutation of – from two strains of BA.2, the BA.2.75, a fast circulating variant, and BJ.1, which does not have fast transmissibility like BA.2.75 but has managed to infect a sizeable population globally.

Dr Rajesh Karyakarte, dean in the BJ Medical College that is part of Indian SARS-CoV-2 Consortium on Genomics, or INSACOG, said he first detected XBB earlier this month in Maharashtra. “We have found 15 cases of XBB in our samples,” he said. “This is the fastest moving variant so far,” he said.

INSACOG is a network that monitors mutations in coronavirus.

He added that the severity of the variant remains unknown but initial data suggest it causes mild illness. More samples of hospitalised patients are being collected to assess severity.

Increased precautions

Since XBB has potential to evade vaccine-induced immunity and reinfect, Kerala and Maharashtra have urged residents to adhere to mask rules and other coronavirus-related precautions as they gear up for Diwali celebrations.

In the Tuesday review meeting by the Union health minister, experts advised that India should continue Covid-appropriate behaviour.

While the government has pushed for booster doses, its uptake is on a steady decline across the country. So far 21.7 crore people have taken a booster shot.

Arora told Scroll.in that the demand has reduced owing to fall in Covid-19 cases. “People don’t feel the need of booster doses,” he said.