India logs highest single day rise in Covid-19 cases in 10 months

On Sunday, India logged 841 fresh cases of Covid-19, recording the highest single-day rise in more than seven months.

The spike in the last two weeks of December — which recorded close to 8,500 cases — resulted in a renewed sense of caution as the year ended with Covid-19 resurfacing in winter after a lull for the best part of 2023.

In December itself, in India the first case of JN.1 variant, believed to be a descendant of the Omicron sub-variant known as BA.2.86 or Pirola, was traced to Kerala after a positive RT-PCR sample was reported at Karakulam in Thiruvananthapuram district. The confirmed JN.1 case was detected in a 79-year-old woman on December 17, when the active caseload in the country stood at 1,701.

Since then, the number of Covid patients has more than doubled. The nationwide active caseload reached 4,309 on December 31.

Since the start of the pandemic, the number of Covid cases in India rose from 45,004,816 on December 17 to 45,013,272 on December 31, an increase of 8,456 cases in just two weeks. In early December, the rise in daily cases tended to remain under 200 in early December, much lower than the 841 reported on Sunday. The figures on Sunday were the highest since May 19, when the single-day count was 865.

Kerala has been the biggest contributor to the tally, with the state accounting for more than 50 per cent of all active cases in India. Active cases stand at 2,082 in Kerala, where 23 Covid deaths were reported since December 17.

The country has recorded 48 deaths across 10 states and two Union Territories (UTs) since December 18. Kerala was followed by Karnataka with 12 deaths, Maharashtra with three deaths, Tamil Nadu with two, and Chhattisgarh, Bihar, Punjab, Rajasthan, Gujarat, West Bengal, Delhi and Puducherry with one casualty each.

Ambarish Joshi, senior consultant, pulmonary and sleep medicine, at Primus Super Speciality Hospital in New Delhi, said that December witnessed a worrying surge in Covid-19 cases that underscored continuing challenges in pandemic management.

“The new JN.1 variant has a single new spike mutation in comparison to Omicron that evades immune response, making it a highly infectious strain that may affect all stages of life,” he added.

Global health body World Health Organization (WHO) has classified the JN.1 variant as a separate variant of interest apart from its parent lineage BA.2.86, due to its rapid increase in prevalence.

In response to the growing numbers, the central government has already pressed authorities into action. In a letter dated December 11, Union Health Secretary Sudhansh Pant called for a pan-India mock drill across hospitals (both public and private) between December 13 and 17 to ensure preparedness for any potential wave. This was followed by Union Health Minister Mansukh Mandaviya asking all hospitals to conduct similar drills once every three months.

On December 18, the health ministry released an advisory urging all states to implement necessary public health measures and report district-wise influenza-like illness and severe acute respiratory illness cases in all health facilities to minimise the risk of an increase in disease transmission.

Administrations in states and UTs were also encouraged to guarantee sufficient testing in every district. The Centre also urged states to carry out more RT-PCR tests, and submit positive samples to the Indian SARS CoV-2 Genomic Consortium (INSACOG) laboratories for genome sequencing.

Current outlook

As many as 163 samples across 10 states and UTs have been detected to have the JN.1 sub-variant till Sunday, according to figures updated by INSACOG on its website.

Kerala, with 83, had the maximum number of JN.1 cases, followed by 34 cases in Gujarat, 18 in Goa, eight in Karnataka, seven in Maharashtra, five in Rajasthan, four in Tamil Nadu, two in Telangana and one each in Delhi and Odisha.

Joshi said that the variant’s uniqueness lies in a fusion of genetic nuances, setting it aside from its counterparts. “Fever, cough, cold, headache, gastrointestinal disorders and breathing issues are some of the common symptoms of JN.1,” he added.

According to Tushar Tayal, consultant, Department of Internal Medicine, CK Birla Hospital in Gurugram, the number of cases will continue to increase given the weather conditions that are favourable for influenza-like illnesses and increased chances of transmission in confined spaces.

Several health facilities in New Delhi, such as Lok Nayak Jai Prakash Narayan Hospital and Lady Hardinge Hospital have decided to step up screening, testing and rehabilitation for seriously ill patients.

The All India Institute of Medical Sciences in Delhi has set up an outpatient department in its emergency department for Covid patients; 12 beds in the ward will be earmarked for the hospitalisation of seriously ill patients.

“While the cases have risen, it is absolutely necessary for us to follow Covid-appropriate behaviour, which includes frequent sanitisation of hands and surfaces that are commonly used, wearing masks and social distancing,” Tayal said.