 "Covid 19, mask free, face mask, travel")
A 78-year-old Kerala woman became the first person in India confirmed to be infected with the JN.1 variant of Sars-CoV-2, the latest sub-variant of Covid-19, which is behind a spike of infections in several countries across the world. The uptick in cases has also prompted the World Health Organization (WHO) to warn nations to continue with strong surveillance and sequence sharing.
While the patient in Kerala reported mild symptoms and has even recovered from her infection since, the Ministry of Health and Family Welfare (MoHFW), keeping in mind how this sub-variant has led to a resurgence in cases and become the dominant strain in several nations, asked states to step up Covid surveillance.
Meanwhile, health experts also suggest that people should consider wearing masks, especially in public places, to contain the spread of the infection. "Even as the virulence of the new variant may be comparatively low, around 20 per cent of persons may develop post Covid-19 symptoms. Hence, everyone must wear masks, especially in closed spaces," DH quoted B Ekbal, a public health expert, as saying.
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Here, we take a look at why JN.1 variant of Covid-19 has given many countries reason to step up their battle against Covid-19 again, with nations like Singapore, Thailand and Indonesia deciding to reinforce a public masking mandate.
What is the JN.1 variant?
The JN.1 sub-variant, a new sub-lineage of the BA.2.86 (also known as Pirola) — by itself an off-shoot of the widely circulating Omicron variant — which experts have cautioned appears to be more immune evasive. The JN.1 variant has also been identified by WHO scientists as a "Variant of Interest (VOI)".
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The WHO designation "variant of interest" is applied to variants of Covid-19, which appear to be growing faster than others and that have genetic changes that are predicted or known to affect virus characteristics. These could include transmissibility, virulence, antibody evasion, susceptibility to therapeutics and detectability.
Where was JN.1 first reported?
According to GISAID, a global science initiative that provides access to genomic data of influenza viruses, JN.1 was first reported in Denmark and Israel in late July 2023. So far, more than 6,600 samples of BA.2.86 and its sub-lineages (including JN.1) have been sequenced in several countries, including China, the UK, Iceland, Spain, Portugal, and the Netherlands.
Where is the JN.1 variant circulating?
According to GISAID data, of the total 15,416 positive cases of Covid-19 sampled across 56 countries, 43 per cent (6,682) of the samples have tested positive for BA.2.86 or its sub-variants, including JN.1.
So far, at least 35 countries have reported the presence of the variant to GISAID. Among them, six countries — Spain, Singapore, Brazil, Belgium, Netherlands and Malaysia — have found the variant in more than 50 per cent of positive samples they have sequenced, data shows.
In Spain and Singapore, nearly two-thirds of all samples sequenced have come back positive for this variant, data shows.
In the US, CDC projects that JN.1 will continue to increase as a proportion of Sars-CoV-2 genomic sequences. Currently, roughly one-fourth of all positive samples being sequenced in the US are returning positive for JN.1, according to CDC data.
Is the JN.1 variant more transmissible?
The JN.1 variant of BA.2.86, which was first detected by the US Centers for Disease Control and Prevention (CDC) in September 2023, has one additional substitution in the spike protein (L455S), and its continued growth suggests that it is either more transmissible or better at evading our immune systems, experts believe.
What is the reason behind the surge in JN.1 cases?
Explaining the reason for the recent surges and what precautions can be taken, WHO's technical lead Maria Van Kerkhove wrote on X (formerly Twitter), "Respiratory diseases are increasing around the world due to a number of pathogens including Covid-19, flu, rhinovirus, mycoplasma pneumonia and others. SARS-CoV-2 continues to evolve. JN.1 [sub-variant of BA.2.86] is already a VOI and continues to increase in circulation."
Sars-CoV-2, the virus that causes Covid-19, has seen a near-continuous series of mutations since it was detected in late 2019. Some of these new variants, such as the Delta variant that was circulating in early 2021, proved to be far more fatal than previously circulating variants, while others, such as the Omicron variant that was circulating through most of 2022, ended up being highly infectious while still being mild in terms of fatalities, she said.
In the case of the latter, the majority of the population across the world had acquired some form of immunity, either through vaccines or previous infections, both factors that remain in play even now, she added.
How dangerous is the JN.1 Covid variant?
According to WHO, as things stand, there is no evidence that JN.1 presents an increased risk to public health relative to the other circulating variants. It said there is no indication of increased severity from JN.1 at this time.
A pre-print study — Virological characteristics of the SARS-CoV-2 JN.1 variant — however, suggests that the variant has shown increased infectivity as compared to BA.2.86.
Covid's JN.1 variant in India
India has seen an uptick in new Covid-19 infections in the past few weeks, with the daily numbers reaching a seven-month high. The new sub-strain JN.1 is believed to be behind the recent rise in Covid-19 cases.
So far, only 21 cases of JN.1 variant of Covid-19 have been identified in India across three states. A total of 19 cases of JN.1 have been traced in Goa and one each in Kerala and Maharashtra.
Over the past two weeks, 16 deaths related to Covid-19 were recorded, with the victims having serious comorbidities.
Symptoms of JN.1 Covid variant
1. Cough: Persistent coughing can be a common symptom.
2. Cold: Symptoms of a common cold, such as a runny or stuffy nose, may be observed.
3. Throat pain: Sore throat or discomfort in the throat is reported.
4. Headache: Individuals infected with the JN1 variant may experience headaches.
5. Loose motions: Gastrointestinal symptoms, like loose motions (diarrhoea), may occur.
6. Mild breathlessness: Some individuals may experience occasional mild breathlessness.
The masks are back
In Singapore, JN.1 variant is being attributed for a massive resurgence in Covid-19 cases. The average new infections in the city-state have jumped from 1,532 cases a day two weeks ago to 8,006 new cases a day for the week ending December 9, according to government data.
Keeping this in mind, Singapore on Monday reintroduced the mandatory use of masks in crowded places, particularly indoors.
Karnataka also imposed a mask mandate, making it mandatory for people above the age of 60, and those with comorbidities, to wear masks.
"Those above 60 years of age and those with comorbidities like issues related to heart, and kidney among others, and those with cough, phlegm and fever should mandatorily wear masks," said state Health Minister Dinesh Gundu Rao.
While other states haven't mandated for masks, officials have urged people to mask up in big, crowded places.
JN.1 variant: How worried should you be?
Former World Health Organisation (WHO) chief scientist Dr Soumya Swaminathan on Thursday said that there is no need to panic currently as it is a variant of interest and not of concern. She, however, urged people to be cautious by taking proper precautionary measures.
"We need to be cautious, but we don't need to worry because we don't have any data to suggest that this variant JN.1 is more severe or it's going to cause more pneumonia, or more deaths…So I think what we need to do is try to take the normal preventive measures that we are all now familiar with," Dr Swaminathan said while speaking to news agency ANI.
She added, "… We're all now very familiar with Omicron. So it's the same family. So not much has changed, but 1 or 2 new mutations have come up. And that's why I think WHO has said let's keep a watch on it. It's a variant of interest. It's not a variant of concern."
JN.1 variant: How to protect yourself from it?
Speaking about the precautionary measures, Dr Soumya Swaminathan urged people to wear masks and avoid going to closed crowded spaces with poor ventilation.
"If you have symptoms, stay at home. Wash your hands regularly. If you have prolonged symptoms then do visit the hospital…Masking is not mandatory but it should be voluntary. There are also common sense things, we should encourage each other," she added.
