Mumbai: Dr Subhash Salunke, technical adviser to the Maharashtra government on Covid-19 control, said he had flagged the possible presence of a new variant of the SARS-CoV-2 virus to the central government as early as mid-February, but the Union government did not take timely measures.
Speaking to ThePrint, Dr Salunke said he studied the situation on the ground in Vidarbha’s Amravati and Akola districts, and hypothesised the presence of a new Covid strain with a much higher transmission rate in the districts.
“I spoke to Deputy Chief Minister Ajit Pawar, the state health secretary, National Institute of Virology (NIV). I spoke with Dr VK Paul (member, health, NITI Aayog), saying this is my perception and it needs to be quickly proved or disproved. I spoke with Dr Sujeet Kumar Singh of the National Centre for Disease Control,” Salunke said.
“I spoke with all the players concerned at the district, state and national level, and they were informed by me categorically that there appears to be a change in agent (virus) and it is a mutational change that needs to be confirmed… but we were taking our own sweet time when it was an emergency and needed to be handled on a war footing,” he added.
Salunke first made the allegations in an interview to Reuters published Tuesday. Dr Paul is quoted in the report as rejecting the allegations that he didn’t act on his information.
According to the report, Paul said “he spoke with Salunke, but described the conversation as Salunke conveying information rather than issuing a warning”. He added that he requested the NIV “study the variant more closely, and told the Maharashtra state government to intensify its existing response to the virus”.
“Reuters could not determine if the NIV carried out any such study. The NIV directed Reuters’ questions to the Indian Council of Medical Research, which did not respond,” the report added.
The variant, now known as B.1.617 or ‘Delta’, is said to be partially responsible for the second wave of the Covid pandemic in India, which infected people in much higher numbers than the first wave. It swamped the country’s health infrastructure, which proved ill-equipped to deal with the magnitude of the case surge.
Its detection was acknowledged by the Union government in the last week of March, when the second wave had begun to take off in India.
The variant, which was later split into three lineages, also spread globally, with the World Health Organization (WHO) saying last month that it is now found in 53 countries. It has also designated one of its three lineages a “variant of concern”.
India has so far recorded 2.96 crore Covid cases, of which 8.65 lakh are currently active, according to official data dated 16 June. The country has recorded 3.79 lakh Covid deaths so far.
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‘Studied ground situation and found something amiss’
In early February, alarm bells started ringing within Maharashtra’s administration when there was a distinct increase in Covid cases in Vidarbha at a rapid transmission rate, said Dr Salunke, a former Director General of Health Services in the state.
“Entire families were getting infected by the virus as against just one or two family members, as seen in the first wave,” added Dr Salunke, who has nearly five decades of experience as a public health specialist, and has worked with the South East Asia Regional Office of the WHO as regional officer and assistant regional director.
The Maharashtra government, Dr Salunke said, asked him to study the ground situation in Amravati and Akola, two districts where the surge in cases was particularly steep, and present an assessment. He visited Vidarbha on 15 February and returned to his hometown Pune on 17 February with a perception that “there was something amiss”, and that there was a strong possibility of a new variant at play.
“Initially, many attributed the spike in cases to a general laxity in the population about following Covid protocol after cases started dropping post the first wave, and movement of people during the gram panchayat elections in the state in January,” he said.
“But, these factors were everywhere. These couldn’t have been responsible for a sudden rise in cases in just Vidarbha,” added Dr Salunke.
He said he met the divisional commissioner, district collectors, district surgeons, deans of medical colleges and public hospitals, as well as representatives of private hospitals during his visit.
Explaining his assessment, he listed three factors that needed to be looked at to study a spurt in cases in a given area — the agent, which is the virus; the host, which is the human being; and the environment, which is temperature, humidity, and any other localised conditions.
“I studied various combinations of these, the natural progression of the disease, the speed of transmission and so on. I came to the conclusion that, compared to the rest of Maharashtra, environment and host factors were not different. The impact of vaccinations was also not a metric to be considered as it had just been a month since Covid vaccinations had started and the drive was yet to pick up,” Dr Salunke said.
He added, “In my mind, I formulated a hypothesis that there must be some change in the agent. I asked the local civil surgeon to send samples to NIV.”
‘Key questions not answered’
While still in Amravati, Salunke said, he spoke with Maharashtra Deputy CM Ajit Pawar and the NIV, and briefed the district administration about his findings.
In the week after returning to Pune, on 17 February, Salunke conveyed his findings to Dr Paul, Dr Singh as well as members of the National Task Force on the pandemic.
“I said, please confirm very quickly. I asked several questions at that time that we needed to address. Is this a mutated virus, what type of strain, is it more virulent, is it responding to the standard treatment protocol, do we need to change this protocol, and finally about whether Covishield and Covaxin are effective against the virus,” Dr Salunke said.
It was towards March end that the Union health ministry said in a statement that a new double mutant strain of SARS-CoV-2 virus had been detected in India, adding that it is highly infectious and has the potential to skip the immunity developed either by natural infection or vaccines.
However, till that time, the district administration in Amravati had not heard back on even a single sample sent for genome sequencing.
At a meeting in mid-April, the Union health ministry informed State Health Minister Rajesh Tope that 50 per cent of Maharashtra’s Covid positive samples sent for genome testing had the newly identified and highly infectious new variant.
“Through February, March and April, I was demanding answers from the National Task Force. I told Dr Paul and Dr Balram Bhargav (Indian Council of Medical Research Director General), how are you not giving more information about this despite it having been nearly two months since the possibility of a variant was first highlighted? Yes, they did send samples for genome sequencing, but the main questions remained unanswered,” Dr. Salunke said.
He added, “We now know that the existing treatment protocol worked against this strain too. But, looking at the way public health infrastructure crumbled under pressure in the second wave, the scramble for drugs, beds and oxygen, it would have helped to have an early warning about the variant given its rapid transmission rate.”
(Edited by Sunanda Ranjan)
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