* A new “Delta plus” variant (B.1.617.2.1 or AY.1) has been formed due to a new mutation K417N in the Delta variant. The Union Health Ministry has said that the Delta Plus variant is now a Variant of Concern in India.
56 cases of the Delta Plus variant of COVID-19 were found in the country till June 30.
States where Delta Plus variant has been detected are Madhya Pradesh, Maharashtra, Punjab, Gujarat, Kerala, Andhra Pradesh, Tamil Nadu, Orissa, Rajasthan, Jammu, Karnataka, Haryana, and Himachal Pradesh.
SARS-CoV-2 Variants of Interest
New WHO Label
Next strain clade
Earliest documented samples
Date of designation
California USA, March 2020
5th March, 2021
Brazil, April 2020
17th March, 2021
Multiple countries, December 2020
17th March, 2021
Philippines, January 2021
24th March, 2021
New York USA, November 2020
24th March, 2021
4th April, 2021
Peru, August 2020
14th June, 2021
“B.1.621”: A new Variant under Investigation
Sixteen confirmed cases of B.1.621 – first identified in Colombia - have been found across the United Kingdom (UK) thus far, and a large proportion of the cases has been linked to overseas travel. At present, there seems to be no evidence of community transmission in the country.
According to Public Health England, there is no evidence to state that this variant causes more severe disease or makes the vaccines currently being used, less effective. However, the variant contains a number of mutations of concern. It has the N501Y mutation, also found in the Alpha variant and made it more transmissible. It also has E484K, also found in the Beta variant that, which, according to experts, can partially evade vaccines.
As per the World Health Organization (WHO), the first known case of B.1.621 was in Colombia in the month of January. Twenty five other countries have also recorded cases since then, including the US, Spain, Mexico and the Netherlands.
Hybrid of Indian and UK COVID-19 variants
Vietnam has uncovered a new Covid-19 variant combining characteristics of the two existing variants first found in India and the UK, which can spread quickly by air. The concentration of virus in the throat fluid increases rapidly and spreads very strongly to the surrounding environment. The WHO has said that there is no new hybrid strain. The strain detected in Vietnam is part of delta strain first detected in India.
Some consequences of emerging variants
Potential for quicker spread (increased transmissibility)
Potential to cause milder or more severe disease in people
Potential to evade detection by viral diagnostic tests: 1.1.7 has S gene target failure
Diminished susceptibility to therapeutic agents like monoclonal antibodies
Potential to evade natural or vaccine-induced immunity
Variants of concern might require one or more appropriate public health actions, such as notification to WHO under the International Health Regulations, reporting to CDC, local or regional efforts to control spread, increased testing, or research to determine the effectiveness of vaccines and treatments against the variant. Based on the characteristics of the variant, additional considerations may include the development of new diagnostics or the modification of vaccines or treatments (CDC).
India predictions: Formulas for better understanding of data
Death rate is number of deaths today vs number of cases today
Corrected death rate is number of deaths today vs number of cases 14 days back.
Estimated number of deaths = Reported deaths x 2
Number of expected deaths today is 15% of the number of serious patients 14 days back.
For one symptomatic positive case, there are 10-30 asymptomatic cases and 20 untested cases.
85-90% positive cases are asymptomatic or have mild infection; 10-15% of positive cases may develop severe infection (require oxygen, steroids, remdesivir); about 5% cases become critical (require ventilator and stronger medicines).
COVID-19 pandemic is due to SARS 2 Beta-coronavirus (different from SARS 1 where spread was only in serious cases); Causes mild or atypical illness in 82%, moderate to severe illness in 15%, critical illness in 3% and death in 2.3% cases (15% of admitted serious cases, 71% with comorbidity< Male > Females); affects all but predominantly males (56%, 87% aged 30-79, 10% aged < 20, 3% aged > 80); with variable incubation period days (2-14; mean 5.2 days); mean time to symptoms 5 days; mean time to pneumonia 9 days, mean time to death 14 days, Mean Time to CT changes 4 Days, Reproductive Number R0 1.5 to 3 (Flu 1.2 and SARS 2), Origin Possibly from Bats (Mammal); spreads through the air (by inhalation of air carrying very small fine droplets and aerosol particles, human to human transmission via large and small droplets or touching inanimate surfaces contaminated with virus . Enters through MM of eyes, nose or mouth and the spike protein gets attached to the ACE2 receptors, which are found in organs throughout the body (heart muscle, CNS, kidneys, blood vessels, liver). Once the virus enters, it turns the cell into a factory, making millions of copies of itself, which are then breathed or coughed out and infect others.
10 Sutras to remember
Universal masking (correct, consistent and 3-layered) is THE prevention.
RTPCR Ct is THE gold standard test for diagnosis.
Zinc is THE mineral; D is THE vitamin.
Day 5 is THE day in COVID phase for mortality prevention.
Day 90 is THE day after which the word COVID ends.
Home isolation is THE modality of treatment. (The policy may vary from country to country.)
12 years is THE age when the mortality starts. (Children 12 years or older should wear masks as recommended for adults – WHO UNICEF guidelines)
CRP is THE lab test for seriousness.
Loss of smell and taste are THE symptoms equal to RTPCR test.
15 minutes is THE contact time to get the infection.
Some more numbers
If hospital capacity reaches 80%, we may have to stop admitting patients to prevent the hospital from being overwhelmed.
In order to plan for surges and increase capacity: It is required to know the number of people who tested positive and were admitted to the hospital with symptoms of COVID-19.
Cases will double after the average doubling time of the country at that time
Cases expected in the community: Get number of deaths occurring in a five-day period. Estimate the number of infections required to generate these deaths based on the country or area case fatality rate
Compare that to the number of new cases actually detected in the five-day period. This can then give us an estimate of the total number of cases, confirmed and unconfirmed
Lock down effect: Reduction in cases after average incubation period (5 days)
Lock down effect in reduction in deaths: Reduction in number of deaths on day 14 (average time to death of that country)
Requirement of ventilators on day 9: 1-3% of number of new cases detected
Requirement of future oxygen on day 7: 10% of total cases detected today
Number of people which can be managed at home care: 90% of number of cases today
Requirement of ventilators: 1-3% of number of cases admitted 7-9 days back
Requirement of oxygen beds today: 10% of total cases admitted seven days back
Oxygen requirement on that day in the hospital at 6am: Number of cases detected to have hypoxia on six minutes walk test.
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