COVID-19 | Omicron subvariant BF.7, linked to China spike, first found in India in July

Medical staff wear PPE as they assist patients at a fever clinic treating COVID-19 patients in Beijing on December 21, 2022. | Photo Credit: Getty Images

The BF.7 variant of COVID-19, believed to be driving the recent surge of cases in China, was first identified in India as far back as July.

Four instances of the Omicron subvariant had been genome-sequenced in people in Gujarat and Odisha in subsequent months, but it was not linked to increased severity or infectiousness in the two States, two senior officials who were part of a meeting convened by Health Minister Mansukh Mandaviya on Wednesday independently confirmed to The Hindu.

“As of now this [BF.7] is not a matter of concern, but what we should be focusing on is surveillance and that’s what States have been told to focus on,” one of them said The Hindu. Both declined to be identified.

With a rise in coronavirus cases in China triggering global alarm, the Health Minister had convened a meeting of senior officials in the Center and the National Covid Task Force to assess the situation in India.

“Covid is not over yet. I have directed all concerned to be on the alert, and strengthen surveillance. I also urge people to take COVID vaccination,” said Mr. Mandaviya.

Omicron BF.7 was detected in Odisha in a single sample tested on September 30, 2022, the State’s Health and Family Welfare department said on Wednesday. “At the time of testing, it was neither a VOC (Variant of Concern) nor VOI (Variant of Interest). In the 3 months since, no other sample of BF.7 has been detected in Odisha,” it added.

Declining cases

India has been reporting a “steady decline” in cases, with average numbers around 158 every day in the week ending December 19. Globally however, there has been a rise in daily average cases in the last six weeks, with about 6 lakh instances reported weekly as of December 19, the Health Ministry said in a statement. “A new and highly transmissible BF.7 strain of the Omicron variant has been found to be behind a wider surge of covid infections in China,” it added.

The dominant variant in India currently is Omicron AB5, (which is linked to BF.7) although this is based on extremely limited numbers. The assessment of government officials involved in India’s COVID-19 management strategy was that the spike in China was largely due to that country’s “zero COVID policy”, which has been in effect since 2020 before being relaxed this month. They believe this has resulted in a large number of people who were unexposed to variants such as Alpha and Delta now being infected by the Omicron subvariant.

India, China different

“Whether BF.7 behaves differently in a population that has been minimally exposed to the coronavirus as opposed to Indians who have hybrid immunity (multiple doses of the vaccine along with exposure to several variants of the virus) is being investigated by the Indian Council of Medical Research,” one of the officials said The Hindu.

An expert told The Hindu that India’s real worry was not BF.7 but XBB, a recombinant variant that was a combination of two lineages (BJ.1 and BA.2.75) but was “highly infectious,” responsible for a surge in many countries and which had the potential to evade antibodies from existing vaccines. “The worry is that China’s large population is barely exposed to the virus and if exposed to something like XBB can seed even newer variants that could have all kinds of medical consequences. That BF.7 is responsible for China’s current spike is just a conjecture based on very limited samples, although it’s almost quite certain it’s some Omicron-linked variant,” said Vinod Scaria, of the CSIR-Institute of Genomics and Integrative Biology.

India has officially reported 4.4 crore COVID-19 cases since March 2020, although several independent investigations peg the number to be much higher. Currently, there are around 3,500 active infections, according to data from the Ministry of Health.

China’s official numbers low

While reports emerging out of China describe flooded hospitals and crematoria and diminishing stocks of medicines, the official numbers reported out of that country continue to be low. China has reported only two deaths since December 3. Officially, only 5,200 people have died from COVID-19 in China over the last three years.

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However, modeling studies estimate a spike in cases in China in early January and two other spikes in mid-January and February because of a rise in travel. Some studies expected a million COVID-19 deaths in China in the coming days. Despite 90% of the Chinese population having been vaccinated, less than half of those over 80 years have been triple-vaccinated.

In India, so far about 2.2 crore vaccines have been administered, although only around 28% of those above 18 years have had three doses. The government’s official policy is to encourage three doses of the vaccine.

(with inputs from Satyasundar Barik)

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