As JN.1 cases rise, experts say infection is mild

India on Wednesday reported 21 cases of the JN.1 Covid variant, a development that is neither surprising nor particularly worrying, scientists said while allaying fears but also advising adherence to existing precautionary measures.

The announcement about the increasing numbers of the new sub-variant, detected in three states, came with the Union health ministry reporting 614 new Covid infections, marking the highest daily count since May 21.

As panic spread and Covid came under the spotlight again, experts stepped in to say there is no need to panic -- available treatments are effective, the infection is mild and all viruses mutate.

"As it happens with most respiratory viruses, including the influenza viruses, the circulating viruses keep changing. Therefore, a sub-variant of SARS CoV-2 is not a surprise at all," Chandrakant Lahariya, a senior consultant physician and public health expert, told PTI.

The SARS-CoV-2 virus is circulating in all settings, he said.

According to official sources, 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 co-morbidities.

On Tuesday, the World Health Organisation (WHO) classified JN.1 as a separate variant of interest (VOI) from the parent lineage BA.2.86.

It was previously classified as VOI as part of BA.2.86 sublineages.

The WHO defines a variant of interest as one that has genetic changes which could increase its transmissibility, virulence, and its ability to evade vaccines.

Based on the available evidence, the additional global public health risk posed by JN.1 is currently evaluated as low, WHO said.

"Despite this, with the onset of winter in the Northern Hemisphere, JN.1 could increase the burden of respiratory infections in many countries," it added.

India has also alerted states to take necessary precautionary measures.

Addressing concerns about the spread of JN.1, health experts said precautions are a must but there is no need for alarm as it is natural for viruses to mutate in the due course of evolution.

"In India, people have already been exposed to various sub-variants, including Omicron variants, and received at least two shots of COVID-19 vaccines. There is no renewed risk of SARS-CoV-2 variant or sub-variant causing severe illness," Lahariya said.

Kartik Vedula, infectious diseases consultant at Hyderabad's Yashoda Hospitals, agreed. He said JN.1 is a new sub-lineage of BA.2.86, an offshoot of the Omicron variant.

"JN.1 differs with an additional mutation in the spike protein. Studies have shown that JN.1 has enhanced immune evasion properties, with the potential for enhanced transmission. However, there is no current data that shows new or severe symptoms in JN.1 infected individuals, and the public need not panic," Vedula told PTI.

Adding a note of reassurance, Vinod Scaria, senior consultant at Mumbai's Vishwanath Cancer Foundation, said the JN.1 variant has possibly been in circulation in India as early as November 2023.

"While this would mean reinfections would pick up significantly, there is no evidence to suggest JN.1 could pose a significant threat to public health compared to other variants in circulation," he added.

JN.1 was first detected in Denmark and Israel in late July 2023.

"It has more than 35 amino acid mutations in the parent strain in spike region, which the virus uses to enter and infect human cells, that may alter its transmissibility," explained virologist Deepak Sehgal, who teaches at the Shiv Nadar University.

"Fortunately, there is currently no indication that the associated disease severity will be higher as compared to other circulating variants. The symptoms remain the same as in COVID-19," he added.

According to WHO, current vaccines continue to protect against severe disease and death from JN.1 and other circulating variants of SARS-CoV-2.

The global health body added that it is continuously monitoring evidence and will update the JN.1 risk evaluation as needed.

The U.S. Centers for Disease Control and Prevention (CDC) said earlier this month that the subvariant JN.1 makes up about an estimated 15 to 29 per cent of cases in the US as of December 8. Last week, China detected seven infections of the Covid sub-variant.

Experts advocate a balanced perspective while dealing with new variants of SARS-CoV-2.

Lahariya stressed the importance of continued vigilance and adherence to existing precautionary measures against JN.1, including the use of masks, maintaining hand hygiene, social distancing, avoiding crowded or poorly ventilated areas, and following proper cough etiquette.

"It is usual that once a new variant of a virus emerges, it is reported from multiple countries. What we need to remember is that if there are multiple variants, one of those would be dominant. That is the case with JN1. It is dominant amongst currently circulating variants and sub-variants of SARS CoV2. That doesn't automatically make it a cause of concern or worry," Lahariya said.

"However, the government's steps should not be over-interpreted by citizens, and there is no reason to be worried. We humans live in a world inhabited by viruses, which are many folds higher than humans on this planet," he added.

Sehgal said the symptoms due to JN.1 infection remain the same as in other variants, adding it is also speculated that the available treatments like Paxlovid, Veklury, and Lagevrio will be effective against this variant.

"However, as a part of prevention, preparedness of the hospitals and health workers, diagnostics, RT PCR Kits, Genome sequencing, etc need to be acquired in case of eventuality. Biggest prevention is for people to follow precautions, taken during COVID-19," he explained.