Understanding JN.1: Debunking panic and dispelling myths

It has now been four since the COVID-19 pandemic hit the world – it all began on December 31, 2019. Since then, the world has seen severe coronavirus waves taking the lives of hundreds of thousands of people including India. At present, there is a noteworthy development in the form of the JN.1 sub-variant within the Omicron variant of SARS-CoV-2, gaining attention.

This sub-variant of the Omicron strain has been identified in various countries and has received recognition as a Variant of Interest (VoI) from the World Health Organization. This development has sparked apprehension and raised some questions. However, is there truly a reason for alarm?

According to Dr Ishwar Gilada, Consultant in HIV/STDs, Unison Medicare & Research Centre, India managed the COVID-19 pandemic much better than several other powerful countries. “We had one of the best vaccination drives against COVID-19, with 75% of the population fully vaccinated and 35% of the population having received a booster (third dose). Third-wave orchestrated by the Omicron Variant mainly with the BA.2 sub-variant infected the majority of the population with the least morbidity and mortality. The BA.2 acted as a savior for India, from infections with BA.4 and BA.5, as well as descendants of BA.2 like BA.2.86 (Pirola) and EG5 (ERIS).

“We are much better prepared now than ever before. Not only that, India supports more than 50 countries in Africa and elsewhere with preparedness protocols, equipment, medicines, and vaccines. That contribution is unmatched globally in the quantum of assistance,” Dr Gilada said.

Every news article in connection with COVID-19 during the last three weeks says — We need not panic, but we should be cautious. This creates undue panic among people! Moreover, it is confusing. What caution do we expect from common people? “Asking people to use COVID Appropriate Behaviour (CAB) is a farce as no one follows it. The good part was that no travel restrictions were imposed even during the New Year. Now that the New Year is over, the true picture will come out within a week or so,” Dr Gilada said and shared a few pointers.

1.       Though identified in August 2023 in Luxembourg and at present in more than 40 countries, JN.1 has neither caused larger morbidity nor any remarkable mortality. Deaths are only in co-morbid people globally.

2.       Though initially contemplated – JN.1 to be more infectious, when India’s first JN.1 case was detected in Kerala, in reality, it was not found to be so. We have a total of 511 cases spread over 10 states in three weeks and it isn’t driving overall numbers upwards. JN.1 numbers are high in these states – Karnataka (199), Kerala (148), Goa (47), and Gujarat (36). Other states with JN.1 detection include Maharashtra, Tamil Nadu, Delhi, Rajasthan, Telangana, Odisha, and Haryana in that order. 

3.       There is neither clustering of infections with JN.1 nor it is yet a dominant strain of coronavirus in India. The most dominant strain remains to be XBB.1.16 sub-variant of Omicron

4.       JN.1 was contemplated as being more immune-invasive, in reality, nothing of that sort has happened or been established. So such fears are unfounded.

5.       The presence of JN.1 has not increased the demand for Oxygen, Hospital beds, ICU beds, or Ventilators. It caused a single death, a 48-year-old man from Dausa in Rajasthan on December 27, and too because he had multiple comorbidities — tuberculosis and silicosis with respiratory failure.

6.       Symptoms in JN.1 affected patients are mild, no different than Omicron BA.2 or its other sub-variants. JN.1 symptoms pose a diagnostic dilemma with Influenza (H1N1 and H3N2) and Respiratory Syncytial Virus (RSV), the latter two being more common.

7.       No fresh vaccination/Covid booster is required or advised anywhere globally.

8.       No mask mandate is required. However, masking can be requested for senior citizens and those with severe comorbidities as well as those with such people at home and going in crowded places. Also, masks help prevent not only COVID-19 infection but also other viral and bacterial infections. Masking is advised for healthcare workers and those people who visit healthcare facilities.

9.       No need for any travel restrictions nor any curbs on social gatherings, meetings, conferences, or religious gatherings.

10.   No need for high-volume Covid testing. Only targeted testing (of suspected cases) is all that is required.

“Unless we get any fresh variant of coronavirus, that is like or more severe than the Delta variant, we need not worry. Preparedness is important and that should be part of pandemic preparedness – not mere COVID-19. Genome sequencing should continue. Preparatory drills should take place. Till the World Health Organization declares JN.1 as a Variant of Concern, it should not bother the common man. As of now, JN.1 is only a Variant of Interest for the scientific community and nodal ministries at the Centre and states,” Dr Gilada said in conclusion.