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What is the new FLiRT variant of the Covid virus, and should you worry? | Explained News

The new coronavirus variant called KP.2 — nicknamed FLiRT — that has been linked to rising cases of Covid-19 in the United States, United Kingdom, and South Korea, has been in circulation in India since November 2023, genomic surveillance data show. About 250 KP.2 sequences have been reported so far by INSACOG, the country’s genome sequencing consortium.

KP.2 is a descendant of the JN.1 variant of the virus. It is a sub-variant of the Omicron lineage with new mutations. FLiRT, the nickname of KP.2, is based on the letters representing two immune escape mutations that allow the virus to evade antibodies.

Genomic scientist Dr Vinod Scaria said: “These two mutations on the spike protein disrupt the major sites on the spike protein where antibodies bind and neutralise the SARS-CoV-2 virus. These mutations allow the virus to escape antibodies.”

What do the genomic data on KP.2 from India show?

A little more than half of the 250 KP.2 genomes sequenced by INSACOG — 128 sequences — were from Maharashtra. The highest number of KP.2 sequences were found in March.

India has been reporting the highest proportion of KP.2 sequences in the world, global data show. KP.2 sequences made up 29% of Covid-19 sequences uploaded by India to the Global Initiative on Sharing All Influenza Data (GISAID), the world’s largest repository of these sequences, over the last 60 days.

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However, JN.1 continues to be the dominant variant of SARS-CoV-2 in the country. There were 679 active cases of Covid-19 in India on May 14, according to Union Health Ministry data, and one death — in Delhi — was attributed to the disease.

Can KP.2 cause severe disease?

FLiRT is characterised by its ability to evade immunity from vaccines and previous infections. Its symptoms are similar to those of earlier variants, including fever, cough, fatigue, and digestive issues.

Experts are watching the variant closely, but they are not very concerned at the moment. “There is no need to worry,” Dr Anurag Agarwal, dean of the Trivedi School of Biosciences at Ashoka University, said. “These [immune escape] mutations [like the ones on FLiRT] have been seen before.”

The US Centers for Disease Control and Prevention (CDC) notes that there are currently no indicators suggesting that KP.2 would cause more severe illness than other strains.

However, could KP.2 drive up infections?

Yes, FLiRT has a heightened transmission rate and, like its parent JN.1, it is likely to drive a wave of infections, Dr Scaria said. Also, the infections are likely to spread silently — because without severe symptoms, most people are unlikely to get themselves tested.

Dr Rajesh Chawla, senior consultant, pulmonology and critical care at Indraprastha Apollo Hospital in Delhi, said given the likelihood of easy spread of the virus through respiratory droplets, there is need to take stringent precautions, especially for those with a compromised immune system.

Senior citizens are vulnerable to severe illness due to factors such as age-related physiological changes, decreased immune function, and the presence of comorbidities. Research indicates that adults aged 60 and older, especially those with pre-existing medical conditions like heart disease, lung disease, diabetes, or cancer, are more likely to experience severe and potentially fatal Covid-19 infections compared to other age groups.

People who are 65 and older, or immunocompromised, and pregnant women are the most vulnerable.

What are the symptoms of KP.2 infection?

This variant, like many of its Omicron predecessors, mainly affects the upper respiratory tract. “There is no documented difference in presentations,” Dr Scaria said.

Dr Chawla said that those affected report fever or chills, cough, sore throat, congestion or runny nose, headache, muscle aches, difficulty in breathing, fatigue, loss of taste or smell, brain fog, feeling less wakeful and aware, and gastro-intestinal symptoms including upset stomach, mild diarrhoea, and vomiting.

Hospitalisation rates for patients with these symptoms were not higher than usual, Dr Chawla said.

How can infection be prevented?

Preventive measures are the same as the ones that have been advised since the beginning of the Covid outbreak four years ago. Social distancing and the use of well-fitting respirators like N95s or KN95s in indoor public settings protect against all variants of the Covid-19 virus.

Increased air flow and filtration in indoor spaces also help reduce the concentration of virus particles. Vulnerable groups and those living in areas where the infection is in circulation should be especially careful.

Do we need booster shots of Covid-19 vaccines?

Most Covid-19 vaccines available in India are aimed at the original variant of the virus, so additional shots are unlikely to help.

“In late April, the WHO’s Covid vaccine advisory group advised the use of JN.1 lineage as the antigen for upcoming vaccine formulations, as the FLiRT variants are within the JN.1 family. However the Indian vaccines are not updated with the JN.1 variant, and therefore booster doses in India are unlikely to be effective,” Dr Scaria said.

Dr Agarwal said that most Indians do not need a booster because they have probably already had repeated infections, including silent infections with JN.1.

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