Should we be worried about FLiRT, the new coronavirus variant?

According to the latest data from the US Centers for Disease Control and Prevention (CDC), the KP.2 variant has been detected in approximately 25 percent of the newly sequenced cases in the second half of April this year.

This variant has also been detected in India.

India has reported a total of 250 cases, according to the Indian SARS-CoV-2 Genomics Consortium (INSACOG), with the highest numbers in Maharashtra (128), West Bengal (30), Rajasthan (21), Odisha (17), Uttarakhand (16), Goa (12), Gujarat (11), Uttar Pradesh (eight), Haryana (three), Karnataka (two), and one each in Delhi and Madhya Pradesh.

Of these cases, there are 32 instances of the KP.1 variant, with the highest numbers recorded in West Bengal (22), Maharashtra (four), Rajasthan (two), and one each in Goa, Gujarat, Haryana, and Uttarakhand.

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Bengal tops with 25 cases

Furthermore, there are 57 cases of the KP.1.1 variant in India, with the highest numbers reported in West Bengal (25), followed by Maharashtra (19), Rajasthan (5), and three cases each in Goa and Uttar Pradesh, respectively.

Additionally, one case each has been reported in Gujarat and Karnataka.

Dr Satyanarayana Mysore, the chairman, HOD and consultant in Pulmonology, Lung Transplant Physician, and Sleep Medicine at Manipal Hospital in Bengaluru, is not surprised by the emergence of the variant.

“The coronavirus, by the laws of nature, has to evolve. Evolution is a key process where the virus will try to change the protein configuration,” he said.

“The new FLiRT variant is one such evolution. We are not surprised by this emergence. Over the last three to four years, numerous variants have been noted. Only very few have turned out to be variants of interest, and one or two have been the variants of concern,” he said.

The World Health Organization (WHO) has classified the FLiRT variant as a severe form and recommended cautious monitoring.

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The symptoms

The FLiRT variant of Covid-19 is reported to be more contagious than its predecessor, JN.1, but current data does not indicate that it causes more severe illness.

It primarily affects the upper respiratory tract and can spread easily through respiratory droplets, posing risks to all individuals, especially the unvaccinated and those with compromised immunity.

Symptoms associated with the FLiRT variant are similar to those of other Omicron variants and include:

• Fever or chills
• Cough
• Sore throat
• Congestion or runny nose
• Headache
• Muscle aches
• Fatigue
• New loss of taste or smell
• Shortness of breath or difficulty breathing
• Nausea or vomiting
• Diarrhoea

These symptoms typically manifest two-14 days after exposure to the virus.

“At this point in time, there is no data to support that the FLiRT variant is of any concern. The State Technical Advisory Committee is abreast of monitoring issues, and our information syncs with WHO. I see no concern with the emerging variant,” Dr Mysore said.

Prevention

Like previous Covid-19 variants, prevention strategies for the FLiRT variant, including the KP.2 mutation, remain the same:

1. Vaccination: Getting vaccinated, including booster shots, is crucial for protecting oneself and the community from severe illness, hospitalisation, and mortality associated with the FLiRT variant. Despite the possibility of breakthrough infections, vaccines still provide significant protection against the virus.
2. Hygiene practices: Regularly washing hands with soap and water and using hand sanitisers, particularly in public places, can help prevent the spread of the virus.
3. Masking: Wearing masks in crowded areas and maintaining physical distance from others are important preventive measures to reduce transmission through respiratory droplets.
4. Avoiding crowded places: Limiting exposure to crowded settings and isolating oneself when experiencing symptoms such as fever, sore throat, and loss of smell and taste can aid in preventing the spread of the variant.
5. Increased ventilation: Enhancing airflow and filtration in indoor spaces can lower the concentration of virus particles, thereby reducing the risk of transmission.
6. Rapid testing: Utilising rapid antigen tests after potential exposure to Covid-19 or following attendance at gatherings can facilitate early identification of infections, enabling prompt isolation and prevention of further spread.
7. Stay informed: Keeping abreast of Covid-19 guidelines and recommendations, particularly regarding vaccination and preventive measures, is essential for safeguarding oneself and others from the FLiRT variant.

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Omicron sub-variant

Dr Mysore also noted that since the FLiRT variant is a sub-variant of the Omicron family, it is unlikely to exhibit new or unique symptoms or transmissibility compared to other strains. He emphasised that the weaker the virus, the greater its transmissibility.

“The main important issue at this stage is not to feel concerned but to continue practising socially and medically appropriate avoidance behaviour,” Dr Mysore said.

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Covid-19 and variants

Variants are an inherent aspect of the Covid-19 mutation, which is a natural phenomenon.

Mutations in viruses like SARS-CoV-2, the causative agent of Covid-19, are a natural part of their life cycle. These mutations primarily arise due to errors during replication by the virus’s RNA polymerase enzyme, leading to alterations in the genetic code.

Furthermore, selective pressures such as immune responses or exposure to treatments can drive the emergence of mutations that aid the virus in evading detection or resisting interventions.

Additionally, viruses can undergo genetic recombination when different strains infect the same host cell, resulting in the emergence of new variants with combined traits.

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Adaptation to new hosts

Mutations can also facilitate adaptation to new hosts when viruses transition from one species to another, such as during zoonotic transmission events.

Overall, monitoring viral mutations is critical for understanding how the virus is evolving and for informing public health strategies aimed at controlling the spread of infectious diseases like Covid-19.

“We need to recognize that Covid-19 itself is now endemic in most countries. This means that pockets of the virus are firmly established in communities, and the infection incidence is relatively low,” Dr Mysore said.

“However, any lapse in Covid-appropriate behaviour or governmental protocols could lead to rising spikes, akin to what we observe with influenza and other seasonal viruses,” he added.

(Edited by Majnu Babu).