New COVID-19 Variant JN.1 Prompts Pakistan to Restart Testing at Airports

Pakistan has resumed mandatory testing of 2% of inbound passengers at its major airports, amid growing concerns over the spread of a new COVID-19 variant, JN.1, which has been detected in several countries around the world.

The National Command and Operation Centre (NCOC), the country’s apex body for managing the pandemic, decided to restart the testing on the directives of caretaker federal Health Minister Dr Nadeem Jan, who said that surveillance at the points of entry, including airports, has been increased to detect and prevent JN.1 variant of SARS-CoV-2, the virus that causes COVID-19.

The testing will help identify and isolate any travellers who may be carrying the JN.1 variant, which has been classified as a Variant of Interest (VOI) by the World Health Organization (WHO), due to its rapidly increasing prevalence and potential to evade the immune system.

According to the WHO, JN.1 is a sub-variant of the BA.2.86 (Pirola) variant, which itself is a descendant of the Omicron or B.1.1.529 variant of SARS-CoV-2. JN.1 has an additional mutation in the spike protein, the part of the virus that attaches to human cells, which may enhance its ability to infect and escape antibodies.

JN.1 was first reported in August 2023 by the US Centers for Disease Control and Prevention (CDC), and has since been found in 41 countries, as of December 16, 2023, according to the WHO. The countries reporting the largest proportion of cases were France, USA, Singapore, Canada, the UK and Sweden.

The WHO said that JN.1 is spreading fast in all regions, probably because of its mutation in the spike protein, and warned that it may cause an increase in COVID-19 cases amid a surge of infections of other viral and bacterial infections, especially in countries entering the winter season.

However, the WHO also said that there is no evidence that JN.1 causes more severe disease or reduces the effectiveness of existing vaccines, compared to other circulating variants. The WHO advised people to continue following the preventive measures, such as wearing masks, washing hands, avoiding crowds, and getting vaccinated, to protect themselves and others from COVID-19.

Pakistan has not reported any case of JN.1 variant so far, and the COVID-19 positivity rate in the country remains low, at around 1%. However, the National Institute of Health (NIH), the country’s premier health research institution, issued an advisory on Wednesday for the prevention and control of JN.1 sub-variant, to alert and facilitate the health authorities and other stakeholders.

The NIH said that the objective of the advisory is to ensure timely preventive and control measures, encompassing preparedness to deal with increased workload expected in the outpatient and in-patient departments during the next few weeks.

The NIH quoted the WHO’s overall risk assessment, which said that despite a rapid increase in JN.1 infections, available limited evidence does not suggest that the associated disease severity is higher as compared to other circulating variants. Currently, available vaccines also offer the same protection against this JN.1 sub-variant as with other variants, it added.

The NIH further stated that the clinical presentation of JN.1 infection is similar to other sub-variants, including cough, sore throat, congestion, runny nose, sneezing, fatigue, headache, muscle aches and altered sense of smell. However, symptom presentation depends on an individual’s immunity from vaccination and previous infection.

The NIH termed vaccination as the most effective way to prevent infection and its severe outcomes, particularly in high-risk groups. More antibodies with complete vaccine or booster shots, the greater the chances of reducing COVID-19 infection, especially among high-risk groups, including the elderly population, people with comorbidities and people working in high-risk settings, it added.

The NIH also advised people to opt for respiratory etiquettes by covering their mouth and nose while sneezing or coughing with their elbow, advised sick patients to stay at home, rest, avoid crowds, and adopt social distancing measures until recovery. The NIH also recommended frequent and thorough hand washing with soap and water and the use of hand sanitiser, if soap and water are unavailable.

Meanwhile, reports emerged that many points of entry, including major airports in Islamabad and Karachi, lacked the COVID-19 testing kits and Personal Protection Equipment (PPE) for the healthcare workers associated with Border Health Services (BHS). Officials said that neither the kits nor the PPE were procured after the WHO declared in June this year that COVID-19 was no longer a public health emergency of international concern.

As per NCOC, the issue of testing kits and PPE was being resolved on an urgent basis, and that the testing of 2% of inbound passengers had been resumed to detect JN.1 variant. The official also said that the travellers who test positive for COVID-19 will be isolated and treated according to the national guidelines.

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