hile Pakistan is scrambling to contain the spread of a novel Covid-19 variant, JN.1, the virus is characterised as highly contagious but less virulent and, therefore, unlikely to cause morbidity and mortality of the scale of previous pandemic phases.

The National Command and Operations Centre has confirmed 15 cases of JN.1, a sub-variant of the lineage of the omicron variant, including eight diagnosed at laboratories of the National Institute of Health, Islamabad, five at Aga Khan University Hospital, Karachi, and two at Dow University of Health Sciences, Karachi.

Although most JN.1 cases have been detected among international travellers, especially from Saudi Arabia, the Aga Khan University Hospital has seen at least five cases of local transmission. The patients, including three women, have no recent history of travel.

While JN.1 cases have been diagnosed mainly in Islamabad and Karachi, one case of JN.1 from Rahim Yar Khan district of the Punjab has also been detected among the confirmed cases in Karachi. The Punjab, Khyber Pakhtunkhwa and Balochistan have witnessed a growing number of influenza patients but remain free of the new Covid-19 variant.

A National Institute of Health report has indicated that out of 3,609 Covid-19 tests conducted countrywide, only 15 samples were found positive for JN.1 with a positivity rate of 0.44pc. Despite a rapid increase in JN.1 infections in Pakistan in the last few weeks, there is no conclusive evidence regarding increased severity, indicating a potentially lower risk of severe illness and hospitalisation.

The World Health Organisation has classified new mutations as variants of interest with genetic changes that are predicted or known to affect virus characteristics such as transmissibility, disease severity and immunity escape, diagnostic or therapeutic escape. These are identified to cause significant community transmission or multiple clusters of infected persons. The variant of concern is associated with changes at a degree of global public health significance, like an increase in transmissibility or detrimental change in Covid-19 epidemiology.

The JN.1 is classified as a VoI and an offshoot of BA.2.86, a sub-variant of omicron variant of the Covid-19 virus. First reported in the US in August last year, the JN.1 variant has been reported widely in many countries in recent weeks, with its prevalence increasing rapidly around the globe.

Dr Javed Akram, the caretaker Punjab minister for specialized healthcare and medical education, says that research scientists in the Punjab are running trials regarding various strains of Covid-19. “The JN.1 strain can evade the immune system and transmit more easily than other currently circulating variants, but it has shown no signs of more severe disease. While there might be more cases with the variant, JN.1 doesn’t pose a greater risk,” he has said, adding that JN.1 is a benign strain among various Covid-19 mutations.

Experts say 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 taste and smell. “The symptom-presentation, however, depends on the individual’s immunity from vaccination and previous infection,” says Dr Rana Jawad Asghar, an infectious diseases expert based in Islamabad.

The JN.1 variant is considered less virulent but highly contagious, he says. There is a need to enhance screening and testing services as more and more patients report flu, chest infections and at times, pneumonia. “With limited evidence available, there is a need to have a specific diagnosis to study as to how the new strain will react,” he suggests.

Following the resurgence of the JN.1 variant in various countries and the possible threat of the new variant in Pakistan, the federal government is procuring 500,000 doses of Pfizer vaccines from the US.

To prevent the spread of JN.1, the experts say, the same strategies as those used to prevent Covid-19 are advised, such as social distancing, wearing masks and having proper sanitation and hygiene. The existing vaccines, tests and treatments are also effective against the JN1 variant.

Following the resurgence of the JN.1 variant in various countries and the possible emerging threat of the new variant in Pakistan, the federal government is procuring 500,000 doses of Pfizer vaccines from the US on the recommendation of the Emergency Operation Centre’s technical advisory group of the Ministry of National Health Services, Regulations and Coordination. The available vaccines offer the same protection against JN1 sub-variants as with other Covid-19 variants.

The caretaker health minister, Dr Nadeem Jan, says the government is closely monitoring the new variant and ensuring that the necessary measures are taken to prevent its spread among the public. “We have strengthened border control measures, alerted the national and provincial health authorities and an effective screening system is in place at the country’s entry and exit points of international airports,” he adds.

The National Institute of Health and the Islamabad Healthcare Regulatory Authority have issued advisories for national and provincial health authorities to ensure timely preventive and control measures regarding the new variant JN.1, encompassing preparedness to deal with the increased workload expected in the outpatient and inpatient departments during next few weeks.

The advisories also suggest to the public that those presenting flu-like symptoms should adopt preventive measures such as frequent and thorough hand washing with soap and water, use of hand sanitiser, observe social distancing as well as respiratory etiquette while sneezing or coughing. The patients must avoid crowds and stay at home. “Since vaccination is the most effective way to prevent infection and its severe outcomes, the more the antibodies, the greater the chances of reducing Covid-19 infection, especially among high-risk groups including elderly population and people with co-morbidities,” says the advisory.

The caretaker Sindh government has established a provincial task force for Covid-19 to monitor the progress of the new variant and suggest ways to neutralise its threat to people’s health.

Similarly, because of the recent upswing in respiratory infections coupled with worldwide dissemination of the novel JN.1 variant of Covid-19, the Khyber Pakhtunkhwa government has directed the district health authorities to enhance screening of influenza-like illnesses and random testing of Covid-19. “As the neighbouring countries have documented occurrences of the JN.1, it warrants the need for a proactive and vigilant approach,” says a spokesman of the KP Health Department.

The Ministry of Health has formed a committee to analyse the new JN.1 variant in Pakistan. It will review the diagnoses of the new variant on old test kits and also put forward its suggestions to the government to implement public health measures to stop its transmission and improve treatment of the affected patients.

The writer is a reporter associated with The News International. An EWC and GIJN fellow, he contributes to various international media outlets. His X handle: @AmerMalik3