COVID-19 Delta Plus Variant in India:  Amidst the COVID-19 pandemic situation in the country, the cases of Delta Plus variant has been a cause of concern for the country. The Union Health Ministry said on Wednesday that around 40 cases of the Delta plus variant which has been classified as a variant of concern (VOC), have been detected sporadically in Maharashtra, Kerala and Madhya Pradesh. In this context, Union Health Secretary Rajesh Bhusan has written to the chief secretaries of Madhya Pradesh, Kerala and Maharashtra, requesting them to take up immediate containment measures in the districts where Delta Plus variant has been detected.

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In its statement, the Union Ministry of Health said, "The Delta Plus variant has been observed sporadically in Maharashtra, Kerala & MP with around 40 cases identified so far. These States have been advised for strengthening surveillance & public health measures."

In his letter to the chief secretaries of the respective states, Union Health Secretary has written that INSACOG (Indian SARS-CoV-2 Genomic Consortia) has intimated that the Delta Plus variant is a VOC has the following characteristics:

1) Increased transmissibility

2) Stronger binding to receptors of lung cells

3) Potential reduction in monoclonal antibody response

INSACOG is an Indian consortium of 28 labs established by the central government to carry out Whole Genome Sequencing in the context of COVID-19 pandemic.

The statement issued by the Union Health Ministry further said that after the report of AY.1 by the Public Health England (PHE) on June 11, retrospective analysis of samples revealed the first occurrence of this lineage from a sample collected from Maharashtra. The sample was collected on April 5. As of June 18, 205 sequences of AY.1 lineage was detected worldwide, with the USA and the UK having over half of the known cases.

The Union Health Ministry statement reported that the INSACOG reported the evolution of Delta plus variant (B.1.617.2) + K417N lineage of SARS-CoV2 called as B.1.617.2.1/ AY.1. The Delta plus variant B.1.617.2.1/ (AY.1) is characterised by the K417N mutation in spike protein. The spike protein aids the virus to gain receptor-mediated entry into human cells.

K417N corresponds to the change of amino acid lysine (K) to asparagine (N) at the 417th position of spike protein. There are other Delta plus variants with other mutations. The AY.1 is the most well-known, but these are not identical. A second clade found in sequences uploaded to GISAID from the USA, is now designated AY.2, but is not seen in India yet. The statement further added, "All Delta sub-lineages are treated as a variant of concern VOC, although properties of AY.1 are still being investigated. Currently, the variant frequency of AY.1 is low in India. Cases with AY.1 have been mostly reported from nine countries of Europe, Asia and America."

The mutations help the virus to become either more transmissible or more virulent or both. With time these mutations known as Variants of Interest (VOI) increase in frequency in the selected population and are considered then as VOC.

The Union Health Secretary in his letter to the chief secretaries of Kerala, Maharashtra and Madhya Pradesh requested them to "ensure that adequate samples of positive persons are sent to the designated laboratories of INSACOG promptly so that the clinical epidemological correlations can be made."