Authorities confirmed the spread of the JN.1 sub-variant of coronavirus in Nepal earlier this month when various communities were observing festivities. JN.1, which is considered a highly contagious variant of Omicron, has now spread to various parts of the country. The whole-genome sequencing carried out two weeks ago at the National Public Health laboratory showed that the youngest sibling of the Omicron is responsible for infection in seven out of 16 infected people.

Infectious disease experts and virologists have said that the spread of the virus during the flu season in which a lot of people throughout the country are getting infected with various viruses is a matter of serious concern.

The spread began at the start of the marriage season and amid festivals of various ethnic communities involving huge crowds, which made for a conducive environment for the new virus variant to spread further, experts say. Apart from that, political parties are also convening huge rallies and jamborees. Public health measures are hard to enforce in political rallies, gatherings of festivals, weddings and other cultural events.

Experts, however, said that the new sub-variant doesn't seem as lethal as the previous ones, such as Delta, but it poses serious risks to elderly people and those having underlying conditions. They have asked authorities concerned to step up surveillance measures including increasing testing and enforcing public health measures such as mandatory masks, social distancing, and washing hands. They say the vaccine against the coronavirus should be administered to vulnerable populations—elderly people and those having underlying conditions.

Here is all you need to know about the status of JN.1 and the measures to safeguard oneself.

JN.1 sub-variant and its spread

Nepal confirmed the spread of the JN.1 sub-variant in the country on January 8. Of the 16 swab samples on which whole-genome sequencing was carried out at the National Public Health Laboratory, the JN.1 sub-variant was detected in seven samples, which is around 44 percent of the total.

The World Health Organisation classifies JN.1 as a separate ‘variant of interest’ given its rapid spread around the globe. The UN health body, however, said that based on available data, “the additional public health risk posed by JN.1 is currently evaluated as low”.

Several countries, including China, Indonesia, the Philippines, Malaysia and Singapore, have reported upticks in new coronavirus cases. The JN.1 strain, first detected in September in the United States, is a descendant of BA.2.86, a highly mutated variant of the Omicron strain of the coronavirus.

Symptoms of JN.1 sub-variant

Most of the symptoms of the JN.1 sub-variant of the Omicron are similar to the symptoms of other variants of the coronavirus: cough, sore throat, runny nose, fatigue, headache, muscle ache, and smell and taste loss.

Who is at risk?

Doctors say all people are at risk of infection, as the virus doesn't differentiate people. But elderly people and those having suppressed immunity—pregnant women, patients related to heart, renal, cancer and others—are at high risk of getting severe.

“Though the hospitalisation rate due to coronavirus infection has not yet increased, the number of people seeking hospital care could rise if the infection rate rises,” said Dr Janak Koirala, an infectious disease expert. “The number of patients with respiratory illnesses has already risen in the hospitals, and if the coronavirus also spreads, it will increase severity in the patients.”

Risk of double infection

As flu season is at its peak, cases of coronavirus infection have started rising, which is not a good sign, according to experts. They say that one could be infected with multiple viruses at once, which increases severity and could even cause death.

“The number of patients suffering from pneumonia has increased of late in hospitals and if a patient suffering from other viruses is also infected with coronavirus, risk of severity increases,” Koirala said.

Ways to avoid infection

Follow the basics, doctors say. Basics—to which most people are familiar with and which were also enforced during the first, second and third waves of the Covid-19 pandemic—are wearing face masks, washing hands regularly, and avoiding crowds, among others. Doctors ask people to stay at home if they have Covid-like symptoms.

As the public health measures have been lifted following the decline in the infection rate of the Omicron variant in 2021, people have stopped following the safety measures. Even the authorities concerned haven’t shown seriousness about the risks and enforce the public health measures.

“If you’ve not received a booster shot yet, get it at the earliest,” suggests Dr Rajiv Shrestha, an infectious disease expert at the Dhulikhel Hospital. “Those having underlying conditions should get inoculated with additional booster shots as well if they were inoculated with coronavirus vaccine six months ago.”

Complacency could be costly

Experts as well as the Health Ministry officials concede that it is not easy to enforce public health measures now like in the initial stage of the coronavirus pandemic. People will not take the issue seriously until the infected patients start dying. Even the uptake of the coronavirus vaccine is very low in the country at present, which shows lack of seriousness on the part of the general public.

It seems that health authorities too have not taken the issue seriously. Most of the Covid-19 testing labs throughout the country lack testing kits, and health desks set up at the international land crossings lack antigen test kits. Infected people are freely roaming in the communities and no agency has been monitoring their movements.

“After all, life is your own. So stay safe and save family members,” said Dr Sher Bahadur Pun, chief of the Clinical Research Unit at the Sukraraj Tropical and Infectious Disease Hospital.

Pun said that people are not getting severe now as the vaccine coverage rate is good in Nepal and a lot of people have been infected in every surge, meaning that most people in the country have natural immunity.

“But that should not be a reason to let go of safety measures,” Pun said. “We should not forget that some people in our communities have underlying health conditions.”

What the Health ministry has to say

The Ministry of Health and Population has said that positive cases of Covid-19 infection have started rising again and urged the general public to avoid crowds and follow public health measures. Officials claimed that the agencies under the ministry were alerted and surveillance measures stepped up following the confirmation of the JN.1 outbreak in the country.

“We have stepped up surveillance, decided to fast-track purchase of testing kits and asked provincial health authorities to manage the testing kits on their own,” said Dr Hemanta Ojha, an official at the Epidemiology and Disease Control Division. “Everyone should follow public health measures. And elderly people should take extra precautions.”