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Published on: Apr 25, 2021
2 minute read
By: Dr Rajan Choudhary

COVID 19 Mutations: An Update

COVID 19 Mutations: an update

India is currently experiencing a very high rate of infections across the country, resulting in record hospitalisations, ICU admissions and now a severe shortage of oxygen. How did this happen? As with all things, it is likely multifactorial, and blame cannot be associated with one single issue. Socioeconomic issues preventing effective lockdown, stretched healthcare resources, poor communication and maintenance of social distancing and mask use. And of course, viral variants, something we will be discussing below.

GENETIC MUTATIONS

Mutations are integrated deeply into the backbone of genetics. When DNA replicates, its two strands split apart and are used as blueprints to create two new strands, each containing half the original DNA. Mutation’s sneak into the replication phase, and can change the proteins the DNA encodes. If these mutations are compatible with life, they survive and may be passed down the generations. If the mutations provide an evolutionary benefit that improves the survival of the organism and allows it to outcompete other organisms, its descendants will survive, and the mutation will flourish.

Complex organisms such as plants and animals have inherent DNA repair mechanisms that reduce the rate of mutations. This is because most mutations are incompatible with life, as they destroy critical proteins required for the most basic functions of cell function and life. Cancer is evidence of what happens when these repair mechanisms fail. Viruses do not have such protection; when the high mutation rate is combined with the high replication rate, viral variants are inevitable.

COVID MUTATIONS

Scientists have been tracking mutations of the SARS-CoV-2 virus closely. Countries across the world are basing the re-opening and recovery of their societies on reducing infection rates and preventing re-infections through vaccination programmes. If the virus mutates, it can result in increased infectivity, mortality, and potentially the ability to escape from natural immunity offered by antibodies.

Indian genome scientists first detected the “double variant” of the novel coronavirus in October 2020, and in the UK in Feb 2021. It has been on the rise, and B.1.617 accounts for almost 70% of genomes submitted by India to the global database GISAID. It has a total of 13 mutations, which in turn lead to the change in multiple amino acids. B.1.617 has multiple mutations and describing it as a “double mutant” virus is therefore inaccurate.

L452R

B1617 s more contagious because of a mutation in the spike protein known as L452R.This mutation has been studied as it has also been found in variants identified in California (including apes in San Diego Zoo). It is thought this improves the binding to the ACE2 receptors in the lung and may also have some ability to escape from neutralising antibodies.

E484Q

The second mutation is E484Q, which also affects the spike protein to make it less susceptible to pre-existing antibodies, though there is limited evidence for this. Looking at convalescent plasma donated by people it appears to have weaker neutralisation of B.1.617 in some people, though this isn’t a consistent finding.

Mutations at position 484 have also been found in other global variants, though these E484K mutations lead to different functions. One study looking at the UK B.1.1.7 variant looked at how this E484K mutation affected viral interactions in vaccinated patients. Patients who have been vaccinated produce antibodies with a wide range of actions targeting multiple sections of the spike protein. When these patient serums were exposed to the B.1.1.7 mutation, it was found to have decreased neutralisation. This raised the risk of reduced vaccine efficacy and threatened the vaccine programme. Currently, public health officials are confident our vaccine programmes cover the emerging variants.

CONCERNS

Whilst B.1.617 is concerning, it currently accounts for about 20% of cases in Maharashtra, and likely a low percentage of total infections in the country. There is not yet enough evidence to classify it as a “variant of concern”, and further research is required. Though it has increased potential for spreading, currently the UK variant B.1.1.7 may be on the rise, and more concerning. It has over 50% increased transmissibility and 60% lethality and contributed to the UK’s most recent wave of infections. Genomic studies have shown it is now the dominant form of the virus in the Indian state of Punjab.

What is most concerning, however, is the risk of more variants emerging. As the infection spreads unimpeded through the population, viral replication remains at an all-time high, which in turn increases the risk of mutations. Current mutations are covered by vaccines, future mutations may not be. This is why we need to lower infection rates as soon as possible.

Social distancing, use of masks, vaccinations, lockdowns, and quarantine when expressing symptoms. We have to follow public health advice, to prevent our infection rates from spiralling further out of control

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Monthly Field Day with Patients & Staff: Building Stronger Connections for Better Health

Healthcare outcomes are shaped not only by medical treatments but also by trust, communication and community engagement. As healthcare systems in India move toward preventive and patient-centric models, initiatives that foster meaningful interaction between patients and healthcare professionals are gaining importance. One such initiative is the Monthly Field Day with Patients & Staff.

A field day creates a shared space where patients and healthcare teams interact beyond clinical settings. These interactions humanise healthcare, improve understanding and encourage long-term wellness practices.

Why Community Engagement Matters in Healthcare

Modern healthcare recognises that health is influenced by behaviour, awareness and social support. According to the World Health Organization (WHO) and NITI Aayog, community-based health engagement improves preventive care adoption and patient outcomes.

Field days help bridge the gap between healthcare providers and patients by:

encouraging open dialogue
reducing fear and hesitation
promoting shared responsibility for health

What Is a Monthly Field Day with Patients & Staff?

A Monthly Field Day with Patients & Staff is a structured wellness initiative organised outside the routine clinical environment. It focuses on interaction, education and preventive health activities.

Typical elements include:

basic health screenings
lifestyle education sessions
fitness or relaxation activities
informal conversations with healthcare staff
family and caregiver participation

The aim is to create a supportive and approachable healthcare experience.

Why Monthly Frequency Matters

Consistency is key in behaviour change and preventive health.

Monthly field days:

reinforce health messages regularly
build familiarity and trust
allow continuous follow-up
keep wellness top of mind

According to public health studies, repeated engagement significantly improves health literacy and adherence.

Benefits for Patients

1. Improved Health Awareness

Patients gain better understanding of:

chronic disease management
preventive screenings
nutrition and lifestyle habits

Education in informal settings improves retention.

2. Increased Comfort with Healthcare Teams

Regular interaction reduces anxiety and hesitation around seeking medical care.

Patients are more likely to:

ask questions
follow medical advice
attend follow-ups

3. Early Risk Identification

Field days often include basic screenings that help detect:

high blood pressure
elevated blood sugar
obesity risk

Early identification enables timely intervention.

4. Enhanced Emotional Wellbeing

Social interaction and community activities reduce feelings of isolation, especially among elderly or chronically ill patients.

Benefits for Healthcare Staff

1. Better Understanding of Patient Needs

Direct interaction outside clinical settings helps staff understand patient challenges more holistically.

2. Improved Communication Skills

Informal engagement strengthens empathy and communication effectiveness.

3. Reduced Burnout

Positive patient interaction and community appreciation contribute to staff morale and job satisfaction.

WHO recognises staff wellbeing as a critical factor in healthcare quality.

Role of Field Days in Preventive Healthcare

Preventive healthcare focuses on reducing disease burden before complications arise. Field days support prevention by:

promoting routine screenings
encouraging healthy lifestyle habits
addressing myths and misconceptions
reinforcing long-term care plans

NITI Aayog identifies community engagement as a cornerstone of preventive healthcare strategies.

Activities Commonly Included in Field Days

Health Screening Stations

Blood pressure, blood sugar, BMI and basic assessments.

Wellness Education

Short talks on nutrition, exercise, sleep and stress.

Interactive Sessions

Q&A discussions with doctors, nurses and health educators.

Physical Activities

Group walks, yoga sessions or light exercises.

Family Engagement

Including caregivers improves adherence and support systems.

Impact on Chronic Disease Management

For patients with chronic conditions such as diabetes or hypertension, regular engagement:

improves medication adherence
reinforces lifestyle modification
reduces emergency visits

Lancet studies highlight that community-based interventions improve chronic disease outcomes.

Building Trust Through Transparency

Field days foster trust by:

making healthcare providers approachable
encouraging open dialogue
demonstrating commitment to patient wellbeing

Trust improves treatment adherence and satisfaction.

Role of Data and Feedback

Feedback collected during field days helps healthcare organisations:

identify common concerns
refine wellness programs
personalise future interventions

Data-driven engagement enhances program effectiveness.

Long-Term Impact on Healthcare Outcomes

Organisations that invest in regular patient-staff engagement observe:

higher patient satisfaction
improved preventive screening rates
reduced disease complications
stronger community relationships

According to WHO, patient-centred care models improve health outcomes and system efficiency.

Why Field Days Are Especially Relevant in India

India’s diverse population faces challenges such as:

limited health literacy
delayed care-seeking
chronic disease burden

Community-based initiatives like field days address these challenges through education and trust-building.

Conclusion

A Monthly Field Day with Patients & Staff is more than a community event—it is a strategic preventive healthcare initiative. By fostering open communication, promoting health awareness and strengthening relationships, field days improve patient engagement and staff wellbeing alike. In a healthcare landscape increasingly focused on prevention and community trust, regular field days play a vital role in building healthier, more connected communities.

References

ICMR – Community Health and Preventive Care Reports
National Family Health Survey (NFHS-5) – Health Awareness and Engagement Dat
NITI Aayog – Community-Based Preventive Healthcare Strategies
WHO – Patient-Centred Care and Community Health Guidelines
Lancet – Community Engagement and Health Outcome Studies
Statista – Healthcare Engagement and Preventive Care Trends India
EY-FICCI – Healthcare Workforce and Patient Engagement Reports

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