Abstract: Rising COVID-19 Cases in India as of May 2025: Detailed Report: As of May 26, 2025, India is experiencing a mild uptick in COVID-19 cases, with 301 active cases reported, driven by emerging subvariants NB.1.8.1 and LF.7, both descendants of the JN.1 lineage of Omicron. This report examines the current epidemiological situation, characteristics of the variants, ongoing research, public health responses, and implications for the population. While cases remain mild and the situation is under control, the rise mirrors regional surges in Southeast Asia, prompting heightened surveillance. This paper critically evaluates the data, highlighting gaps in testing and the need for robust genomic surveillance to manage future risks.
Keywords: COVID-19, NB.1.8.1, LF.7, JN.1, India, Omicron, genomic surveillance, public health
1. Introduction: Rising COVID-19 Cases in India as of May 2025
The COVID-19 pandemic, caused by SARS-CoV-2, has evolved into an endemic phase globally, with periodic surges driven by new variants. As of May 26, 2025, India reports 301 active cases, an increase from 257 on May 19, following a regional trend in Southeast Asia where countries like Singapore, Hong Kong, and Thailand have seen significant spikes. This report analyzes the rise in India, focusing on the NB.1.8.1 and LF.7 subvariants, their characteristics, and the public health response. With India’s history of devastating waves—45,041,748 cases and 533,623 deaths reported since January 2020—the current situation demands scrutiny to prevent escalation.
2. Current Epidemiological Situation
2.1 Case Statistics
As of May 26, 2025, India has 301 active COVID-19 cases, up from 257 on May 19, according to the Ministry of Health and Family Welfare (MoHFW) dashboard. Over the past 24 hours, 44 new cases were added, maintaining a recovery rate of 98.81%. The increase, though mild, is the highest in a year, with Kerala (273 cases in May), Tamil Nadu (66), and Maharashtra (56) reporting the most significant numbers. Karnataka recorded 38 active cases, including a COVID-related death in Bengaluru—an 84-year-old with comorbidities. A nine-month-old in Bengaluru also tested positive, highlighting vulnerability across age groups.
2.2 Regional Context
The rise in India mirrors a broader trend in Southeast Asia:
- Singapore: Cases surged from 11,100 in late April to 14,200 in early May, a 28% increase, with hospitalisations up by 30%.
- Hong Kong: Test positivity rose from 6.21% to 13.66% over four weeks, with 31 deaths in the first week of May—the highest weekly toll in a year.
- Thailand: 33,030 cases were reported between May 11-17, linked to the Songkran festival in April.
- China: Positivity rates in hospitals doubled from 3.3% to 6.3% by May 4, indicating a potential wave.
India’s relatively low numbers suggest early-stage detection, but experts warn of underreporting due to insufficient testing, especially in states reporting “zero” active cases.
3. Variant Analysis
3.1 Dominant Variants in India
The Indian SARS-CoV-2 Genomics Consortium (INSACOG) reports that JN.1 remains the most common variant in India, comprising 53% of sequenced samples, followed by BA.2 (26%) and other Omicron sublineages (20%). However, two new subvariants, NB.1.8.1 and LF.7, have been detected and are linked to the recent rise.
NB.1.8.1
- Detection: One case was identified in Tamil Nadu in April 2025.
- Characteristics: A descendant of JN.1, NB.1.8.1 carries spike protein mutations A435S, V445H, and T478I. These mutations suggest increased transmissibility and immune evasion compared to earlier variants. The World Health Organization (WHO) classifies NB.1.8.1 as a Variant Under Monitoring (VUM), indicating a need for further study but not yet a Variant of Concern (VOC) or Interest (VOI).
- Risk Assessment: WHO’s preliminary analysis rates NB.1.8.1 as a low global public health risk, but its mutations raise concerns about vaccine efficacy and reinfection rates.
LF.7
- Detection: Four cases were identified in Gujarat in May 2025.
- Characteristics: Also a JN.1 sublineage, LF.7 shares similar traits with NB.1.8.1, including enhanced transmissibility. It lacks the loss of taste/smell symptom typical of earlier variants like Delta but presents with mild upper respiratory symptoms. WHO classifies LF.7 as a VUM.
- Regional Impact: LF.7 and NB.1.8 are driving case surges in Southeast Asia, particularly in Singapore and Hong Kong, where they account for over two-thirds of sequenced cases.
3.2 JN.1: The Parent Variant
- Background: JN.1, a descendant of Omicron BA.2.86 (Pirola), was first identified in August 2023. It carries a single mutation in its spike protein, potentially enhancing immune evasion, according to Yale Medicine.
- Symptoms: JN.1 symptoms include sore throat, mild cough, fatigue, fever, and occasionally diarrhea or conjunctivitis (pink eye). Loss of taste/smell is rare compared to Delta.
- Severity: Most cases are mild, with no hospitalisations or ICU admissions reported in India’s current surge. However, high-risk groups (elderly, diabetics, immunocompromised) may experience moderate symptoms.
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4. Research and Genomic Surveillance
4.1 INSACOG’s Role
INSACOG, established in December 2020 by the MoHFW, ICMR, and others, has been pivotal in tracking SARS-CoV-2 variants in India. Its recent data highlights the emergence of NB.1.8.1 and LF.7, though JN.1 remains dominant. Genomic sequencing of positive samples is conducted following RT-PCR or Rapid Antigen Tests (RATs), with multiplex PCR tests used to differentiate COVID-19 from other respiratory viruses.
4.2 Global Research Context
- WHO Updates: On March 15, 2023, WHO revised its variant tracking system to focus on Omicron descendants, reflecting their global dominance. As of May 23, 2025, WHO emphasizes the importance of sharing genomic data to monitor variants like NB.1.8.1 and LF.7.
- Yale Medicine: Research indicates JN.1’s spike protein mutation may enhance immune evasion, though its impact on transmissibility or severity remains under study.
- European CDC: The ECDC tracks variant proportions, noting that sublineages like LF.7 emerge rapidly after VOC/VOI classification, necessitating continuous surveillance.
4.3 Gaps in Research
India’s surveillance system, while robust, faces challenges:
- Underreporting: Experts suggest that the true number of cases may be higher due to low testing rates, especially in rural areas where 67% of cases were reported during past waves.
- Limited Sequencing: Not all positive samples undergo genomic sequencing, potentially delaying variant detection.
- Waning Immunity: Studies attribute the rise to declining population immunity, inconsistent booster uptake, and relaxed preventive behaviors, but data on booster efficacy against NB.1.8.1 and LF.7 is lacking.
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5. Public Health Response
5.1 Government Actions on Rising COVID-19 Cases in India as of May 2025
- Surveillance: The Integrated Disease Surveillance Programme (IDSP) and ICMR’s respiratory virus sentinel network are actively monitoring cases. A review meeting on May 25, chaired by the Director General of Health Services, concluded that the situation remains under control.
- Advisories: Karnataka issued guidelines urging pregnant women, children, and those with comorbidities to wear masks in crowded places and use hand sanitizers. Similar recommendations are in place nationwide.
- Testing: Authorities in Mumbai have begun testing all individuals with influenza-like illness (ILI) or severe acute respiratory infection (SARI) for COVID-19, with 16 hospitalisations reported in May.
5.2 Vaccination Status
India’s vaccination campaign, launched on January 16, 2021, has administered over 1.7 billion doses, with 720 million fully vaccinated as of January 2022. However, booster uptake remains inconsistent, contributing to waning immunity. Experts recommend boosters for high-risk groups, as current vaccines may have reduced effectiveness against JN.1 subvariants.
5.3 Community Sentiment
Posts on X reflect cautious concern, with users noting the detection of NB.1.8.1 and LF.7 in Tamil Nadu and Gujarat. Health experts on the platform urge vigilance but stress that these variants are not currently classified as VOCs by WHO, aligning with official statements.
6. Critical Evaluation
6.1 Strengths of Response
- Proactive Surveillance: India’s established systems like INSACOG and IDSP enable early variant detection.
- Mild Cases: The absence of severe illness or ICU admissions suggests that existing immunity and vaccinations are mitigating impact.
- Regional Collaboration: India’s monitoring aligns with WHO and Southeast Asian health authorities, facilitating data sharing.
6.2 Challenges
- Testing Gaps: Low testing rates in some states may mask the true extent of the outbreak, as noted by specialists.
- Public Complacency: Relaxed preventive behaviors and increased social mixing, as seen in Thailand post-Songkran, could fuel transmission.
- Vaccine Efficacy: The lack of specific data on booster effectiveness against NB.1.8.1 and LF.7 raises concerns about long-term protection.
6.3 Opportunities
- Enhanced Sequencing: Increasing genomic sequencing capacity can improve variant tracking, especially in rural areas.
- Public Awareness: Campaigns emphasizing masks, hand hygiene, and boosters can curb transmission, particularly for vulnerable groups.
- Research Investment: Collaborative studies with global bodies like WHO can clarify the impact of JN.1 subvariants on immunity and severity.
6.4 Threats
- Potential Surge: A decline in immunity, as seen in Southeast Asia, could lead to a larger wave if not addressed.
- Healthcare Strain: High-risk groups may overwhelm hospitals if cases escalate, especially in under-resourced regions.
- Misinformation: Inconsistent messaging about variant severity could lead to panic or negligence, as seen in past waves.
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7. Discussion
The current rise in COVID-19 cases in India, while mild, underscores the virus’s persistence as an endemic threat. NB.1.8.1 and LF.7, though not classified as VOCs, exhibit traits like increased transmissibility and immune evasion, necessitating close monitoring. The regional surge in Southeast Asia serves as a warning, with factors like waning immunity and social mixing amplifying transmission. India’s history of severe waves—particularly the Delta-driven second wave in 2021, which caused over 90% of cases at its peak—highlights the need for vigilance.
Critically, the establishment narrative of “situation under control” may downplay underlying risks. Low testing rates and potential underreporting, especially in rural areas where 67% of cases were reported in 2020-2021, suggest the true burden may be higher. The lack of comprehensive data on booster efficacy against new subvariants further complicates the response. While the absence of severe cases is reassuring, the vulnerability of high-risk groups, as evidenced by the Bengaluru death, demands proactive measures.
8. Conclusion: Rising COVID-19 Cases in India as of May 2025
As of May 26, 2025, India’s 301 active COVID-19 cases reflect a mild but notable rise, driven by JN.1 subvariants NB.1.8.1 and LF.7. These variants, detected in Tamil Nadu and Gujarat, exhibit increased transmissibility but cause primarily mild symptoms, consistent with Omicron’s profile. The situation, while under control, requires enhanced surveillance, testing, and public awareness to prevent escalation. India’s robust systems like INSACOG provide a foundation for response, but gaps in testing and research must be addressed. As the virus continues to evolve, a balanced approach—combining scientific rigor with public engagement—will be crucial to manage this endemic phase.
9. Recommendations
- Increase Testing: Expand RT-PCR and RAT testing, especially in rural areas, to capture the true extent of the outbreak.
- Enhance Genomic Sequencing: Prioritize sequencing of all positive samples to track emerging variants in real-time.
- Booster Campaigns: Launch targeted campaigns to increase booster uptake among high-risk groups, with research to assess efficacy against NB.1.8.1 and LF.7.
- Public Education: Promote masks, hand hygiene, and social distancing through media campaigns, emphasizing protection for vulnerable populations.
- Global Collaboration: Share genomic data with WHO and Southeast Asian health bodies to strengthen regional preparedness.
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10. References
- Data synthesized from the Ministry of Health and Family Welfare COVID-19 Dashboard, INSACOG reports, WHO updates, and media sources like The Hindu, India Today, and Business Standard, accessed May 2025.
- Historical data on India’s COVID-19 waves from Nature’s Scientific Reports.
- Variant characteristics from Yale Medicine and WHO’s SARS-CoV-2 variant tracking updates.
