Dr Cyriac Abby Philips, better known as “The Liver Doc,” isn’t sounding the alarm just for India’s sake. From his hospital in Kerala, the multi-award-winning hepatologist is watching an uptick in COVID-19 cases with a familiar sense of unease—not because it feels like 2021 all over again, but because the virus seems to be mutating into something subtler, sneakier, and stubbornly persistent.
He isn’t alone. Across India, emergency rooms are filling with patients reporting prolonged fevers, unusual rashes, and dry coughs that worsen at night. This time, throat pain often leads to voice changes—hoarseness, laryngitis, and a lingering irritation that doesn’t resolve quickly. And while most aren’t ending up in ICU, the pattern is troubling enough that his hospital has reopened a COVID ward.
“Ok Covid is here,” Dr Philips posted. “Different, but still here.”
His detailed list of symptoms mirrors those seen in Australia and parts of Asia recently: fatigue, rash-like urticaria, dry cough, and voice loss. But what makes his observations especially worth noting for countries like ours—with lower testing, fewer public warnings, and growing pandemic fatigue—is that India tends to act as an early warning system. With over a billion people and high transmission volumes, its hospitals often spot trends that ripple across the world weeks later.
“My patients are getting affected,” he wrote. “Many are coming back with itchy bumpy rashes that don’t seem to go away.”
He’s joined by other medical professionals witnessing the same. Dr Ashwin Rajenesh noted, “The covid transient rashes are back? We did have them initially pre-delta, then sort of completely disappeared during omicron. Dengue-like myalgia and malaise [are] prominent symptoms. Lots of secondary bacterials this time around day 5–7, again something we hadn’t seen earlier.”
Dr Philips responded: “The hives are pretty bad this time. Also secondary bacterial infections. I concur.”
It’s that kind of frontline pattern recognition—not panic—that Australia’s clinicians and public health officials should be paying attention to. India is, once again, becoming a laboratory of transmission, and clinicians like Dr Philips are acting as its early messengers.
Despite the wave being relatively mild so far, it’s the unpredictability that’s driving the concern. Asked on X whether this might get “1st lockdown bad,” Dr Philips responded: “Not seeing very sick patients. Few of them in the ICU. But ER is getting full with fever cases and my OPD also seeing patients coming in with prolonged fever.”
What’s particularly noticeable this time is the unpredictability of symptoms. One user, Aadeesh, shared: “Got sick three weeks back. Strange symptoms—no fever, severe bodyache for 2–3 days, loss of smell and taste for 10 days… very bad cold, still fatigued, voice changed initially.” These accounts aren’t medical evidence, but they echo a larger concern: this isn’t behaving like the flu, and it’s not behaving like Omicron.
Dr Philips responded to one such post saying, “I’m not scared by Covid. I’m scared of what comes after Covid.”
His fear is rooted in experience. Long COVID remains poorly understood, and many patients continue to face weeks of exhaustion, lingering inflammation, and unexplained symptoms. He has written and spoken at length about post-viral complications and the strain they place on both patients and hospital systems.
Here in Australia, NB.1.8.1—a subvariant of Omicron—is beginning to appear across New South Wales and Western Australia. Wastewater data in Perth has also shown increased viral fragments, suggesting more infections than official numbers show. In NSW, test positivity reached 5.7% by mid-May. That may seem low, but in a country where testing rates have plummeted, it is a likely undercount.
While our health officials aren’t sounding the alarm, the rise in cases coincides with winter—a time when respiratory illnesses already put pressure on the system. Hospitals are gearing up for flu and RSV, offering free immunisations until the end of June. Yet COVID’s new forms, despite being milder on average, are now known to be lingering longer—dragging down energy levels, keeping people off work, and spreading quietly in households.
India is currently reporting over 1,000 active cases, with Kerala, Maharashtra, and Delhi leading the count. Subvariants like LF.7 and NB.1.8.1 are believed to be behind the rise. Singapore, meanwhile, has seen a 28% week-on-week increase in COVID cases, rising from 11,000 to 14,200 in early May. Hong Kong’s test positivity rate has doubled, and Thailand has logged over 71,000 infections this year alone.
In each case, authorities are resisting lockdowns or mass restrictions. The focus is on individual responsibility—staying home when sick, wearing masks in crowded indoor spaces, and keeping vaccinations up to date. Yet, as Dr Philips points out, there is a risk that without clear guidance or attention, communities may simply sleepwalk into another wave of illness.
To be clear, the health response in Australia is calibrated to our current risk. Hospitals are not overwhelmed, and no new restrictions are being proposed. But part of public health is listening to frontline clinicians—even those outside our borders—when the symptoms start looking unfamiliar.
Dr Philips, by virtue of his clinical position, reach, and credibility, is one such voice.
His message is simple: “If you are sick, stay at home. Get supportive care at home. Mask up in closed public places.” He may be treating patients in India, but his words resonate across oceans. With our own winter setting in, now might be the right time to tune in.
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🦠 India's @theliverdr warns of new #COVID wave with unusual symptoms: rashes, voice changes & fatigue. 🌏 Cases rising in Kerala & Delhi; subvariants NB.1.8.1/LF.7 spreading. 🇦🇺 Aussie doctors urged to note India's early warning signs. #TheIndianSun
🔗 https://t.co/cMjZs8F3eq pic.twitter.com/4oSHyOScLb
— The Indian Sun (@The_Indian_Sun) May 29, 2025
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