Speedy Vaccination Best Bet to Check Fast-mutating Coronavirus as Variants Get More Lethal

·9-min read

Similar to all viruses, the SARS-COV-2 has thousands of variants that have been identified and they are mutating fast and taking new forms. The only to arrest it from spreading fast is speedy vaccination at a large scale. The new variants in the UK, South Africa and Brazil are highly transmissible and have triggered panic as experts believe vaccines may be less effective against them.

However, a quick and effective process of inoculation is the best bet for the world at this juncture of the pandemic. Health experts have cautioned that Indians need not panic over the mutations, but the country needs to stay vigilant.

So far, 150 people in India have tested positive for the UK variant of coronavirus, according to the Union Health Ministry on Saturday.

ALSO READ | There is Evidence That New Covid-19 Variant Carries Higher Risk of Death: UK PM Boris Johnson In an alarming incident the UK variant “501.Y.V1” was reported on January 8 when a care home worker in Canada’s Ontario tested positive for the coronavirus. In the next two weeks, as many as 127 of the care home’s 129 residents fell sick and 32 died.

The UK variant of the virus is known to be at least 40% more infectious.

The “501.Y.V1” came under the world’s scanner in December and only in a matter of little over a month, it has spread so fast that the US Centers for Disease Control and Prevention (CDC) expects it to be the main coronavirus variant in America by March.

Meanwhile, South Africa and Brazil are dealing with another variants — the “501.Y.V2” and “501.Y.V3”, respectively — are also spreading fast. In South Africa, the mutation, also referred to as B1.351, was found in early October and announced in December, when the country’s health minister said the strain seemed to affect young people more than previous strains. It has contributed to a surge of infections and hospitalisations across South Africa.

As the South African variant has escaped the antibodies in people who have recovered from Covid-19. Therefore, scientists are worried for vaccines might be less effective against it. The South African variant has been identified in more than two dozen countries, including Canada, Australia and Israel, but not in the United States.

The “501.Y.V2” mutation is similar to that in the UK and appears to be more transmissible. However, there is no evidence that it is more fatal.

In early January, top infectious-diseases expert Anthony S. Fauci said that the vaccines may have a diminished impact against this variant, but they probably will still be effective.

Moderna has said its vaccine protects against the South Africa variant, with an important caveat: The vaccine-elicited antibodies were also less effective at neutralizing this mutation in a laboratory dish.

Meanwhile, the Brazil variant has more than a dozen alterations, several of which are found on the virus’s spike protein, which binds the virus to a cell, which is why researchers think the strain is probably more transmissible. There is also some early evidence that antibodies might not recognize the P.1 variant, which could lead to reinfection.

What has changed?

In mid-January, two separate studies by London School of Hygiene and Tropical Medicine and Imperial College London were presented to Britain's New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG).

They linked data from people who tested positive for the virus in the community -- rather than in hospital -- with death data and found a roughly 30 percent increase in the risk of death associated with the new strain.

The groups used slightly different methods, but both matched people with the new variant to those with the older variants, taking into account other variables like age and location and controlling for hospitals being under pressure.

Other studies by Exeter University and Public Health England also found higher deaths and both came up with even higher figures.

Based on these analyses, NERVTAG said there was "a realistic possibility" that infection with the new variant is associated with an increased risk of death compared with previously circulating variants.

The increase in transmissibility associated to the variant was already causing alarm, because the more people the virus infects the more people will suffer serious illness and the risk of death.

"Unfortunately, it looks as if this virus might be both" more infectious and potentially more deadly, John Edmunds, a professor in LSHTM's Centre for the Mathematical Modelling of Infectious Diseases, told a press briefing Monday

"So it's really a serious turn for the worse unfortunately," he said.

How reliable are the findings?

Researchers said there were still uncertainties in the data and said the picture would become clearer in the next few weeks.

Edmunds said the findings were "statistically significant".

But he said while the studies used information from those tested in the community, most people who die of Covid-19 go straight to hospital and are tested there.

Researchers do not yet have that hospital information.

NERVTAG said this lag in data could be why the studies did not find evidence of an increase in hospitalisations of people with the new variant, which seems at odds with the findings of increased severity of disease.

It also said the mortality data used in the research only covers eight percent of the total deaths during the study period and said the results "may therefore not be representative of the total population".

Why more deadly?

Researchers think it could be the same set of mutations that has made it more infectious -- although all stress more study is needed.

One mutation in particular increases the virus' ability to latch on more strongly to human cells and NERVTAG head Peter Horby, an emerging infectious disease professor at Oxford University, said evidence suggests this means it could make it easier to become infected.

"If it's then able to spread between cells much quicker within the lungs, that may increase the rate of disease and the rate of inflammation, which may then progress quicker than your body can respond to, so it could explain both characteristics of the virus," he said.

Bjorn Meyer, virologist at France's Institut Pasteur, told AFP that the issue could be viral load.

"The virus might not have evolved to be more deadly as such, but it might have evolved to grow more or better, which could cause more damage in a patient overall," he said.

Does this affect treatments?

Horby, who also leads the Recovery trial -- which identified the steroid dexamethasone as effective for severely ill hospital patients -- said there was "no evidence" that treatments would work less well.

Anti-inflammatories such as dexamethasone "should work equally as well because it's not related to the virus, it is related to the host response", he said.

Horby said overall improvements in therapies and treatments -- including things like better strategies for hospital respiratory support -- have brought down case fatality rates since the first wave and could even "offset any difference with this new variant".

As for the vaccines, a preliminary study this month from Britain and the Netherlands found the variant would not be able to evade the protective effect of current vaccines.

Pfizer/BioNTech and Moderna have also released early research suggesting their vaccines would still be effective against the strain.

Don't viruses weaken as they spread?

Scientists have sought to challenge the belief that the virus will become get less virulent as it evolves to become more infectious.

The virus that causes Covid-19 is already "very good at its job of getting transmitted" said Emma Hocroft, an epidemiologist at the University of Bern.

"So I don't think that we can make this assumption that it wants to be less severe. I don't want to downplay that it is severe for many people, but for the majority of people, it's not severe," she told AFP.

She said the ability to transmit before it kills was "a really low bar", citing diseases like measles and HIV that have remained as dangerous.

Graham Medley, a professor of Infectious Disease Modelling at the LSHTM, told the Monday press briefing that despite uncertainties in the new studies on the new variant in the UK, they should dispel the idea that it would become less virulent.

Researchers think it could be the same set of mutations that has made it more infectious -- although all stress more study is needed.

One mutation in particular increases the virus' ability to latch on more strongly to human cells and NERVTAG head Peter Horby, an emerging infectious disease professor at Oxford University, said evidence suggests this means it could make it easier to become infected.

"If it's then able to spread between cells much quicker within the lungs, that may increase the rate of disease and the rate of inflammation, which may then progress quicker than your body can respond to, so it could explain both characteristics of the virus," he said.

Bjorn Meyer, virologist at France's Institut Pasteur, told AFP that the issue could be viral load.

"The virus might not have evolved to be more deadly as such, but it might have evolved to grow more or better, which could cause more damage in a patient overall," he said.

Does this affect treatments?

Horby, who also leads the Recovery trial -- which identified the steroid dexamethasone as effective for severely ill hospital patients -- said there was "no evidence" that treatments would work less well.

Anti-inflammatories such as dexamethasone "should work equally as well because it's not related to the virus, it is related to the host response", he said.

Horby said overall improvements in therapies and treatments -- including things like better strategies for hospital respiratory support -- have brought down case fatality rates since the first wave and could even "offset any difference with this new variant".

As for the vaccines, a preliminary study this month from Britain and the Netherlands found the variant would not be able to evade the protective effect of current vaccines.

Pfizer/BioNTech and Moderna have also released early research suggesting their vaccines would still be effective against the strain.

Don't viruses weaken as they spread?

Scientists have sought to challenge the belief that the virus will become get less virulent as it evolves to become more infectious.

The virus that causes Covid-19 is already "very good at its job of getting transmitted" said Emma Hocroft, an epidemiologist at the University of Bern.

"So I don't think that we can make this assumption that it wants to be less severe. I don't want to downplay that it is severe for many people, but for the majority of people, it's not severe," she told AFP.

She said the ability to transmit before it kills was "a really low bar", citing diseases like measles and HIV that have remained as dangerous.

Graham Medley, a professor of Infectious Disease Modelling at the LSHTM, told the Monday press briefing that despite uncertainties in the new studies on the new variant in the UK, they should dispel the idea that it would become less virulent.