Dr. Shyam P Lohani

The coronavirus has spread to almost the entire world after over a year of the first case reported from Wuhan, China. In recent times, various new strains of the coronavirus have been reported from around the world which indicates that the virus is mutating rapidly. These mutations are of concern not only as they have been found more contagious and/ or deadly but also the fact that the rate at which virus mutating may invalidate or make vaccine developed so far less effective.
The development and spread of new variants have raised several questions for both healthcare professionals and the general public. The following three questions are increasingly becoming relevant now: Are the new variants more contagious? Are the vaccines still effective against new variants? Are there different or additional preventive measures we should adopt to remain safe?

Contagiousness
Once the virus infects our body, the immune system tries to kill it. When our immune system is unable to tackle it, the virus strain infects the population. The new mutations have been detected in areas where COVID-19 cases are highly implicating that they have occurred in places with high level of immunity. It is neither new nor unexpected to witness mutations in viruses including the coronavirus causing the COVID-19 pandemic. Mutations will continue to occur as long as the coronavirus spreads through the population.
In September 2020, one mutated version of the coronavirus was reported from southeastern England. The variant known as B.1.1.7 accounts for about 60 per cent of new COVID-19 cases in the UK. It is now reported from many countries, including India and Nepal. Different variants have been reported from Brazil, California, and other parts of the globe. A South African variant called B.1.351 may have the ability to re-infect people who have recovered from original version of the coronavirus. Moreover, available vaccines offer some protection from a severe disease in people infected with B.1.351.
All three variants from the UK, South Africa, and Brazil seem to be more contagious or easy to catch. All of them have undergone changes to their spike protein. As a result, they are more contagious. The reason for rapid mutations and increased number of new strains is due to a quick rise in the number of cases as every COVID-19 infection potentially gives chance to mutate. But the question still is unanswered that why mutant is more contagious and deadly. Scientists say that the prolonged COVID-19 infection and reduced immunity may be a cause of mutations. The changes in the spike protein which it uses to bind with the human cells are the main reason for rapid mutations. The changes in the spike protein may help the virus bind more strongly to human cells.
Another reason the virus is mutating into more contagious forms is that a level of immunity has developed in most populations in places where cases of COVID-19 have been widely reported. Additional reason why we are seeing a number of mutations now is that viruses have a natural tendency to mutate.
It should be emphasised here that there is no evidence that the new strains produce any additional or new symptoms or make people sicker. It has been estimated that the new variants are 40-70 per cent more contagious. It means more people get infected due to its contagiousness, therefore more people are dying. The increase in the number of cases results in an increase in serious cases and thus more people need to be hospitalised causing additional pressure to the already overstretched healthcare system in some regions. This may result in people with comorbidities suffering greatly and add to the mortality rate.

Effectiveness of vaccines
At this time, healthcare professionals and even the general public are concerned about the effectiveness of currently available vaccines to the new variants. Recently, Pfizer and BioNTech announced that a preliminary study shows their vaccine is effective against the mutation in the spike protein in the two variants. The rapid vaccination drive shall result in faster control of COVID-19 and it will mutate less.
It has been said that the Moderna vaccines will also be effective against the new coronavirus strains. In addition, Pfizer/BioNTech and Moderna, the manufacturers of the vaccines currently being used in many countries, have said they can change the vaccine to adapt to new strains within six weeks. There have been reports that antibodies developed in people previously infected with other COVID-19 strains appear to have worked against the new variants.
The variant known as B.1.351, which was identified in South Africa shows that the COVID-19 vaccine from Oxford-AstraZeneca provided minimal protection from that version of the coronavirus. This means that people who received the Oxford-AstraZeneca vaccine experienced mild or moderate illness.
Even if the vaccine doesn’t provide protection perfectly, it will still provide partial protection meaning some people may be protected and others who did get infected with that strain of COVID-19 after being vaccinated would have a less severe case.
The good news is that the rate of successful treatment is similar to any of the variants. Mutation occurs and viruses constantly change, and over time new variants of a virus are expected to emerge. Oftentimes, new variants emerge and disappear. Other times, new variants emerge and persist. It is important to have strict compliance with public health preventive strategies, such as physical distancing, use of masks, hand hygiene, and isolation and quarantine, and mass vaccination are essential to contain the spread of the virus causing COVID-19 and protect humanity.
The current pandemic has increased the importance of accreditation of information portals that are being utilised for knowledge generation for a particular disease. The myths need to be debunked rapidly by responsible professionals and organisations. Therefore, it is called upon the health-related professional organisations to come forward and provide correct information for stakeholders.

(Professor Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)