The devastating increase in new daily COVID-19 cases in the United States has slowly begun to subside, and vaccinations are beginning to protect millions of the country’s most vulnerable people.
But any recovery from the worst chapter of the pandemic so far could be reversed – or exacerbated – by new coronavirus variants that experts say could pose a variety of challenges to get the virus under control.
Three specific variants have so far given rise to alarm bells: B.1.1.7, which has been identified in the United Kingdom, B.1.351 in South Africa and P.1 in Brazil, all of which have been discovered in the USA. Experts believe that B.1.1.7. as much as ‘50 to 70 percent more contagious ’compared to previous variants, meaning more people are likely to become infected.
This could pave the way for more hospitalizations and ultimately more deaths, as England has suffered in recent months. There has been a huge increase in cases traced back to the new variant, which has made hospitals struggling to accommodate the country’s ballooning number of COVID-19 patients, and the country has set new records for the national daily death toll. The Centers for Disease Control & Prevention has warned that B.1.1.7 could become the dominant variant in the US by March.
B.1.351 has expressed concern about the apparent ability to influence the performance of Moderna and Pfizer-BioNTech’s respective COVID-19 vaccines, but so far there is no evidence that it makes any of these vaccines completely ineffective. P.1, meanwhile, is worrying because it has emerged and spread widely in a city in Brazil whose population has already been plagued by the virus, pointing to the possibility that it could cause re-infection. According to the CDC, it appears that these variants are also “easier and faster to spread” compared to others.
“These variants could change the course of this pandemic, and it is certainly worrying,” said Dr. Krutika Kuppalli, an assistant professor of medicine at the University of South Carolina Medical School.
It is normal for a virus to mutate over time, especially one that circulates as widely as the coronavirus.
“If you have such a high level of infection, you give the virus a lot of chance to adapt itself,” said Ryan McNamara, a researcher at the University of North Carolina School of Medicine.
Most mutations do not significantly alter the virus or the disease that causes it, and some may even be harmful. But sometimes useful mutations arise that under the right circumstances can spread the version of the virus better than in the past.
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Researchers are still evaluating how exactly these variants differ from their predecessors, as well as how they affect the effectiveness of existing treatments and vaccines for COVID-19, including those not yet approved in the US. A UK study in January suggested that B.1.1.7 could cause more serious cases of the disease, but the CDC stressed that “more studies are needed to confirm this finding.”
In addition to concerns about increasing hospitalizations and deaths, another increase in cases could mean the U.S. sees a growing proportion of “long-distance guards,” or patients whose symptoms persist for months after their initial infection, Kuppalli said. The condition could also take a significant toll on the country’s healthcare system, not to mention the quality of life and emotional well-being of patients, she added.
Even against the frightening prospects raised by the new variants, the US is by no means powerless. During a newsletter of 21 January in the White House, dr. Anthony Fauci, the country’s leading specialist in infectious diseases, stressed that he and other experts ‘pay close attention’ to these variants, saying: we must never change the vaccine. ”
Here’s a look at how viruses mutate, and why detecting new variants and sharpening your own personal precautions is the key to controlling the pandemic.
How do viruses mutate?
When the coronavirus infects a new host, it uses the person’s cells to make copies of itself. Some probably have bugs or mutations in their genome that make the copy slightly different from the original virus that caused the infection.
“Viruses mutate all the time,” said Stanley Perlman, a doctor and coronavirus researcher at the University of Iowa. ‘And most of the time these mutations go nowhere because they do not help the virus. Some of them can actually kill the virus. ”
But mutations can also give the virus an advantage.
In the context of this pandemic, the normal virus replication process is driven by more than 100 million people worldwide who are known to have been infected in the past year or so. This means that the virus had ample opportunity to mutate and possibly infect better. All three variants on the CDC’s radar have mutations in their peak proteins, which are part of the virus that is primarily responsible for the successful invasion of our cells.
This is not even the first time the virus has mutated to become more contagious since the pandemic began. According to the World Health Organization, the first coronavirus strain initially detected in Wuhan was replaced by one that had a specific mutation called D614G.
The journal Nature reports that by June 2020 ‘the D614G mutation was found in almost everyone [coronavirus] samples worldwide. ”
Several research teams in the US found last fall that the mutation changes the ear protein of the virus so that it can better penetrate and infect the cells. They found that it could make the virus repeat itself more quickly and become transmissible, but that the mutation may also have made it more vulnerable to being neutralized by the antibodies that humans obtain through vaccination.
A virus’ main purpose is always to “sustain” itself, McNamara explained, and this particular pathogen has infected people for quite a short time. According to him, the relatively large number of variants that the world has noticed over the past year or so indicate that the coronavirus is still adapting to its new host. The only way we can stop the natural process is to stop the spread of the virus itself.
What the US can do to keep variants away
Some countries perform regular, random genome sequencing of the virus when someone tests positive within their borders, giving researchers an idea of which variants have the predominance and where it has spread.
Compared to other countries, the US has not implemented such a nationalized sequencing program. According to the Associated Press “less than 1 percent are positive [virus] copies ”are sequenced here, while ‘Britain follows about 10 per cent.’
Volunteers hand out door-to-door COVID-19 home test kits in an effort to stop the distribution of the new SARS-CoV-2 variant in Ealing, West London, UK, 3 February 2021. Henry Nicholls / Reuters
Experts believe that the US can and should do more, given the amount of virus circulating and the possibility that a new, significant variant could also emerge in the states. Researchers are already tracking one, called CAL.20C, which was first detected in California last month.
The CDC said it was stepping up its sequencing efforts, including collecting 750 samples of the virus a week from “state health departments and other public health agencies” for sequencing.
Vaccination will undoubtedly be just as important as a public health tool as ever before, and it is unlikely that any new variant will completely eradicate the high levels of protection of the two vaccines allowed for emergency use. Pfizer and BioNTech said their vaccine is still protective against ‘key mutations’ in B.1.1.7 and B.1.351.
The companies are also developing booster shots that can improve immune responses to new variants of the virus, as Bloomberg News first reported. Moderna announced in late January that it expects its existing two-dose vaccine regimen to be ‘protective against emerging strains’. [of the virus] detected to date, ”but plans to test a ‘boost candidate’ that will provide more protection against B.1.351 ‘and possibly future tensions’
Both vaccines cause a ‘polyclonal’ reaction, which means that it encourages the body to create different types of antibodies that target different parts of the virus. The virus needs to ‘change itself comprehensively’, McNamara said to completely evade the protection generated by a vaccine.
Variants have already shown the ability to partially reduce the efficacy of the vaccine. According to Reuters, the vaccine developed by Johnson & Johnson – which, according to the company, had an overall efficacy of 66 percent – produced different results, depending on the region where it was tested during clinical trials. In the US, ‘efficiency reached 72 per cent’, but in South Africa, where B.1.351 accounted for ’95 per cent of the COVID-19 cases reported ‘during the trial, efficiency reached 57 per cent.
According to the World Health Organization, the term “vaccine efficacy” refers to the percentage by which the incidence of diseases is reduced in those who are vaccinated, compared to those who are not. In other words, it focuses on prevention. In addition to preventing disease, vaccines can also reduce the chance of a serious illness. Reuters noted that Johnson & Johnson’s vaccine was 89 percent effective in ‘preventing serious diseases in South Africa’.
According to Fauci, the existence of coronavirus variants emphasizes the importance of vaccinating the American public as quickly and effectively as possible.
‘If we can implement our vaccination programs with the vaccines we currently have and bring the level of virus replication and dynamics in the community to a very low level, the virus will not mutate as effectively as when you have an explosion of infections. not, ”Fauci told PBS NewsHour anchor and managing editor Judy Woodruff.
The fact is that to prevent the spread of these variants and reduce the likelihood of new ones appearing in the US, we already have the tools we need: the same pandemic precautions that have been in place since the country first came into being. March locked up. from last year.
“We know how to prevent spread to a certain extent – to a large extent – and by preventing spread, we prevent the disease,” Perlman said.
Adherence to protocols such as social removal, contact with those outside our households and restricting the wearing of a mask reduce the opportunities the virus has to mutate, and make it less likely that new variants may emerge.
“It’s a collaborative effort,” Kuppalli said. “So we all need to play their part.”
Editor’s note: Johnson & Johnson is a sponsor of the PBS NewsHour.