New mutant strain of coronavirus

By Dr B. J. C. PERERA
Specialist Consultant Paediatrician

The entire world is in despair following the detection of the new mutant strain of SARS-CoV-2 organism that causes COVID-19. In an inescapable scenario, which has already frightened the daylight out of everybody from the beginning of 2020, this new development is like someone falling from the frying pan right into the fire. As if we did not have enough trouble with the original organism, this added problem is likely to have some further ramifications on the state of play of this blight.

Mutations are known to be a part of the standard behaviour of viruses. In a way, many scientists, especially the virologists, would have expected this. This type of behaviour is expected, but when it really occurs, it is yet another blow to the people all over the world.

This new mutant strain was officially reported in the UK around 14^th December 2020. In fact, it was first detected in September 2020. In November, around a quarter of cases in London were caused by the new variant, and it shot up to nearly two-thirds of all cases of COVID-19 in mid-December. The new strain is believed to be the cause of the upsurge of cases in the UK. The rapid spread of the new variant of the coronavirus has now led to the introduction of strict tier-four mixing rules for millions of people in the UK, and harsher restrictions on mixing at Christmas in England, Scotland and Wales. It has led to new lockdowns in many areas of the UK, and prompted many countries to impose a travel ban on people leaving the UK to go to other destinations in the world.

It is thought that the variant either emerged in a patient in the UK or has come from a country with a lower ability to monitor coronavirus mutations. It has already been detected in Denmark, Australia, the Netherlands, Italy and Gibraltar. This was the position a couple of weeks back. It may have already spread to many other countries.

One really worrying aspect of this problem in the UK is that the upsurge of cases came despite several large areas of the country at that time being under lockdown, with many businesses in some areas closed and people being prevented from meeting indoors.

At least three things are coming together to make this mutant to be taken ever so seriously:-

* It is rapidly replacing other versions of the virus

* It has mutations that affect parts of the virus that are likely to be important

* Some of those mutations have already been shown in the lab to increase the ability of the virus to infect cells

It is quickly replacing other strains because it is thought to be eminently more transmissible. The figure mentioned by the Prime Minister of the UK, Boris Johnson, was that the variant may be up to 70% more transmissible. He has picked up this figure of 70% from a presentation by Dr Erik Volz from Imperial College London, a foremost authority on the subject. The British PM has also said it is really too early to tell, but from what they have seen so far, it seems to be growing faster than any other variant. However, in some quarters at least, there remain questions about whether it is any more infectious, at all. Professor Jonathan Ball, a reputed virologist from the University of Nottingham has gone on record as saying “The amount of evidence in the public domain is woefully inadequate to draw strong or firm opinions on whether the virus has truly increased transmission“.

Researchers now believe that a mutation to the genes that code for COVID-19’s spike protein, the part of the virus that clings to human cells allowing infection is the most likely cause for its increased transmissibility. However, what scientists know about this mutation in SARS-CoV-2, is still evolving, as they collect more samples of the virus from cases from around the world. The ongoing research has produced some conflicting results about whether specific genetic changes are helping the virus to spread more easily, or cause more disease. In a November 2020 publication in the reputed scientific journal Nature, scientists studied more than 12,000 mutations of SARS-CoV-2 from viruses in 99 countries and concluded that none were more easily spreading from person to person.

There is also some uncertainty about the effectiveness of the currently available vaccines against this mutant strain. Officials say that the vaccines are still likely to work against the new variant, but that more research is being done to confirm that this is indeed the case. The UK’s Chief Scientific Advisor, Patrick Vallance, has said “The working assumption is that the vaccine response should be adequate for this virus, but we need to keep vigilant about this”. Mr Boris Johnson has gone on record as saying “There is still much we don’t know. While we are fairly certain the variant is transmitted more quickly, there is no evidence to suggest that it is more lethal or causes more severe illness. Equally, there is no evidence to suggest the vaccine will be any less effective against the new variant“.

Still for all that, because the current leading vaccines rely to some extent on targeting the spike protein, this mutation could be the first step in the virus becoming resistant to the current vaccines. Professor Ravindra Gupta, Professor of Clinical Microbiology at the Cambridge Institute of Therapeutic Immunology and Infectious Disease, had told the British Broadcasting Corporation (BBC) “This virus is potentially on a pathway for vaccine escape, it has taken the first couple of steps towards that,“. He has also added a caveat to say “If we let it add more mutations, then you start worrying.“

All this just adds up to the absolute fact and the proven scientific notion that we cannot really be absolutely certain about the disease COVID-19, and especially this mutant strain. Nothing is so far written in stone. There are conflicting reports and a tremendous amount of uncertainty about this entire saga.

As for us in this resplendent pearl of the Indian Ocean, we really need to worry about a couple of things. One is what will happen if the mutant strain comes here? Or for that matter, has it already arrived here? Our brilliant virologists and public health specialists have to work on this. We cannot rely on everything that emanates from the scientific circles of other countries. There seems to be a surge of cases over the last couple of weeks even in our country. We need to find out whether it is the original strain or a mutant strain. I am quite sure that our most competent scientists are working on these aspects. The second thing is about the vaccine. Will it work against mutant strains? That will be another vital conundrum that we need to keep in mind, IF AND WHEN, we get the vaccine.

We desperately need ‘home-grown’ answers., and not the usual waffling pontifications from other countries, especially those from the Western hemisphere.