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Some oddities of coronavirus mutations

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All RNA viruses tend to evolve rapidly; about a million times faster than human genes. Yet for all that, if SARS-CoV-2 stands out at all among them, it is simply because of the markedly slow pace at which it evolves, compared to many of its relatives. For example, it is thought to evolve about five times less rapidly than the biologically related influenza viruses. It has been postulated by Nextstrain, an open-source project that tracks the evolution of pathogens in real time, and other sources as well, that SARS-CoV-2 is accumulating an average of about two mutations per month.

 

By Dr B. J. C. Perera

MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL) 

Specialist Consultant Paediatrician

 

There is a lot of talk as well as considerable uncertainty and apprehension associated with the spectacle of natural and spontaneous changes or ‘mutations’, as they are called, in the SARS-CoV-2 virus that causes COVID-19. These trepidations are currently apparent, not only among people but also in the medical circles as well. We have all read several accounts of patients who recovered from Covid-19 only to be infected with SARS-CoV-2 again later, allegedly by a different “strain” of the virus. In late August 2020, came news about the world’s first “documented” or “confirmed” case of reinfection with SARS-CoV-2: a man from Hong Kong, diagnosed in March, had contracted “a new virus variant” circulating in Western Europe during the summer. The very next day, news broke out that two people in Europe also appeared to have been reinfected. After that, it was a story about the first American case of the kind, involving a patient in Nevada, who was said to have suffered worse symptoms the second time around. The preprint study which had not been peer-reviewed, on which those reports were based, seems to no longer be available in the global scientific literature.

Yet, for all that, all this talk about newly mutated, perhaps even more virulent forms of SARS-CoV-2, is most definitely igniting and sparking fear and sowing confusion. The vital question is whether there could be either an increase, or for that matter even a decrease, in the severity of the illness caused by these mutant viruses.

For one thing, it is important to keep in mind that isolated cases of reinfection also happen with other viruses. That fact should not necessarily be alarming. Reinfection usually tells us something only about how the human immune system works. On just the face of it, that occurrence is not definitive evidence that a virus does always change in ways that make it more dangerous. Of course, it is well-known that viruses routinely mutate. However, perhaps more importantly, quite a lot of these changes and modifications to their basic structure are bad for the virus itself or even fatal to the virus, according to some scientific studies. Only a minority of mutations are neutral, and only just a tiny minority of mutations are beneficial to the virus itself. The word “mutation” may sound ominous, but it is a rather boring and well-recognised fact of viral life and its implications may not always be all that malevolent for humans.

Yes, of course, the SARS-CoV-2 is mutating, too. One might justifiably ask “So what?”. The million-dollar question is whether it has become more virulent or more infectious than it was when it was first detected in Wuhan in December 2019? The current evidence suggests that it has not been proven to be more virulent. So what indeed?

Like the viruses that give us influenza or measles, SARS-CoV-2 has a genetic code made up of ribonucleic acid (RNA). But RNA is highly mutable, and since SARS-CoV-2 infects us by using our body’s cells to replicate itself again and again, every time its genome is copied, there is a real chance that an error might creep in. That is the unavoidable basic progress of the life-cycle of the virus. Most mutations actually get lost rather quickly, either by chance, or because they damage some part of the main structure or the functions of the virus. Only a small proportion end up spreading widely or lasting for long periods of time. Mutation may be the fuel of evolution but, especially for an RNA virus, it also is just business as usual. Mutations may not always make the virus comply with the celebrated theory of Charles Darwin of survival of the fittest.

All RNA viruses tend to evolve rapidly; about a million times faster than human genes. Yet for all that, if SARS-CoV-2 stands out at all among them, it is simply because of the markedly slow pace at which it evolves, compared to many of its relatives. For example, it is thought to evolve about five times less rapidly than the biologically related influenza viruses. It has been postulated by Nextstrain, an open-source project that tracks the evolution of pathogens in real time, and other sources as well, that SARS-CoV-2 is accumulating an average of about two mutations per month.

When translated to real time, it means that the forms of the virus circulating today are only about 15 accumulated mutations or so, different from the first version traced to the outbreak in Wuhan in China. This really is a tiny number when one considers the fact that the SARS-CoV-2 genome consists of about 30,000 nucleotide components. The implication is that the viral versions that are prevalent today are at least 99.9 per cent the same as the original index strain from Wuhan. If one were to say it in a more simplified way, for an RNA virus, SARS-CoV-2 is in the slowest lane of evolution.

In fact, from a purely scientific perspective, all these discussions of SARS-CoV-2 having developed into however many different “strains” is misleading. Scientists tend to reserve the word ‘strain’ for versions of a virus that differs from the original in major biological ways. SARS-CoV-2’s different forms are very similar; and technically, it is far better to label them as “variants”.

The coronavirus’s sluggish pace of mutation is good news for us. That is because a virus that evolved more rapidly would have a greater chance of outrunning any vaccines or drugs developed to counter it. Having said that, have even the small mutations so far changed SARS-CoV-2 in any important ways? For example, has it become more deadly? The answer might surprise many. Up to the present time, there is no evidence to suggest that any newer or mutated forms of SARS-CoV-2 have become more virulent or more lethal; nor for that matter, that it has become less so as well.

For example, a recent preprint paper (i.e. not yet peer-reviewed) by Erik Volz, of Imperial College, London, UK, and other co-workers, including members of the Covid-19 Genomics UK Consortium which analysed 25,000 whole genome SARS-CoV-2 sequences collected in the United Kingdom, found that one particular mutation in the virus, known as D614G, had not increased mortality in patients. There has been much discussion over whether the D614G mutation, which affects the so-called spike protein of the virus, has made SARS-CoV-2 more infectious. In a very broad sense this appears to be so and that contention has led to some of the affected countries to which it has spread, taking drastic steps in locking-down certain areas.

The spike protein sits on the surface of the coronavirus, and that really matters because it’s the part of the virus that attaches itself to the host’s cells. “D614G” is an abbreviation for a change at position 614 of the spike protein. The D614G mutation, which probably initially arose in China, first appeared to become more and more frequent in the outbreak in northern Italy in February. The G614 form of the virus has since spread all over the world and has become the dominant variant. The D614G mutation does seem to have increased the infectivity of the coronavirus, at least in cells grown in laboratories, according to a recent paper by the computational biologist Bette Korber and others, published in the journal ‘Cell’. Apparently based partly on this and some other studies as well, health authorities in various countries have claimed that the G614 form of the coronavirus may be 10 times more infectious than the version first detected in Wuhan.

The more recent UK variant, commonly known as B-1.1.7, is definitely a more contagious variant of the coronavirus. It first emerged in the U.K. in late 2020. It has 23 accumulated mutations. It has acquired 17 of these at once, a feat that has not been seen before. Of particular concern to scientists are eight mutations that affect the gene for a spike protein on the surface of coronaviruses. The worries are the results of the fact that the viruses use the spike protein to grab onto human cells. This mutant strain too appeared to spread faster than other variants in the United Kingdom but has not shown itself to cause more severe disease.

These scientific details could have an abiding effect on the future of this capricious and miserable virus that causes COVID-19. A pandemic virus may disappear from the scene due to one or more of three reasons. The first of these is the notion that a virus that is capable of taking lives would kill a significant number of affected people but those who manage to recover will have some degree of immunity against the very same virus. So, reinfections may be naturally prevented following the first infection with the virus, provided of course that the patient survives the initial onslaught. The second factor is that the virus may induce extensive immunity in a populace, the so-called ‘herd immunity’, either through widespread infection of a large proportion of the population or a similar scenario being enacted through vaccination against the virus. The end result of this is to produce a rather resistant population against the effects of the virus. The third possibility is that repeated mutations would lead to converting the virus into a much less troublesome and less virulent form that it ceases to be a major medical problem and converts the blight into an insignificant and toothless type of an entity. Such impotent strains might even be able to completely overwhelm the more virulent types, with tremendously beneficial implications for the whole of humanity.

These are thought to be at least some of the mechanisms through which the Spanish Flu of 1918 disappeared within a year or so. It was destined never to return in the same life-threatening format for a period of over 100 years or so, right up to the present time.

It has been said that hope springs eternal in the human breast. We do hope and even pray that through some of these postulated mechanisms, the inhabitants of Mother Earth would be spared further turmoil, intense suffering and absolute mayhem that has been their lot for the last year or so, through the doings of this dastardly blight of a nasty coronavirus. We have suffered immeasurably. It is about time that we got a decent break in this fight.



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Features

Sohan…adapting to the ‘new normal’

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Surprisingly, the Coronavirus pandemic seems to have galvanised our entertainers into action.

True, most of the big bands are finding the going pretty tough, these days, as most public shows, like concerts, sing-along, and dances, have been put on hold.

Fortunately, we do have artistes who capitalise on unexpected situations to continue to keep the public, and their fans, entertained – of course, doing it differently

Band leader Sohan, of Sohan & The X-Periments fame, who is always innovative, when it comes to music, has hit upon a novel idea, in order to keep his band occupied, for the next three months.

He has decided to put The X-Periments into ‘recording mode.

Says Sohan: “I’m getting them involved in doing in-house recordings at my home studio.”

And, what’s more, I’m told that Sohan has found a secret sponsor, so the boys will be paid, too. Obviously, it’s a win-win situation and that makes Sohan extra happy!

The veteran artiste/entertainer went on to explain that the main CD will contain cover versions of his favourite songs, and will also include a duet with his daughter Erandika who is scheduled to be in Sri Lanka, hopefully, in May. She is currently in the States.

The song, Sohan has in mind, is that immensely popular golden oldie, made popular by the late Nat king Cole (and daughter Natalie Cole) – ‘Unforgettable.’

Clifford Richards will be seen in a virtual concert, along with Corrine Almeida, and Sohan

The second CD will feature Sohan’s original songs, both western and oriental. 

Sohan will be working with Shobi Perera, Kumar de Silva, Rajiv Sebastian, Roshan de Silva, Chrys Wikramanayake, Rukshan Perera and Damian Wikkramatillake on his novel project, while Krishantha de Silva, who manages Sonexco Enterprises, will take on the role of coordinator.

Although this project will keep The X-Periments, busy, one day of the week will be designated as ‘recording day’ and they have a deadline of three months to complete this project, said Sohan.

There is also a possibility of Sohan inviting a few of his friends to join him in the vocals but that will depend on the materiel he decides on.

“There is no point in hanging around, waiting for work. Musicians have to innovate and create work to keep going, during these challenging times.”

 Sohan is also working closely with Corinne Almeida  and Clifford Richards and has an idea of doing a virtual concert, with the same line up that was featured at the Valentine show, called  ‘Love at the Edge.’

Rajitha, of Misty, is helping them with the technical details of the show,

No doubt, things are looking a bit rosy for Sohan & The X-Periments, and Trishelle.. 

The guys are also working with Benjy and Aquarius, on a mega event, for Richard de Soysa, to be held at Nelum Pokuna,  which is scheduled for mid- May, of 2021, and will feature 10 leading artistes ..

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Remembering Dr. Neville Fernando

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This tribute is in remembrance of my father-in-law, the late Dr. Neville Fernando who would have celebrated his 90th birthday on 9th March 2021. He passed away unexpectedly on the 4th of February 2021 due to the deadly COVID-19 virus.

His birthday will be remembered with an almsgiving to the priests at the Kotikawatta temple to invoke merits on him to attain the Supreme bliss of Niravana. Religious observances on his birthday were an annual occurrence even during his lifetime.

As I ponder his memories, being ‘no more’ is the saddest thought that crosses my mind. I suspect that if you are reading this you understand what I mean logically. Death means that our loved ones never grow a year older, although logic does little to clear up our confusion when his birthday continues to happen year after year.

His memories and deeds throughout his life brought back towards the day I joined his family, when I was just a medical house-officer at the Nawalapitiya Hospital in 1982, through the marriage to his only daughter. Even then he was known to be a real legend and an honest politician. Today, I am in this position as a cardiologist due to his encouragement, loving care and continuous assistance in whatever means. My mind is full of memories of those loving moments shared together. He was a loving, kind and straight gentleman. I may also use the words handsome and charismatic leader. He will inspire us throughout our lives. His pleasant disposition will charm anyone and uplift our mood.

He led a good life and now has a left a good legacy of four children( three boys and one girl) whom any father would be proud of, nine grandchildren and five great grandchildren loved by everyone. He is now no more and no one can fill the void nor bring back the warmth and love he exuded.

We all have courage and we have our convictions, but rarely have the courage of our conviction. His kindness and compassion were his key attributes that made him so special. He had been a good general practitioner before coming to Parliament defeating a formidable leftist politician Leslie Goonewardene who represented Panadura for decades. It was a landmark victory for the UNP in 1977. He was a kind and compassionate doctor who served the rich and poor alike in Panadura for many years and was sought after by his patients for his well known ‘athguna’ (healing hands). This is where he earned his loyal fan base to enter into politics.

Among many things he achieved in Panadura establishing the “Kethumathi” Maternity Hospital, the only one of its kind outside Colombo, helping Sri Sumangala Girls College expansion programme, starting Agamathi Girls school and Janadhipathi Boys School and self funding the Sri Saugatha Vidyalaya Pirivena building at n the Rankoth Viharaya temple in Panadura. Likewise he helped many Buddhist temples during his tenure.

He also started an industrial zone in Modarawila, Panadura which was an abandoned marshy area before that. He had provided the first computer lab and two acres of additional land to expand the Sri Sumangala Vidyalaya which is spoken with gratitude by the students of his alma mater. He did not expect anything in return.

He was a fearless ,principled and honest man who opposed JRs’ motion to takeaway Mrs.Bandaranaikes’ civic rights as he never wanted to compromise his basic human qualities over politics. Very soon he left the Government before any attempt to expel him and formed a small party with few other honest politicians. Later he joined SLFP on the invitation of Mrs.Bandaranaike and worked in the party as an Assistant Secretary for the progress of the country.

He was a maverick par excellence ,an entrepreneur ,extraordinaire and a businessman with a foresight. As one of the pioneers in the hospitality industry, he built hotel Swanee, subsequently he started JF and I, one of the most modern printing and packaging factories in the country to date. He also pioneered a porcelain factory called “Royal Fernwood Porcelain” in Kosgama. Which provided so many employment opportunities and in time to come, helped to economically develop the area.

Continuing his political career, he entered Parliament again as an SLFP opposition member. Later on in 1994 he decided to give up politics.

His divestments in the Porcelain factory enabled him to purchase Asha Central Hospital which was developed with latest equipment and brought to international standards. This is the time I had to take a difficult decision to leave the Government as a Consultant Cardiologist and join Asha Central Hospital in 1998 to help him in his endeavour. He developed and managed Asha Central Hospital till 2007 and subsequently sold it to start his new venture SAITM or South Asian Institute of Technology and Medicine with the encouragement of the then Min.of Higher Education Wishwa Warnapala.

Infact I was very much concerned about the new development because of the past experience in the country with the North Colombo Medical College. He always used to tell “every child should have the right for a decent education either in a government or non-government organisation”. His main vision was to give a higher education opportunity for the students .Therefore apart from medicine he also established nursing, engineering , IT, management programmes with the help of esteemed academics who believed in his vision. He established the Dr Neville Fernando Teaching hospital (NFTH) in Malabe to provide clinical training for his students at the medical faculty .It was a impressive state of the art hospital with 1002 beds and latest medical equipment . All of this was done during his 80s which was a remarkable achievement.

SAITM gave him immense pride and a lot of pain at the same time. He was very proud of the fact that he was able to give so many scholarships to deserving students (close to Rs.600 million scholarships during his time).In addition to saving a tremendous amount of foreign exchange he was also able to give an opportunity to students to stay in Sri Lanka with their parents, without having to go overseas for their education leaving behind all family and friends.

However, he had to face many obstacles during this period and was socially and politically crushed due to SAITM. With time, he made a decision to give the NFTH to the Government in return for the clinical training of the medical students of SAITM. In 2017 SAITM was closed down by Maithripala Sirisena who gave in due to the heavy opposition made by the unions against private medical education.

At 89 years of age he was an avid Facebook warrior and used to keep abreast of what was going on in the social media. He was a big cricket fan and never missed watching a cricket match day or night.

Writing about this unique personality cannot be limited to a few words. His life is a monumental story full of new chapters. He dreamed big and his dreams were of public service, even when he was no longer a politician. He yearned to make this country a better place for people to live in, even in his eighties.

May his journey of Sansara be a short one and may he attain the supreme bliss of Nirvana!

 

Dr Mohan Jayatilake

Consultant Cardiologist

 

 

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Boogie Night with Suzi

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Yes, music lovers, get ready to boogie the night away, this Saturday, March 13th.

From 9.00 pm to 10 pm, you would be given the opportunity to see Friends’ former female vocalist, Suzi Croner (Fluckiger) boogie away on Facebook, on Talent Network Group (TNG).

Suzi is excited about this new scene, which will be live streamed, worldwide., and she plans to belt out songs from the Friends’ era (’80s and ’90s), country, and rock ‘n’ roll.

She is already working on her repertoire and says she will make ‘Boogie Night with Suzi’ a real exciting event.

TNG is a Dubai-based project, administered in Dubai, with moderators, worldwide.

And, that means, the whole world is going to see Suzi boogie away.

Several local artistes have already been featured on TNG.

 

 

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