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The new COVID19 variants; Characteristics and concerns

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a type of coronavirus with crown-like spikes on its surface. This virus has been identified as the causative agent for COVID-19 (otherwise referred to as COVID-19 disease). Like other viruses, the SARS-CoV-2  has been undergoing changes through mutations. Mutations are changes in the genetic code of a virus that naturally occur over time when an animal or person is infected­, giving rise to new variants. Variants are viruses whose genetic sequence changes as a result of mutation [1]. Preliminary research indicates that these variants spread more easily and quicker than the original virus and that antibodies generated through vaccination with currently authorized vaccines recognize these variants [2]. According to genetic analysis thus far, multiple variants of the virus have been documented globally, some of which are;

  • B.1.1.7 was first identified in the United Kingdom and has been detected in various parts of the globe. The variant is also referred to as SARS-CoV-2 VOC 202012/01 (Variant of Concern, the year 2020, month 12, variant 01) and its origin is still unclear [3]. Preliminary epidemiologic, modeling, phylogenetic, and clinical findings suggest that SARS-CoV-2 VOC 202012/01 has increased transmissibility compared to other existing variants of the virus (WHO 2020). However, research is still ongoing to confirm these findings [2]. As of Dec 2020, this new variant has been reported in 31 other countries [3]
  • B.1.351 which was detected in South Africa. South Africa has named this variant 501Y.V2, because of a N501Y mutation [3]. It emerged independently of B.1.1.7 but shares some mutations with it. According to genomic data, the 501.V2 variant has rapidly displaced other lineages circulating in South Africa, and early studies indicate the variant is associated with a higher viral load, which may suggest the potential for increased transmissibility, however, these are still subject to further investigation [3]. Just like the B.1.1.7, it is not yet clear if the new variant is associated with more severe disease or worse outcomes. It was detected in October 2020 and cases caused by this variant have been reported in the US [2]. It has also been reported in Zimbabwe and now constitutes more than 60% of the cases around its borders. It has also been identified in Botswana, Gambia, Ghana, and Zambia [4].
  •  P.1 variant was first identified in travelers from Brazil, who were tested during routine screening at an airport in Japan, in early January [5]. This variant contains a set of additional mutations that may affect its ability to be recognized by antibodies [2]. However, research to confirm these claims is still ongoing.
  • 20A.EU1, also known as the “Spanish variant. This version of COVID-19 picked up a mutation on its spike protein that was designated A222V. The mutation of this virus is believed to have occurred in Europe when travel restrictions were eased for holiday travel.

Most of all of these variants have been identified in the US and the variant from the UK is suspected to become dominant in the days ahead [6]. Some experts have indicated that there is an increase in the number of cases from these variants in children [7], however, according to others, children are being infected with the old variants in much the same way as there is no convincing evidence yet [8]. In any case, the research on these claims is still ongoing.

Furthermore, there are also concerns about the situation of these new variants and the already available vaccines as some preliminary evidence suggests that some immune responses driven by current vaccines could be less effective against some of the new strains. For example, a small clinical trial on the Oxford-AstraZeneca vaccine might not be effective at preventing mild to moderate illness from the South African variant [9]. According to Prof Gupta, vaccines train the immune system to attack several different parts of the virus, so even though part of the spike has mutated, the vaccines should still work. However, if more mutations add, there is a need to worry. According to Prof David Robertson, from the University of Glasgow the virus will generate vaccine escape new mutants and hence the vaccines might need to be updated often and the good news is that the vaccines can easily be tweaked [10]. Vaccine makers are currently studying strain-specific boosters or next-generation vaccines that could target multiple variants in the near future [11]. Meanwhile, for now, early research has it that the Pfizer-BioNTech and Moderna COVID-19 vaccines can provide protection against the variants identified in the U.K. and South Africa [12] [13].

Science is still evolving about these new variants and yet to understand how widely these new variants spread, how the disease caused by these new variants differs from the disease caused by other strains of the disease, and how these variants may affect existing therapies, new vaccines, and tests [14]. It is expected that new variants of the virus will continue to emerge, most will come and go even unnoticed, some will persist but will not be common, some will increase in the population for a while and then fizzle out [8]. It may also be difficult at this stage to confirm if some of the mutations are due to changes to the virus or changes in human behavior. Furthermore, there is currently no evidence to suggest that these new variants cause more severe illness or transmissibility [15]. As research continues, the World Health Organization (WHO) advises that national and local health authorities should continue to strengthen existing disease control activities, including monitoring their epidemics closely through ongoing epidemic surveillance and testing, contact tracing, and where appropriate continue to adjust health measures to reduce the spread of the virus and its variants.

Except for the South African variant, most of these variants are yet to be reported in Africa but this could be attributed to the fact that systematic sequencing surveillance is not being reported from all the countries [1]. In any case, the WHO advises that countries should continue to implement the risk-based approach for international travelers in the context of COVID-19. The new variants do not, however, call for new preventive measures or strategies, we have to continue respecting the barrier measures to curb the spread of COVID-19. There is also an urgent need to step up current vaccination campaigns because, the more people are infected, the more chances for more mutations to occur.

The new variants have not been reported in Cameroon, however, there is the need for continuous surveillance and if possible systematic sequencing to detect these variants should they happen. While waiting for the complete rollout of the vaccine in Africa and Cameroon in general, it is important that the Cameroonians take the preventive measures more seriously, report any suspected case and stay vigilant.

References

  1. World Health Organisation. Seven things to know about COVID-19 variants in Africa. WHO | Regional Office for Africa n.d. https://www.afro.who.int/news/seven-things-know-about-covid-19-variants-africa (accessed February 17, 2021).
  2. National Centre for Immunization and respiratory diseases, Division for Viral Diseases(NCIRD) ­( 2021). New Variants of the Virus that Causes COVID-19
  3. WHO 2020: Emergency preparedness and response. SARS-CoV-2 Variants
  4. Covid: South Africa variant now “dominant” in Zimbabwe. BBC News 2021.
  5. Daniel C. DeSimone (2020); What’s the concern about the new COVID-19 variants? Are they more contagious?
  6. Weintraub K. “It’s like we’re trying our best to help the virus”: A fourth wave is looming if the US fails to contain COVID-19 variants, experts say. USA TODAY n.d. https://www.usatoday.com/story/news/health/2021/02/16/covid-19-us-fourth-wave-variants-coronavirus/4460958001/ (accessed February 17, 2021).
  7. Bloomberg JG|. Analysis | Why the Mutated Coronavirus Variants Are So Worrisome. Washington Post n.d.
  8. Stuart Ray and Robert Bollinger 2021; New Variants of COVID 19, What you should Know
  9. Should I be concerned about COVID-19 variants? Experts break it down. TODAYCom n.d. https://www.today.com/health/how-many-strains-covid-19-t207173 (accessed February 17, 2021)
  10. James Gallagher 2020; New coronavirus variant: What do we know?
  11. Andrew Joseph (2021); The good and the (potentially) bad: What scientists know about variants and Covid-19 vaccines
  12. Mayo Clinic. COVID-19 variants: What’s the concern? Mayo Clinic n.d. https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/covid-variant/faq-20505779 (accessed February 17, 2021)
  13. World Health Organisation. Episode #20 – COVID-19 – Variants & Vaccines n.d. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/science-in-5/episode-20—covid-19—variants-vaccines (accessed February 17, 2021)
  14. COVID-19 linked with a wider set of symptoms than previously thought – REACT study | Imperial News Imperial College London. Imperial News n.d. https://www.imperial.ac.uk/news/214693/covid-19-linked-with-wider-symptoms-than/ (accessed February 17, 2021).
  15. Covid-19: New variant with potentially worrying mutations found in UK. The Irish Times n.d. https://www.irishtimes.com/news/world/uk/covid-19-new-variant-with-potentially-worrying-mutations-found-in-uk-1.4485832 (accessed February 17, 2021)