Mutations of the Covid-19 virus have prompted much debate around the world. The emergence of variants is inevitable and in the race to vaccinate against Covid-19 these mutations pose some challenges. The lag between vaccine rollouts in wealthy nations and lower income nations is an area of particular concern. Whilst wealthy countries vaccinate and create herd immunity against existing strains, new strains could emerge in unvaccinated populations. Vaccine producers are being compelled to go back to testing their inoculations against new strains, just as rollouts have begun. Such is the case with the AstraZeneca Oxford vaccine which has been withdrawn from its South African rollout, following the release of data which showed poor efficacy against locally detected mutation of Covid-19. Kirsty Short explains what these variants are and how they effect vaccine development and distribution. This article first appeared on The Conversation.- Melani Nathan
UK, South African, Brazilian: a virologist explains each Covid variant and what they mean for the pandemic
By Kirsty Short*
Australia has recently seen SARS-CoV-2 (the virus that causes Covid-19) escape several times from hotel quarantine, including in Brisbane, Perth and Melbourne.
These incidents have been particularly concerning because they involved people infected with āvariantsā of the virus.
But what exactly are these variants, and how concerned should we be?
BREAKING
Victoria coronavirus Holiday Inn worker case has highly contagious UK variant
8 very close contacts and 136 work close contacts – still waiting for resultsā Joe O’Brien (@JoeABCNews) February 8, 2021
Whatās a variant?
Viruses canāt replicate and spread on their own. They need a host, and they need to hijack the cells of the host to replicate. When they replicate in a host, they face the challenge of duplicating their genetic material. For many viruses, this isnāt an exact process and their offspring often contain errors ā meaning theyāre not exact copies of the original virus.
These errors are referred to as mutations, and viruses with these mutations are called variants. Often, these mutations donāt affect the biological properties of the virus. That is, they donāt have any effect on how the virus replicates or causes disease.
Some mutations can impair the virusās ability to replicate and/or transmit. Variants with such mutations are quickly lost from the viral population.
Occasionally, however, variants emerge with an advantageous mutation, one that means itās better at replicating, transmitting, and/or evading our immune system. These variants have a selective advantage (in biological terms, they are āfitterā than other variants) and may rapidly become the dominant viral strain.
Thereās some concern weāre seeing a growing number of variants with advantageous mutations, contributing to the severity of the Covid-19 pandemic.
Hereās a look at the main three variants you mightāve heard about in the media.
The āUK variantā ā B.1.1.7
This variant was first detected in the United Kingdom towards the end of 2020. It has a large number of mutations, many of which involve the virusā spike protein, which helps the virus invade human cells.
It has spread rapidly throughout the UK since it emerged, and to at least 70 other countries, including Australia.
The fact it has spread so rapidly, and quickly replaced other circulating variants, suggests it has some sort of selective advantage over other variants.
After examining the evidence surrounding the new variant, the UK New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) concluded it āhad moderate confidenceā the variant is substantially more infectious than other variants.
This may be the result of one of the mutations in the spike protein of the variant ā a mutation called āN501Yā. One preprint manuscript, uploaded last month and yet to be peer reviewed, found N501Y is associated with increased binding of the virus to a receptor found on the surface on many of our cells, called āACE2ā. This could mean the variant is even more efficient at entering our cells.
Although initially the variant wasnāt associated with more severe Covid symptoms, more recent data have led NERVTAG to conclude thereās āa realistic possibilityā that infection with the variant āis associated with an increased risk of deathā compared with non B.1.1.7 viruses.
However, the group acknowledged there are limitations of the available data, and this remains an evolving situation.
The āSouth African variantā ā B.1.351
This variant was first detected in Nelson Mandela Bay, South Africa, in October 2020. Since then it has been found in more than 30 countries.
Similar to the UK variant, it quickly outcompeted other SARS-CoV-2 variants in South Africa. It now accounts for more than 90% of SARS-CoV-2 samples in South Africa that undergo genetic sequencing.
Like the UK variant, it also has the N501Y mutation in the spike protein, meaning itās more efficient at gaining access to our cells to replicate. This may help to explain its rapid spread.
It also contains several other concerning mutations. Two of these, called āE484Kā and āK417Nā, are bad news for our immune system. They can reduce how well our antibodies bind to the virus (though this is also based on preprint data awaiting peer review).
But thereās no evidence yet to suggest the South African variant is more deadly than the original variants.
The āBrazilian variantā ā P.1
This variant was first detected in Japan in a group of Brazilian travellers in January 2021.
Itās now highly prevalent in the Brazilian state of Amazonas, and has been detected in countries including South Korea and the United States.
Like the South African variant, the Brazilian variant has the spike protein mutations N501Y, E484K and K417N (as well as numerous other mutations).
While thereās no evidence this variant causes more severe disease, thereās concern it has facilitated a wave of reinfections in Manaus, the largest city in Amazonas, which was thought to have reached āherd immunityā in October last year.
What does this mean for vaccines?
Major vaccine developers are testing the efficacy of their vaccines against these and other variants. Generally, the currently licensed vaccines protect relatively well against the UK variant.
But recent phase 2/3 data from both Novavax and Johnson & Johnson suggest reduced protection against the South African variant. The Oxford/AstraZeneca vaccine group also released data over the weekend suggesting its vaccine offers only minimal protection against mild-moderate disease caused by this variant.
However, itās important to recognise reduced protection doesnāt mean no protection at all, and that data are still emerging.
Whatās more, numerous vaccine manufacturers are now investigating whether tweaks to the vaccines can improve their performance against the emerging variants.
The take-home message is that variants will emerge, and we need to closely monitor their spread. However, thereās every indication weāll be able to adapt our vaccine strategies to protect against these and future variants.
- Kirsty ShortĀ is a Senior Lecturer atĀ The University of Queensland. This article is republished from The Conversation under a Creative Commons license. Read the original article.
Read also:
- SA shouldnāt discard AstraZeneca vaccine, says Madhi
- AstraZeneca Covid-19 shot is still worth using ā WHO
- New AstraZeneca vaccine in the works to fight SA-discovered ā501.v2ā variant