The coronavirus that causes COVID-19 is mutating. The highly transmissible variant that is spreading rapidly in the UK has led to a strict national lockdown. That variant is called B.1.1.7 and has been detected in numerous parts of the US. Scientists are hopeful that the vaccines will protect against this new strain. Another new strain, the South African COVID variant, has some virologists extremely concerned.
The South African COVID Variant (501Y.V2)
These mutations have some people nervous. That’s because the South African COVID variant has undergone at least 20 mutations. Several of the mutations are at the level of the spike protein. This is the way the virus attaches to human cells. If the mutation is substantial enough, it may make it harder for neutralizing antibodies to inactivate the virus.
Dr. Scott Gottlieb was FDA commissioner of the FDA during the early days of the Trump administration. He is concerned that the monoclonal antibody drugs developed by Regeneron and Eli Lilly may not be effective against this South African COVID variant. In fact, laboratory research suggests that variants B.1.1.7 and B.1.351 resist neutralizing by antibodies more than the original virus (Nature, March 8, 2021).
You may remember that President Trump, Rudy Giuliani and Gov. Chris Christie all received these IV medications soon after testing positive. They attributed their rapid recoveries to the antibody treatments. It would be very disappointing if these powerful tools became ineffective because of the new mutations.
How Contagious is the New Variant?
The British Health Secretary, Matt Hancock told the BBC:
“I’m incredibly worried about the South African variant. This is a very, very significant problem…it’s even more of a problem than the U.K. new variant.”
That’s because the South African variant is also highly contagious. That means it may spread at least as easily as the variant that has completely shut down the UK.
“Right now that strain does appear to be prevalent in South America and Brazil, the two parts of the world, right now, that are in their summer, but also experiencing a very dense epidemic, and that’s concerning.”
Remember, summer is supposed to be the lull before the storm. That is, viral spread is generally lower in summer than in cold weather. The fact that the South African COVID variant B.1.351 is running rampant in Brazil right now is indeed worrisome.
Does Recovery from COVID Protect You from Variants?
Scientists have been concerned that evolving variants of the SARS-CoV-2 virus might not provoke an immune response in people who have who have recovered from COVID. Two new studies indicate, however, that so far immune response from antibodies and T cells are able to counteract known variants. [There are some exceptions, however. Scientists worry fear that people who have recovered from one strain of SARS-CoV-2 may not be protected from a new variant and could become reinfected. That has already happened to one patient in Brazil (Preprints.org, online, January 6, 2021).]
One group of scientists found that most antibodies in convalescent plasma are aimed at the receptor binding domain on the virus spike protein (BioRxiv, March 18, 2021). Some of the variants already have ways to escape one type of antibody, but none have developed a way to evade all three classes.
Scientists at the National Institute of Allergy and Infectious Diseases reported this week that convalescent T cells, an important part of the immune system, respond appropriately to variants such as B.1.1.7, originally identified in Great Britain, and B.1.351, the South African COVID variant (Open Forum Infectious Diseases, March 30, 2021).
According to the investigators,
“virtually all anti-SARS-CoV-2 CD8+ T-cell responses should recognize these newly described variants.”
Will the Vaccines Work Against the South African COVID Variant?
A far more controversial concern is the question of vaccine effectiveness against the South African COVID variant. Some scientists fear that existing vaccines may not protect against it as well as hoped.
The immunologist who helped develop the “Oxford” vaccine now being distributed by AstraZeneca in the UK is Professor Sir John Bell. In January, he said he was more concerned about the effectiveness of the vaccine against the South African COVID variant than the UK variant. Unfortunately, his fears were confirmed in March. Results of a clinical trial showed that the AstraZeneca vaccine did not protect people from the B.1.351 variant (New England Journal of Medicine, March 16, 2021).
Many virologists are confident that the existing vaccines will work against all the new coronavirus variants. Research is underway to determine if the available vaccines are effective against both mutations (B.1.1.7 and 501Y.V2) We should have answers by the end of this month.
What to Do?
We are fans of Dr. Eric Topol. He has been a frequent guest on our syndicated public radio show. His books include: The Patient Will See You Now and The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. Our most recent interview with him was:
Show 1184: How Technology Could Make Medicine More Humane
Medicine is heavy on technology but often lacking in empathy. How could technology be coupled with listening to make medicine more humane?
Dr. Topol is a cardiologist and professor of molecular medicine at the Scripps Research Institute. He is the founder and director of the Scripps Research Translational Institute. Dr. Topol is encouraging public officials to take the virus variants very seriously.
He wants them to:
“vaccinate 24/7 like it’s an emergency. Because it is.”
At the moment we are not seeing any public health organization, hospitals or clinics vaccinating 24 hours a day seven days a week. Why not?
He also wants N95 masks distributed to everyone. He is a strong advocate for home COVID testing. Dr. Topol wants everyone to have an adequate supply so that people can test daily.
Vaccines vs. Variants:
Why such a full court press? The sooner we can get the pandemic under control, the sooner the variants will have less impact. The more virus that is spreading, the greater the likelihood of mutations. The more mutations, the greater the chances that we will lose control.
We will keep you posted on developments with the South African COVID variant. In the meantime, be careful! Many hospitals are stretched to their limits. Get vaccinated as soon as possible.
You do not want to catch this virus. Many visitors to this website have said it’s no big deal, but there are increasing cases of “long COVID.” These “long haulers” recover from the initial infection but are left with long-term serious health complications. You can listen to our interview about this topic with two physicians who have experienced this personally:
Show 1230: What Happens When COVID Symptoms Don’t Go Away
Even young healthy people may have trouble when COVID symptoms don’t go away for weeks or months. Find out what it’s like.
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