Tip/Thought of the Day

What to know about COVID-19 variants

Coronaviruses have been known to cause a multitude of infections ranging from the benign “common cold” to more lethal infections like the SARS outbreak in early 2000, to this pandemic. The World Heath Organization (WHO) derived an acronym in February 2020 to avoid stigmatizing its origins in terms of animal, geographical or population associations. Since this “novel” or new coronavirus was first seen in 2019, it was dubbed COVID -19. As the pandemic progressed, the virus did what any virus does to continue its ability to infect, it mutated and developed variants.

These variations can impact how a virus transmits, how it gets from one person to the next, and its virulence, how lethal it will be to the infected person. As with any rapidly evolving situation, recommendations change as we gather more data. Due to the deadly impact COVID-19 has had on the world, all the best minds are focused on getting us answers.

Where did the variants originate?

There are lots of COVID-19 strains in existence around the globe, but experts are most concerned about the variants below. They’re named based on where they originated – for example, the U.K. variant was first detected in the United Kingdom.

  • K. or British variant, also known as B117
  • South Africa variant, aka 501Y.V2 or B.1.351
  • Brazil variant, aka P.1
  • California variant, aka CAL.20C

The CDC and the World Health Organization developed new designations for the variants: “variant of interest”; “variant of concern”; and “variant of high consequence.” The CDC outlines the new designations as follows:

  • A variant of interest has caused discrete clusters of infections in the United States or in other countries, or seems to be driving a surge in cases. It also has gene changes that suggest it might be more contagious or that may help it to escape immunity from infection or vaccination. Therapeutics and tests may not work as well against it. The CDC is watching three of these.
  • A variant of concern has been proven through scientific research to be more contagious or to cause more severe disease. It may also reduce the effectiveness of therapeutics and vaccines. People who have previously had COVID-19 may become reinfected by the new strain. The B.1.1.7, B.1.351, P.1, B.1.427, and B.1.429 variants circulating in the United States are classified as variants of concern
  • A variant of high consequence causes more severe disease and greater numbers of hospitalizations. It has also been shown to defeat medical countermeasures, such as vaccines, antiviral drugs, and monoclonal antibodies. So far, none of the variants meet this definition.

What is different about the variants?

Studies of the B117 variant show that the virus has experienced roughly 17 genetic changes from the “original” coronavirus. It appears that the spike protein, or the outer covering that gives SARS CoV-2 its spiky appearance, has modified. These proteins help the virus attach to human cells in the nose, lungs and other areas of the body.

New information released by the CDC states that the dominant strains in the U.S. are the California strain (CAL.20C) and the U.K strain (B117). As of mid-February, the California strain accounted for 52% of sequenced samples from California, 41% of samples from Nevada and 25% of samples from Arizona, CDC data shows.

It is expected that those percentages will increase rapidly considering the variants are more transmissible, the easing of restrictions in several states, and pandemic fatigue (people becoming more lax with their individual precautions such as mask wearing or gathering with others). Experts agree that the current down-trend of virus infections and deaths is like the eye of a hurricane; letting our guard down now leaves the country vulnerable to a fourth wave of infection from the variants.

In January, researchers at the CDC predicted that the U.K. variant would become the dominant one in the U.S. by March. Epidemiologist Summer Galloway, the lead author of that report, said last Wednesday (3/10) that it probably accounts for 20% to 30% of the samples being sequenced today. At a White House coronavirus update on Friday (3/19), Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and the chief medical adviser to President Biden, pointed to one study showing a 64% increased risk of death for people infected with B.1.1.7 compared to those infected with the older variant. He also showed a second study that indicated a 61% higher risk of death with B.1.1.7.

Will the existing vaccines still protect people from the variants?

There are concerns that the currently authorized vaccines, and other vaccines that are close to authorization, could prove less effective against some of the other new variants. For example, some studies suggest that Pfizer and Moderna vaccines are about half as effective against the South African variant.

Pfizer and Moderna have both said their COVID-19 vaccines will work against the U.K. variant. This is likely because the part of the virus that mutated isn’t involved in how the vaccines work.

Sources state that real-life use of the Pfizer/BioNTech and Moderna vaccines indicate that while the B.1.1.7 variant can elude, somewhat, the immune response prompted by immunization, it’s not enough to make the vaccines any less effective in protecting people. Since the vaccines cause a broad immune response so although slightly weakened, it’s still powerful enough to prevent serious disease and death. Meaning, we may get sick and still be able to transmit the virus, but we will likely not require hospitalization or die from the infection.

The methods used to create mRNA vaccines makes them relatively easy to adjust – so even as Moderna and Pfizer are producing more vaccines to roll out across the country, they are figuring out how to tweak the mRNA for future doses to better protect against new variants. This is done much in the same manner as influenza vaccines are adjusted yearly to counter the presumed dominant variants of the flu season.

Do the new variants impact children differently?

The latest research puts the worst fears to rest. A large study by health officials in Britain found that young children are only about half as likely as adults to transmit the variant to others.

“That’s exactly what we had been seeing with this current variant that’s circulating in the U.S., too,” said Apoorva Mandavilli, who wrote about the science. “Nothing has really changed on that front.”

Stuart Ray, M.D., vice chair of medicine for data integrity and analytics at Johns Hopkins, says that although experts in areas where the new strain is appearing have found an increased number of cases in children, he notes that the data show that kids are being infected by old variants, as well as the new ones. “There is no convincing evidence that any of the variants have special propensity to infect or cause disease in children. We need to be vigilant in monitoring such shifts, but we can only speculate at this point,” he says.

What can be done to protect against the variants?

Protecting against the new variants is a two- pronged approach. Vaccinating as many people as possible, as quickly as can be done is the most effective thing that can be done to protect people from serious illness or death. The second layer of protection is for people to continue following precautions like mask-wearing, physical distancing, maintaining sound cleaning regimens of high traffic surfaces, hand hygiene, and ventilating areas when people must be inside.

“The bottom line is that anything we do to reduce transmission will reduce transmission of any variants, including this one,” said Angela Rasmussen, a virologist affiliated with Georgetown University. But “it may mean that the more targeted measures that are not like a full lockdown won’t be as effective.”













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