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SARS-CoV-2 is upping its game, we should up our public health response too

I’m getting a lot of questions about the new variants of SARS-CoV-2 coronavirus, the virus causing COVID-19, and thought I’d summarize what we know so far and what we can do about it. 

While viruses and bacteria undergo mutations all the time, many of them do not affect how infectious the virus is or the course of illness. SARS-CoV-2, like other coronaviruses, is generally slow to mutate thanks to built-in error-correcting proteins that fix most mistakes in replication. 

It generally accumulates one or two mutations per month. However, the number of mutations in the important “spike protein” that plays a key role in infection and is the target for most COVID-19 vaccines, as well as the association with a rapid rise of cases in these locations, has raised concerns.

In recent weeks, a number of new virus mutations have been identified in the U.K., South Africa and Brazil, producing new “variants” of the virus which differ from the virus first detected in Wuhan, China, in 2019. These are called “B.1.1.7,” “501Y.V2” and “B.1.1.28” respectively. 

Two mutations in particular are receiving a lot of attention. One is called “N501Y” and it’s found in both the U.K. and South African strains. It may facilitate virus replication. The other is called “E484K” and has been found in the South Africa and Brazil strains. This mutation might affect the ability of the immune system to recognize the virus after natural infection or vaccination.

Most scientists are confident that current COVID-19 vaccines will protect against the new variants, but there’s a risk that they may become less effective if the virus continues to mutate. 

This is another reason why it’s important to reduce the number of people who become infected – because mutations are more likely to occur when the virus infects new hosts. Researchers are monitoring these changes through genetic sequencing—looking for changes in the genetic code of the virus. Finding a mutation doesn’t tell us anything about its effects, but the more COVID cases, the more likely virus mutations are. As transmission continues, expect more virus mutants to be found.

The virus is already infectious at baseline, so it is extremely important to remind everyone of the effectiveness of the public health measures (we are not helpless!) and individual responsibility to prevent spread of COVID. It is important to monitor the change of the virus but it is more important to focus on the virus overall by limiting the number of cases, controlling transmission and deploying the vaccines as soon as possible. 

If you have been in contact with someone who becomes ill whether it’s from the original SARS-CoV-2 or the variant – you need to quarantine for 7-10 days. This is to break the chain of transmission and prevent you from infecting someone else. 

Bottomline, even though these variants are not more deadly, we should still be more cautious because it is more transmissible, which means potentially more cases, and potentially more hospitalizations and potentially more deaths. 

Variant or no variant, please continue to wear a mask when outside the house or indoors with people from outside your household, maintain at least a one-meter distance between yourself and others, and regularly clean your hands with an alcohol-based hand rub or wash them with soap and water. Don’t forget to avoid the 3Cs: closed spaces, crowded places and close-contact settings. 

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Dr. Melvin Sanicas (@Vaccinologist) is a physician-scientist specializing in vaccines, infectious diseases, and global health.

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