Here’s what you need to know about the new COVID-19 variants, according to an infectious diseases expert

coronavirus variants
Photo via NIAID/Flickr (CC BY 2.0)

Coronavirus variants have made their way into the U.S. In late December, the U.K. variant was found in California, Colorado, and a handful of other states, and with other variants invading a number of countries, it’s sparked worldwide concern. Especially since the CDC said the U.K. variant could become the dominant strain of COVID-19 in the U.S. by March, and other variants like the South African variant and the U.S-born Columbus strain have been discovered since the beginning of January.  

Would the currently approved COVID-19 vaccines still be effective against the new variants? Or will our lives have to change all over again?

To find answers about the potential impact of the coronavirus variants, Nautilus messaged Dr. Supriya Narasimhan, the chief of infectious diseases at Santa Clara Valley Medical Center in California. Here’s a rundown of the conversation.

Nautilus: How worried should people be about a new coronavirus variant spreading so much in the U.S.?

Dr. Supriya Narasimhan: The new variants of SARS-Cov-2, including the U.K. variant, have NOT been associated with greater disease severity or mortality. So at an individual level, it does not matter if a person has an infection with the regular strain or the variant. However, the variants appear to be more infectious and transmissible. On a population level, this means more people will get sick, a portion of those who get sick will need hospitalization and ICU stays, and a portion of those will not survive. If there are a large number of infections, proportionally there will be a larger number of deaths even if the percentage of fatalities is constant.

It also means that there will be a greater burden on healthcare systems, which are already overwhelmed, and that may translate to delayed care and worse outcomes from both COVID and non-COVID entities. It also means that a larger number of our healthcare workers may get sick themselves because their exposure risk is higher. They are also facing caregiver and PPE fatigue, which you see in the general population. 

Nautilus: Will the coronavirus variants change how we conduct ourselves during the pandemic again? For instance, can we go to the grocery store if we take normal pandemic precautions? Can we go to a food truck? Should we continue our family bubbles? Basically, will the new variants make us readjust our lives again?

Narasimhan: The emergence of the variants definitely means that we need to continue to maintain masking, physical distancing, hand washing, and minimizing contact with sick persons. It is very likely the variants have spread more than we have realized, and we have not recognized the extent of spread because it can only be detected by genomic sequencing. Dr. [Anthony] Fauci pointed to this very fact in an interview with Newsweek on Jan. 5. 

Some data suggests that the U.K. variant has a higher viral load which means people with it shed more virus—aka being more contagious. We need to be as, if not more, diligent than before, but there is no reason to think that these measures which have worked so far will fail us. I think it is the failure to observe these measures consistently that accounts for transmission. I still think that eating outside is risky. Takeout is probably safe, especially with handwashing. We should continue family bubbles—most of the recent spread has not been from large gatherings but from small ones, sometimes just gatherings of two families.

Nautilus: Will the current vaccines that are approved for use in the U.S. still be effective against possible variants? Or will changes need to be made to the vaccine?

Narasimhan: It is difficult to say at this time. Obviously, the vaccines have not been studied directly against these variants. The immunity induced by the vaccines are meant to be polyclonal (aka antibodies are generated against multiple different parts or antigens in the viral spike protein) so theoretically, one mutation is less likely to have a significant impact. Early reports suggest that the Pfizer vaccine retains its activity against the N501Y mutants, of which the U.K. variant is one. But a more infectious variant may mean that we have to immunize a larger percent of the population to get herd immunity.

Likewise, we have not yet distributed enough vaccine to see what vaccine selection pressure does to the virus. In other words, the vaccine pressure may cause the emergence of more mutations (I certainly hope this does not happen), and if it does, we may have to tweak the vaccine in the future. But what the last year has shown is that we are capable of engineering a novel vaccine in a span of months, so re-engineering them to include mutations is not insurmountable. What seems a bigger issue is the culture of denialism and vaccine hesitancy in the community—people have to take the vaccine for it to work.

Nautilus: Is there anything else we need to know/be worried about with the variants?

Narasimhan: The South African Variant called VOC: 501.V2 is a worrisome one as well. A particular mutation in position 484 of the spike protein called E484K has been shown to bypass immune protection conferred by previous infection. It seems to have a couple of other mutations (E484K and K417N) which decrease its binding to antibodies. It is spreading widely in the African continent and has been seen in other countries. If these mutations confer immune evasion, that could be problematic. … [The California Public Department of Health] just released an [All Facility Letter] on a new variant L452R. They do not yet know the significance of this variant. It suffices to say that these variants will continue to need monitoring over the next few months.

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