Roughly one year into the COVID-19 pandemic, as new vaccines are being rolled out under emergency use authorizations, new strains of COVID-19 have emerged. This raises many questions, including what the COVID-19 virus mutations are, what causes virus mutations, and whether the coronavirus vaccine will provide adequate protection against them. While researchers are learning new information about the virus every day, in this blog post we will share what we know so far about the new strains of COVID-19 and what they mean for the pandemic.
What is a virus mutation?
According to the National Center for Biotechnology Information, viruses are constantly changing as a result of genetic selection through a process called recombination. Recombination is when different viruses exchange genetic information, which can then lead to a novel virus. Viral mutations occur when an error is incorporated into a virus’s genetic code. Every once in a while, mutations and recombinations can lead to a more contagious or threatening virus.
The process of viral mutation is something well known in healthcare. One example is the virus that causes the flu, which changes to such an extent that new flu vaccines are provided every year to fight against the newest versions of the virus. That being said, the fact that the coronavirus is mutating is not a surprise, but how the virus is mutating, and the rate at which it is changing is something we are continually learning about. For instance, coronaviruses typically evolve slower than the flu, but can mutate more and more as they are spread.
Monitoring the coronavirus mutations, scientists have hypothesized that SARS-CoV-2 has likely experienced mutations to its RNA genome one to two times per month since it was first discovered in China in 2019.
In the world of healthcare, whenever a potentially significant variant emerges—as with the COVID mutations—experts focus on learning about three key factors: how easily the variant can spread, the severity of the symptoms it causes and whether or not it can overwhelm the immune system of someone who has developed antibodies to the original variant, either by previous exposure or vaccination.
As of now, the three most significant coronavirus mutations scientists have identified are the UK variant (B.1.1.7), the South Africa variant (B.1.351), and the Brazil variant (P.1). There’s ongoing research surrounding how each might spread, if they cause more severe disease, and if the coronavirus vaccines will protect people against these new variants. While there are some studies claiming that some of the new strains of COVID-19 may increase the risk of death or cause more severe disease, more studies are needed to confirm these results. Many scientists estimate that at least one of these variants spreads more easily than the original virus that has been circulating around the world for almost a year now.
Ashish Jha, MD, the dean of Brown School of Public Health, estimates that new strains of COVID-19, which have already reached the United States, could cause 10 million new infections and 15,000 deaths by the end of February 2021.
Marc Lipsitch, Ph.D., a professor of epidemiology at Harvard’s T.H. Chan School of Public Health told reporters, “It’s a big deal for a world that’s already stretched trying to keep in control the old variant… If we don’t change our control measures, once it becomes common, it will accelerate transmission considerably.”
New strains of COVID-19
Below is what we know thus far about each of the new strains of COVID-19:
The B.1.1.7 variant
The B.1.1.7 variant, also referred to as the United Kingdom (UK) coronavirus, was the first notable COVID mutation to arise and give pause to health experts. Experts estimate that this variant, which first emerged around September 2020 in the United Kingdom, has a mutation in the spike protein, where the amino acid asparagine is replaced with the amino acid tyrosine. The UK coronavirus is highly prevalent in London and southeast England, and since its discovery, it has been detected in different countries around the world, including the United States.
Some say it is possible that the B.1.1.7 variant might have mutated through an immunocompromised person who had a rare, chronic case of COVID-19. This person’s long-lasting infection would have allowed the virus to replicate for a long period of time and build up mutations inside the patient’s body, with a new “super strain” spreading to others since then. British public officials and researchers have indicated that the UK coronavirus is more transmissible than other variants–with an estimated range from 50% to 70% more contagious.
As of January 31, 2021, according to the CDC, a total number of 467 cases caused by this variant have been reported in the U.S. The cases have been found in 32 states including Alaska, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin, and Wyoming.
The B.1.351 variant
The B.1.351 variant, also referred to as the South Africa coronavirus, is a COVID mutation that was first detected in early October and has similar mutations to the B.1.1.7 variant. As with the UK variant, more studies are needed to determine if the South Africa coronavirus causes increased disease severity than the original strain.
As of January 2021, this variant has been detected in around 30 countries, including the United States. The first two U.S. cases were confirmed in South Carolina, with seemingly no connection between the cases nor known travel history.
The P.1 variant
The P.1 variant, also referred to as the Brazil coronavirus, was first reported in Japan during routine screening by the National Institute of Infectious Diseases (NIID) in four travelers coming from Brazil. By the end of January 2021, the Minnesota Department of Health (MDH) reported the first known case of the Brazil coronavirus in the U.S.A recent study suggests that some of the mutations of this variant can affect the ability of antibodies (from previous infection or the COVID-19 vaccine) to detect and fight this mutation of the virus.
Many experts believe that the coronavirus vaccines that are being administered will still be, for the most part, effective with the emerging new strains of COVID-19. However, some of the mutations occur in the virus’s spike proteins, which bind to human cells (which act as host cells), enabling the virus to infect them. Most of the developed coronavirus vaccines are designed to teach the immune system to produce antibodies that recognize and neutralize spike proteins, so it is possible that some of these genetic mutations may reduce the ability of neutralizing antibodies and therefore affect how well the spike-based vaccines work.
The same can happen in the case of naturally obtained immunity gained from having a previous COVID-19 infection. Wendy Barclay, the head of Infectious Diseases at Imperial College London, said: “There’s a chance that the antibodies that were made in the first infection won’t work as well against the new variant.” She noted that vaccines trigger antibodies to fight off viruses through a variety of different mechanisms in your body, so even if antibodies have a reduced ability to block spike proteins, the vaccine has other ways to block the virus. This further emphasizes the importance of the vaccine, even with the reduced efficacy that can occur with the new strains.
How we will move forward
As more new strains of COVID-19 emerge, health experts are trying to quickly learn and understand their mechanisms to prevent their spread.
The arrival of the new strains of COVID-19 to the U.S. are an important reminder that the pandemic isn’t over. Although vaccinations are being distributed and administered across the country, wide access to testing—in conjunction with health practices such as social distancing, hand hygiene, and face coverings—can help slow the spread of COVID-19 and its new variants.