Variants of Concern
Time to get very strict — or to ease off?
A few months back we hardly knew the word. Now, “variant” has become achingly familiar. Variants create a threat that may radically complicate our global pandemic response. VERY worrisome is that the longer the pandemic prevails, the more that new variants will develop.
A variant is a virus whose genetic make-up is slightly altered. It is a spontaneous change — a mutation — that occurs when the virus replicates. Of the hundreds of COVID-19 variants, today there are three variants of concern (VOC). Current they are — the UK, the South African, and the Brazil variants. Other candidates for the VOC list include one from California and one just identified from Nigeria.
The problem with a VOC is that their slightly altered genetics affect how they react when they contact a host like yourself. The mutations in all three VOCs are changes to the knobby protuberances called spikes on the surface of the virus. The spikes enable the virus to invade human cells, to replicate, damage the cell and create disease. The changes to the spike allow the virus to more easily invade our cells and thus produce disease more readily than did the original coronavirus.
If a VOC is more infectious — the UK variant spreads between 50% and 70% more easily than the original coronavirus — it will soon become the dominant virus in a community.
A short math lesson….
In England, Ireland, and Israel, the UK variant became the dominant virus in a couple of months. This evolution was accompanied by a surge in the total number of cases. If other factors are equal, with a more infectious coronavirus, the basic reproduction number (Ro value) will increase, and quickly we will move into another wave of increased cases.
Recent reports from England suggest that the mortality rate for the UK virus is about 33% higher than the original coronavirus. The 53% mortality for the recent outbreak at Roberta Place in Barrie also points to a potentially higher mortality rate for the UK variant.
Another difference is very worrisome. Children almost universally shrug off the coronavirus, however children and young and older adults seem to be equally susceptible to the UK variant.
If the virus continues to circulate uncontrollably in different parts of the world, no one can return to normal. The hoped-for solution is in the creation of effective vaccines. The hope is that vaccines will enable global control. After the start of the pandemic the first vaccines were produced, put through phase I, 2, and 3 trials, and were approved for emergency use in 11 months — an incredible accomplishment.
Currently we have three different vaccines that are in the public space. They are remarkable for having up to 95% efficacy. In comparison the flu vaccines are 40-60% effective at preventing influenza. The thinking is that if we can get enough of the population immunized — estimates are 50-80% — the Coronavirus will become markedly diminished in its ability to spread through the community.
With the advent of VOCs, the ugly possibility is that new variants will not be sensitive to the vaccines now in use. Studies suggest that the three vaccines in current use are quite effective against the UK Variant and somewhat less so against the South African variant. The vaccine makers are now playing catch-up, altering their vaccines in response to the changing genetics of the mutating virus — a process that will reward the nimble, and will have a huge effect on the success of global pandemic control.
There has been recent emphasis on the importance of the quality of face masks. Initially it was suggested that any cover including a head scarf was valuable protection for yourself and others. These inadequate face coverings are still seen in public.
The more recent understanding about COVID-19 transmission through aerosols (the tiny droplets that are swept into the air from our throats and lungs by simple breathing and then linger in the air) is that they play a huge part in indoor COVID-19 transmission. Masks, to be effective, should obstruct the passage of these aerosol droplets. The best masking options are to use a three layered tightly-fitting mask; to wear two masks at the same time as Dr. Anthony Fauci has recently been doing; or to use the now available KN95 masks (a version of an N95 used by at risk health care workers)
What can you do if a more infectious variant enters our community?
The answer is to do more of the same,
and to be stricter about it!
- physical distancing,
- wearing a good mask,
- not travelling or meeting indoors except with your immediate family,
- Get vaccinated as soon as possible.
