The New Coronavirus Strains
Is now the time to panic?
As 2021 has slowly crept into our field of vision, news of SARS-CoV-2 variants have been in the headlines. As of this week, the “UK strain” of the novel coronavirus has been found in a few US states.
Although viral mutations are not unexpected, any news of change or disruption is highly unsettling in the midst of a global Pandemic. But before you start breathing into a paper bag, let’s talk about what this means.
When living organisms reproduce, genetic material has to be duplicated to make new offspring. During this process, occasional “typos” occur in the newly replicated genetic code. Most of these typos don’t matter because the change does not alter the organism’s function. However, there are times when these typos are significant and the resulting change gives the organism a survival advantage. When this random improvement happens, the new variant (or “strain”) will continue to rapidly replicate and expand its footprint.
In other words, the process of optimizing the genetic code is a simply a happy accident, but one that can be significant to an entire living population.
For most infectious organisms, random improvements (or “mutations”) are biologically advantageous if the change in function leads to a greater ability to cause disease. Remember, a virus needs a host to survive, so killing the host is not the virus’ goal. Viral survival depends on infecting and replicating as fast and furious as possible. And that is exactly what the new UK variant is doing.
In the case of the UK strain, the mutation is thought to be about 50% more contagious than the prior dominant strain. The reason this viral strain is more infectious is not entirely clear. Some studies indicate the strain causes an increased viral load in the nose and mouth, leading to greater ability to spread person to person (Ahem… the mask goes over the nose.) Alternatively, the new strain may have increased ability to enter and commandeer human cells. Either way, the result is an increased ability to more easily infect humans and cause disease.
For the love, Dr. Natasha. Is there any good news here?
Well, maybe?
The new strain is not more harmful to humans and is easily detectable by our well-established PCR tests. Current evidence also suggests the mRNA vaccines will still be effective against this UK strain. Those are good things.
But.. More contagious spread means more infected individuals in a population. When lots of infections happen in one area, that’s when we see the medical system strain. And as we have learned throughout the Pandemic, these waves of increased illness lead to more suffering and death simply due to the large percentage of a community being ill at one time. Due to the infectious nature of the new strain, the UK has imposed significant lock-downs to assist in disease mitigation.
The UK strain has also been found in younger age groups, specifically the under-20 crowd. Again, the strain does not seem to be causing more significant disease in humans. But since this strain is able to enter cells more easily and cause active infection, both adults and children are more likely to get infected and infect others.
Oh, one more thing. There’s a South African strain that has more genetic changes on the spike protein than the UK strain. This may make our current leading vaccines less effective against it.
[1/10/20 update: Pfizer-BioNTech stated their mRNA vaccine is protective against the new strains. This is based on a pre-print (not peer reviewed) showing antibody neutralization to both strains in vitro. This news is initially reassuring as research continues. I’m certain we will continue to hear more in the future.]
I know. It’s a lot. Again, viral mutation is not unexpected, and as each day passes we are learning more. Be assured that the greatest minds of science are working together to help end this disease. Optimizing multiple testing and sequencing strategies, ramping up vaccine delivery, doing our part to share accurate information to those we love, and working to increase trust in public health - these are all ways we will be able to defeat whatever the virus continues to throw at us. We will work together to navigate the best choices for our families, leaning into evidence and leading with our action.
As we all continue to slog on, maintain your vigilance. Wear a mask when you are around other humans, inside or out. Stay out of other people’s homes. Keep up your hygiene practices. Don’t assume anyone has immunity. Get tested if you are not feeling well. Stay home if you are sick or waiting for test results. Follow the advice of your local health experts. Keep up with your family’s routine health care. Do one thing everyday that makes you happy. Find gratitude. Practice grace.
P.S. - On a personal note, I want to wish all of you a Happy New Year. If you are new to this letter, welcome. Here’s a brief introduction and credibility check.
Although this new calendar page offers no promises, my hope for all of us is to leave this year in a better place than we arrived. One of the ways this may happen is to increase our community immunity through safe and effective vaccination.
After the FDA granted an EUA for the Pfizer-BioNTech vaccine, both Dr. Kevin and myself registered to be vaccinated and received our first dose prior to Christmas.
We continue to be thoughtful and deliberate in our discussions of risks and benefits with our friends, colleagues, and patient families who are eligible to be vaccinated. I encourage each of you to lean into the advice of your trusted personal physicians as your opportunity to be vaccinated approaches.
We are far from the end of the Pandemic, but every protected person feels like a step closer. I’m grateful for this historic opportunity in the face of tragic loss. And I hope that my family, friends, colleagues, co-workers, and community members agree to accept the vaccine as they are able.
Coming up this month: A look forward to the next vaccines reaching Stage 3 trials, things to know after you get the COVID vaccine, and why you should trash the sippy cup. Stay tuned!
All of your kind comments are read and appreciated. As always, growth is my fuel. If you have found this helpful, I appreciate you sharing this with someone new.