‘Escape Mutation’ of New COVID-19 Strain

By Dr. Sanjay Perera | Published: 2:00 AM Apr 27 2021
Focus ‘Escape Mutation’ of New COVID-19 Strain

By Dr. Sanjay Perera 

Scientists have detected what is believed to be the world’s most mutated COVID-19 strain, as fears grow that new super variants may prolong the pandemic.

It has been revealed now that the coronavirus variant carries 34 mutations. And among those changes are: 

• 14 with the spike protein – the part of the virus which it uses to get inside human cells and make people sick.

• The Brazilian variant has 18 mutations in total, with 10 mutations in the spike.

• The UK strain has 17 mutations, including eight in key protein.

The apparent new variant also contains the worrying E484K change – referred to as an ‘escape mutation’ – which helps the virus beat antibodies and is coming in other worrying strains. The variant of interest (VOI) was discovered in three air travellers who arrived in Angola from Tanzania in the middle of February.

Like most countries which now have uncontrolled surges, Tanzania’s Government has engaged in COVID-19 denialism and President John Magufuli called for prayers and herbal-infused steam to beat the virus up until his sudden death in March due to COVID-19. It is feared the rampaging spread of the virus as cases increase, fuels these mutations – which may allow the bug to become more deadly, more transmissible and more adept at dodging antibodies. Most of the notable variants can be traced back to the B1 strain – but the new variants appear to have evolved from a different source.

The new VOI has been temporarily dubbed VOI.V2, while some have called it the “Tanzania variant.” The Human Vaccines Project said the virus carries “more mutations” than any previous strain. This comes as fears grow of rampant COVID-19 outbreaks across the world – this could derail efforts to beat the pandemic. Brazil has been described as a “biological Fukushima” due to the uncontrolled spread, while India is hitting record levels of infection, with more than 300,000 new cases every single day. Both have spawned new variants such as the P1 from Brazil and the “double mutant” COVID-19 from India.

Global daily case counts are now hitting highs not seen since the very peak of the pandemic last year, with more than 800,000 daily infections.

New mutations of the coronavirus can make it harder for the body’s immune system, which has been primed to look out for the ‘original’ strain either through vaccination or prior infection, to recognise it. Antibodies – proteins produced by the immune system to fight the virus – may be weaker against new strains. 

Again I beg our Sri Lankan Authorities not to be over-dependant on vaccines as the solution to containment of COVID-19 in the country. I have said this before and repeating again “please do not be delusional that vaccines will save our country. Countries that were overly dependent on vaccines and local concoctions are the countries with the biggest surges and new variants.”

India - daily infections double to 400,000 in 10 days

Having let its guard down with mass religious festivals, political rallies and crowds at cricket matches, India is experiencing a vicious second wave, recording almost two million fresh infections this month alone. This week, it overtook Brazil to become the country with the second-highest number of cases worldwide, after the United States.

Like in Sri Lanka, after nationwide lockdowns which caused widespread misery and one of the sharpest downturns of any major economy, the Indian Government is yet desperate to avoid repeating the hugely unpopular shutdown.

As a result, Indian hospitals which have a bigger healthcare network compared to Sri Lanka and other Asian countries, are now struggling to cope, running short of beds, oxygen and coronavirus medicines like Remdesivir.

In a new disturbing trend, doctors across the most affected cities told me they had seen an increase in the number of COVID-19 patients aged below 35 and suffering from more severe symptoms compared to last year. 

“We are also seeing children under the ages of 12 and 15 being admitted with symptoms in the second wave. Last year there were practically no children presenting symptoms,” Dr. Khusrav Bajan, a consultant at Mumbai’s P.D. Hinduja National Hospital, told me during a telephone conversion this week. 

The country’s drive to vaccinate its 1.3 billion people has also hit obstacles, with just 114 million shots administered so far and stocks running low, according to local authorities.

The threat of new coronavirus strains also means masks and social distancing could be needed well into 2022

Despite the vaccine rollouts, most socially responsible governments and countries are not relaxing border controls. It’s feared should a new variant take hold, further lockdowns may be needed to clamp down and stop the spread. Studies have shown the current vaccines do still work against new variants, but are less effective.

Dr. William A. Haseltine, a former Harvard professor, told me there are holes in the global monitoring of COVID-19, such as in Tanzania, India, Brazil and the Indian region countries and this lack of monitoring could throw up more surprise mutations. 

I quote – “The more the virus spreads, the more variants arise, and the greater the chance the virus may increase in transmissibility, evade our immune response, and increase in virulence,” – unquote.

There seems to be a vacuum of information coming from Tanzania, India, Brazil and a few other countries which needs to be addressed promptly by experts (including in SL), as virus mutations pose a ‘serious threat’ to our current arsenal of vaccines – and there may already be variants which will dodge first-generation jabs.

I personally believe, because of a lack of systematic surveillance even in Sri Lanka, that there are, as of yet, unobserved variants with enhanced properties to increase transmission, disease, and immune evasion. 

However, having said this it could be ‘critical’ that as many people as possible get vaccinated as soon as possible, but not be overly dependent on it for COVID-19 safety in SL.

The pandemic is nowhere near finished

Each week we have seen four and a half million cases being reported worldwide and know those are an enormous underestimate as in my opinion, we are still seeing a really significant number of deaths – nearly three million. What I want to stress is that the pandemic is surging forward everywhere.

My colleague, Dr. Tony Lockett, from King’s College London’s Institute of Pharmaceutical Science, told me about the prospect of a devastating new mutation emerging from the rampant spread worldwide. 

I quote - “The effect – well it could be devastating – much worse than the original as younger people could become sicker and those who have had the virus get re-infected with the new strain, it’s really very scary.” - unquote.

His comments come as it was warned that coronavirus mutations could render vaccines redundant in less than one year, according to a survey of epidemiologists by The People’s Vaccine Alliance.

Schools, universities and economy

I am of the view that schools, universities and businesses should operate. 

However, wearing of masks, washing of hands, checking of temperature in these places of study or work is “not a strategy.” These are basic health guidelines. The lethargy of health authorities to strategise more aggressive and progressive protocols instead of basic guidelines cannot be comprehended.  

To the authorities, I request:

• There are 4 strategies that could be implemented for educational institutions. Stipulate them, provide them to the education sector, and ensure these strategies are implemented by school authorities. 

• In a burdened economic environment it is not practical to impose regulations on work places to conduct daily PCR tests on staff – which is the easiest way out for health authorities. This will drain already struggling enterprises. Instead, there are cost-effective technologically advanced environment cleansing systems which are not only cost-effective to the private and government sectors, but makes monitoring of COVID-19 safety ‘a cakewalk’ and not a nightmare. Strategise and implement these modern protocols. 

As a Pharmaceutical and Healthcare Advisor I am saddened to note, the lack of progressive systems and protocols - which are cost-effective - being introduced to the country to keep the wheels in motion.   

Conclusion 

Most international and Sri Lankan Experts and Groups such as the GMOA agree with me and I fear – we will need much more than 15,000 tests/day to control the new surge in Sri Lanka, as it is most likely a more infectious variant in which R is higher (rate of transmission) and is now spreading through air droplets.

Interventions need to be much more intensive to bring R below 1. Because we haven't been testing or looking for virus over the past 4 months (despite our concerns and plea), this variant would have been exploding undetected for weeks in the country, and the New Year festivities exposed and surged the spread we see now.

Since testing is also capacity limited, we also need to increase efficiency of PCR testing. I recommend that random testing could be reduced, and focus testing on people with symptoms - coughs and colds. PCR testing needs to be increased in workplaces, factories and government institutions or alternatively environment testing. Random testing doesn't make sense when we don't have enough testing capacity!

The public and businesses should also be told that if they or any worker with a temperature or cough or cold or other symptoms, should stay at home and report to the local health sector. This should be strictly and immediately enforced by authorities with institutions not adhering to this rule being severely punished. 

To the authorities I humbly plead, Don’t compare our COVID-19 safety successes thus far to countries that are in the bottom ranks in the WHO list. Do not ride on luck. 

Compare ourselves to countries that are faring better than us, study the positive protocols used by these successful countries and rise in our ranking.

Don’t be delusional that SL can eliminate COVID-19 completely. This is a global pandemic. But working together with genuine experts with no hidden agendas SL can be a ‘COVID-19 safe haven to the World.’  

About the writer:

The writer is a PHD holder in Pharmaceutical and Healthcare Management and a Consultant and Adviser on Primary Healthcare, COVID-19 and Public Safety. He also is a consultant on COVID-19 safety protocols for Hong Kong, Vietnam and German Institutions.

He is also the former CEO of an Electronic Media Group.


By Dr. Sanjay Perera | Published: 2:00 AM Apr 27 2021

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