Andean variant: “It remains to be determined whether it is more contagious and deadly”

Pablo Tsukayama He is 38 years old and is professor of microbiology at the University Peruvian Cayetano Heredia and doctor in molecular microbiology. It was he who led the team which, a week ago, “introduced the world” to the variant of the Covid-19 C.37 coronavirus, which has been dubbed the Andean variant and what the one that has made the most progress in the latest studies carried out in Argentina.

The growth of this variant, which descends from a virus family called B.1.1.1, and which has been circulating since the start of the pandemic, it has occurred in Chile and Peru, and has already been identified in various countries in the region and in Europe. At the genetic level, C.37 reports two mutations in the spike protein, or peak, as it is called in English.

Tsukayama, via a survey carried out in a laboratory in Lima and developed by Cayetano Heredia University, began tracking this variant in December, and last week published the result in the journal Virological.org, a place where specialists around the world discussed their preliminary results.

In dialogue with THE NATIONTsukayama gave details on how they arrived at this discovery and what is expected in the next stages of the research. In addition, he was surprised by the large presence of the Andean variant in the city of Buenos Aires and in the suburbs. “The PAIS relationship with the spread of the Andean variant in Argentina is surprising and interesting. Amazing because we had followed the database where there was only one report from Argentina and it was from February 20th. Now I see that they have grown very quickly and explosively ”.

-How is a new variant detected? What are you looking at?

-There are already thousands of variants in circulation. The term “variant” refers to a unique combination of mutations. Therefore, each country has its own combination of variants in circulation. The big deal, however, is when one variant quickly comes to dominate the scene. This is what we are seeing now. We only started seeing this one at the end of December in Lima. We sample around 100 genomes per month. Only one of this variant was seen in December. So it goes unnoticed. But, towards the end of March, what we saw in Lima is that the record already represents 40% of the samples.. This rapid growth in three months is an early sign that we have a more heritable variant.

The other thing that we observe is that he descends from a very ordinary line, which is nothing special, which is called B.1.1.1, which is not the same as B.1.1.7 , which is that of the United Kingdom and which is of concern. When a subline appears, which has a new behavior and develops rapidly, we move towards a consortium of international researchers who are in charge of assigning new codes and new lineages. In this place, we present the evidence. We have explained that it is new, that it is developing in these countries and that it has these characteristics. They examine it and, if they approve it, give it a new name. In this case, it was C.37, and it was decided last week.

– Identifying it in a place makes it named there. What happens when, as in this case, it has also been identified in France and Germany? Can case zero be traced?

-It can be traced, up to a point, but not with complete certainty. The main evidence to date is that it appears in Peru and most of the first cases observed occur here and in Chile. This suggests that he could appear in one of these two countries. But We have the problem that in both countries and throughout Latin America we are doing surveillance well below the level that we should. So if we saw one in December, it probably already showed up a month or two earlier. It can even come from another country in the region that introduced it to Peru or Chile. The truth is, very little was known about the variants last year. In recent months, the search for variants has expanded significantly in all countries of the world due to the most dangerous variants that have emerged. Before December, very few countries were doing this consistently. As it appears first here, and the largest number of cases occur in the region, the most intuitive is to think that its origin is in Latin America. and from there it was exported to Europe and the United States. In these areas, these large-scale studies are being done and if they had appeared there first, they would have identified it already.

-Once a variant is identified. What is the next step?

-The next step is to notify and alert other countries to add it to the list of variants that need to be monitored. Now that it has a name, it is easier for other countries to identify it. We have started to review previous reports from Argentina where there was talk of a specific mutation, “L452Q”, observed since February. But they didn’t know why it was because they hadn’t observed another. When other countries raise the alert, it is easier to identify. What follows now, and which will take more time, is to quantify what is discussed. For example: if it is more transmissible or more fatal. For that, we need to do studies with biostatistical epidemiologists and mathematical modelers who help estimate how much more transmissible it is and how deadly it is compared to the wild variant of Wuhan.. These new studies require new collaborations, which we do not have in Peru, but we are looking for colleagues from outside. But it will take longer. One can only hope to see how it increases in countries where it already exists or if it appears in new countries.

As a result of the report we made, unreported cases arose, for example, in Ecuador and Portugal. Let’s see how far you can go and what happens when you arrive in a new country. It may happen that it goes out, because it competes with other variants that circulate and lose. It can also be established and dominated. We have to wait and see what happens, especially in countries where other dangerous variants are present.

-In the case of Argentina, where it competes with other dangerous variants like the British and Manaus, has it drawn your attention to the fact that it has grown taller than the others?

-In Argentina, he had formidable rivals and he made his way. But it is very difficult to predict this because such studies have not yet been done. In other words, a study was not made where the variants are put in competition on the same ground and one observes which will win. It depends on many factors. Above all, the time of entry. In other words, who has arrived before and how many have arrived. It is necessary to see through which borders the greatest number of cases are filtered. It depends on that and other demographic factors. Terrible weeks are coming to Peru, due to the pace of the pandemic. From what I have seen, the situation in Argentina is not good either. Now we need to see the effect of these variants and, if so, behave differently. This is something we don’t know yet.

-What was your reaction to finding a new variant of something like this? What was your reaction to the acceptance of the discovery by the international community?

-We had a lot of doubts at the beginning. There was little data in Lima to confirm this. But in the forums where there are people I respect a lot who are experts in the matter, they said that there is something new there and we have to be careful. When there is a certain consensus in the scientific community, you already feel that you are looking for something interesting.. However, the results that we have and are reporting here in Lima, in a way, run counter to those reported by the National Institute of Health of Peru. This is because they used an alternative test to identify the variants, but it is not as accurate.

This was a sensitive issue, as we also don’t want to come into conflict with the health authorities and the government. But this has already been figured out and we will try to resolve the lag in the results. How do you feel personally? It is very difficult because it is something that is killing a lot of people in the area. You can’t stop thinking about it. So it’s a bit of a strange realization. But that’s what we have to do. The important thing is what we do now, which is to discuss it with other colleagues in the region. Because we are all in the same situation, ie analyzing this with limited resources and there is an extreme emergency situation. It is well received, but the only thing left is to support and try to contribute. What we have done has opened up the possibility of new regional collaborations. It’s the best way to do it in these times.

-Have the Argentinian health authorities or researchers been contacted to provide data or work together?

I haven’t spoken to anyone from Argentina yet, but we are more than willing to listen. They called me from Chile, from the embassy. Also from the Brazilian Embassy because they are worried. But this is all very recent and I think we need a little more proof. But I think that at some point coordinated actions will be needed between countries.