How many variants of COVID-19 are there? COVID strains, explained

COVID-19 variants have been in the headlines for weeks. First, it was B.1.1.7, aka the UK variant. Then public health experts began to warn of B.1.351, a strain that was first detected in South Africa, followed by reports of P.1, a variant that appeared in Brazil. There have also been reports of additional variants appearing in other places, including the United States, which makes it seem like it really is, really difficult to follow.

Of course, these variants didn’t just appear – they started to spread – and it’s scary to hear.

Just know this: It is natural for viruses to have variants. RNA viruses like SARS-CoV-2, the virus that causes COVID-19, “can mutate when they replicate,” Thomas Russo, MD, professor and chief of infectious diseases at the University of Buffalo in New York. “Most of these mutations have no functional consequences – it doesn’t change the properties of the virus or the severity of the disease it causes,” he says. But, in some situations, a series of mutations can spread and create what is called a variant of the original virus.

Sometimes these variants don’t make any major difference to whether a virus gets infected or how sick it can give you, says Dr. Russo. But, in other situations, the variants can spread more easily and lead to more serious complications than the original strain. “These are the ones that worry us,” says Dr. Russo.

Okay, but how many variants of COVID-19 are there? And how exactly should you be worried about which variations are making the headlines? The doctors explain.

How many variants of COVID-19 are there? And are they more deadly or contagious?

Technically, there is no limit on the number of variants a virus can have, and that includes SARS-CoV-2. “There are probably too many variants to count,” says David Cennimo, MD, infectious disease expert and assistant professor of medicine at Rutgers New Jersey Medical School. That’s why he prefers the term “variant of concern” to help describe the strains you should actually be concerned about.

“A variant is of concern if it appears to behave significantly different from our usual, clinically established standards for communicability, severity,” he says. The Centers for Disease Control and Prevention (CDC) have specifically listed the following variations as being worth knowing:

• B.1.1.7, aka the UK variant. This strain, detected for the first time in England, has a large number of mutations. This includes a mutation in the SARS-CoV-2 spike protein that appears to help the virus attach to your cells more easily. As a result, Russo explains, it can spread more easily than the original SARS-CoV-2. In January, British scientists presented evidence suggesting that the variant could be more deadly than other strains. The virus has since been detected around the world, including the United States
• B.1.351, aka the South African variant. This variant has a few mutations in common with B.1.1.7, including mutations in the spike protein. At this time, the CDC says, there is “no evidence” to suggest that the variant has an impact on the severity of a case of COVID-19 that a person might experience. The variant was first detected in South Africa and was reported in the United States at the end of January.
• P.1, aka the Brazilian variant. This variant was first detected in four Brazilian travelers who underwent routine screening at the Japanese airport in Haneda. The variant has 17 mutations, three of which are in the spike protein. There is some evidence to suggest that this variant is more infectious than other strains. The variant was detected in the United States at the end of January.

Dr Cennimo calls these variants “the big players to date,” adding that “each has shown its ability to become the dominant virus in the region.”

Will the COVID-19 vaccine work against these variants?

Research into COVID-19 vaccines and their response to each variant is ongoing but, so far, the data is mostly promising.

Pfizer-BioNTech shared in a study published in late January that its COVID-19 vaccine was effective against the British and South African variants of the virus. They noted in a press release that the “neutralization” against the South African variant in laboratory studies was “slightly lower” compared to the neutralization of other viruses. But, the companies said, this is unlikely to lead to a significant reduction in the vaccine’s effectiveness.

Moderna shared in a press release at the end of January that B.1.1.7 had “no significant impact” on the effectiveness of the vaccine. The South African variant, however, caused a “six-fold reduction” in neutralizing titers, i.e., antibodies. Yet, Moderna said, neutralizing titer levels against B.1.351 “remain above levels that should be protective.”

The Johnson & Johnson vaccine, which is not yet authorized for use in the United States, has been shown to be 66% effective overall in preventing moderate to severe forms of COVID-19 and up to 85% effective in preventing serious illnesses in the phase 3 clinical trial. Recently shared results. The vaccine has prevented people from being hospitalized or dying from the virus 28 days after being vaccinated, according to a press release. However, the vaccine’s effectiveness varied depending on where it was studied: it was 66% in Latin America and 57% in South Africa, while it was 72% in America. While Johnson & Johnson haven’t explained why, Dr Russo says different strains of the virus may be to blame.

“Vaccines may work less well against some variants,” he says. “But we still think it’s above the threshold to provide protection.

The TL; DR: The South African strain seems to be the trickiest for vaccines right now – but they still seem to be working against it.

Can you get a new variant if you’ve already had COVID-19?

It’s hard to know for sure. Dr Cennimo cites data from the Brazilian city of Manaus to suggest that people may be able to re-infect themselves. About 75% of the population was infected with SARS-CoV-2 as of October 2020 but, since mid-December, the region has seen an increase in cases. The researchers found that the P.1 variant was responsible for 42% of infections. “We should assume that reinfection is possible,” says Dr Cennimo.

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Dr Russo agrees. “At the very least, it suggests that the immunity offered by natural infection is not optimal,” he says.

The good news in all of this is that the same COVID-19 prevention methods that have always worked in the past continue to work against these variants, Dr Cennimo says. So, continue to practice social distancing, wear a mask when you are with people outside your household, and wash your hands regularly.

And, even though it is difficult when we are a friggin year into this pandemic, continue to do your best to protect yourself and your loved ones from COVID-19. “People have to stay vigilant,” says Dr Cennimo.

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