How bad are all of these new COVID variants?

Viruses mutate; just like everything, really. But experts are now worried about some of the thousands of variants of the coronavirus that have emerged around the world. We wrote about the UK variant last month; there are now more, including one in Los Angeles. You don’t need to panic. But it’s good to be informed.

One of the main reasons we are seeing new variants now, a year after the start of the pandemic, is that there are so many more viruses than 12 months ago. The more viruses there are in the world, the more likely it is to mutate. And the more variations there are, the more likely it is that some of them will be bad news.

If we (as a global community) had done a better job of containing the virus in the first place, we might not have gotten to the point where there are several variations that are different enough to worry experts. But here we are.

Another thing to remember is that you will only find variations if you search for them. The UK variant, B.1.1.7, was discovered in part because the UK does a lot of what’s called surveillance testing – monitoring exactly what types of coronaviruses exist. The United States is also a part of it, but much less. Variant B.1.1.7 was probably already in other countries by the time it was discovered in the UK; they just hadn’t found it yet.

What are the variants to know?

B.1.1.7 was found in November 2020 in the UK, where it had probably been circulating since September or before. This New York Times article has more details on the strain and its mutations. It appears to be 50% more transmissible than a typical COVID virus. It has several mutations, including eight on the spike protein.

(The spike protein is the part of the virus that interacts with our cells. When we make antibodies against the spike protein, these antibodies can prevent the virus from infecting us. MRNA vaccines include the genetic code for the spike protein. , who allows our cells to make the protein and then make antibodies against it.)

B.1.1.7 is more transmissible, but the disease it causes does not appear to be worse than usual.

B.1.351 was discovered in South Africa, in samples dating from October 2020, and it also shows mutations in the spike protein. It appears to be more transmissible than typical COVID, but does not change the severity of the disease. This variant and the UK variant share a mutation called N501Y. A recent study, published in pre-print, found that the Pfizer vaccine Is seem to protect against variants with this mutation.

P.1 is a variant from Brazil, first detected in December 2020. It also has mutations that seem worrying, especially on the spike protein. One of its mutations, E484K, may be able to escape antibodies; there are some reason to suspect that people who have recovered from a previous case of COVID can be infected with these mutations.

CAL.20C is a variant become popular in Los Angeles. We don’t know much about it yet.

For all of these variations, the science is still very new. The things we know about them are tentative. None of them appear to cause more serious illness; most are probably sensitive to existing vaccines; and PCR tests still seem able to detect them.

They have also often become the dominant strains in their area, but for some of the variants there is a bit of a chicken and egg problem to determine if they are responsible for spikes in cases or not.

What is happening now?

Two things. First, scientists are struggling to answer unanswered questions about these variants.

For example, we need to know if they are really more transmissible, and if so, by how much. We need to know if the variants can evade our natural immunity (which would mean you could catch the virus twice) and if they can evade the immunity of the different vaccines and vaccine candidates that already exist. We need to know if any of the variants cause more severe disease or if there are clinical differences. And we need to strengthen our oversight, in each country, to be able to find new variations as they emerge and see where existing variations take over.

Over time, if it turns out that new variants may elude existing vaccines, the vaccines may need to be updated. We do this for the flu shot every year; we may need to do the same for the COVID vaccine.

But the other element of action is simpler, even if it remains difficult: we must do everything we have done for prevention, but to a greater extent. If a variant is more transmissible, it is even more important to wear masks and stay home and take the tests seriously. It’s great, additional important to get vaccines as soon as possible. So in that sense, even though the virus does change, our most important measures to control it haven’t changed.