New R.1 Covid variant detected during an epidemic in the United States; First identified in Japan

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While the dominance of the Delta variant in the United States is nearly universal, news of another spreading strain of Covid-19 has recently surfaced.

Known as R.1, the new variant was first found in the United States in Kentucky, which Governor Andy Beshear says is among the three states with the highest infection rates. R.1 was first identified via an outbreak at a skilled nursing facility.

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According to a CDC report, among 83 residents and 116 healthcare workers, 26 residents and 20 workers have tested positive for Covid. Twenty-eight specimens were subjected to whole genome sequencing and on March 1 were found to have mutations aligned with the R.1 line. (The outbreak reportedly started with one staff member infected.) “Attack rates were three to four times higher among unvaccinated residents and [workers] as among those who have been vaccinated, ”according to the results.

About 90% of facility residents and 52% of staff had received 2 doses of the vaccine. Of these, 25.4% of residents and 7.1% of workers were infected. This, according to the CDC’s analyzes, raises concerns about the reduced protective immunity against R.1 of vaccines.

Additionally, four possible re-infections have been identified, “providing evidence of limited or declining natural immunity to this variant,” according to the report. All of these people suffered from symptomatic illnesses. One of them died.

Although the CDC does not yet define R.1 as a variant of concern or of interest, the strain has several “mutations of importance”. One of them “shows evidence of increasing transmissibility of the virus,” according to the agency. Others have also been seen in variants of concern which, according to the CDC, “show evidence of reduced neutralization by convalescent and post-vaccination sera.” Another mutation observed in R.1 could reduce the effectiveness of neutralizing antibodies.

The good news is that despite the breakthrough in infections, vaccination was associated with a decreased likelihood of infection and symptomatic illness in patients and staff. In addition, R.1 does not appear to compete with – and therefore be more transmissible than – Delta. As of April 22, the CDC had only reported 1,125 cases of R.1 in the United States. According to Forbes, there are now more than 10,000 recorded cases of the variant. But those numbers are pale compared to the millions of Delta cases.

R.1 was first identified in Japan in January 2021 among three members of the same family. One of those infected was in her 40s and the other two were under 10 years old. “These three patients lived in Japan and had no history of travel abroad,” according to an NIH report.

As of April 22, 2021, NIH analysis indicates that “the percentage of SARS-CoV-2 isolates belonging to the R.1 line in Japan has increased more rapidly” than in the United States.

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