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By James Gallagher
Science and Health Correspondent
The rapid spread of a new variant of coronavirus has been blamed for the introduction of strict level four mixing rules for millions of people, tighter restrictions on mixing at Christmas in England, Scotland and Wales, and other countries that impose the UK a travel ban.
So how has it gone from non-existent to the most common form of the virus in parts of England in a matter of months?
Government advisers on new infections have “moderate” confidence that
it is more capable of transmitting than other variants.
All the work is in an early stage, contains great uncertainties and a long list of unanswered questions.
As I have written before, viruses mutate all the time and it is vital to keep a laser focus on whether the behavior of the virus is changing.
Why is this variant a concern?
Three things come together that mean it’s getting attention:
- It is rapidly replacing other versions of the virus.
- You have mutations that affect part of the virus that is probably important.
- Some of these mutations have already been shown in the laboratory to increase the virus’s ability to infect cells.
All of these come together to build a virus case that can spread more easily.
However, we do not have an absolute certainty. New strains can become more common simply by being in the right place at the right time, like London, which only had level two restrictions until recently.
But already the rationale for the level four constraints is in part to reduce the spread of the variant.
“Laboratory experiments are required, but do you want to wait weeks or months? [to see the results and take action to limit the spread]? Probably not in these circumstances, “Professor Nick Loman of the Covid-19 Genomics UK Consortium told me.
How much faster is it spreading?
It was first detected in September. In November, about a quarter of the cases in London were the new variant. This reached almost two-thirds of the cases in mid-December.
You can see how the variant has come to dominate the test results at some centers like the Milton Keynes Lighthouse Laboratory.
Mathematicians have been running the numbers in the spread of different variants in an attempt to calculate how much of an advantage this could have.
But separating what is due to people’s behavior and what is due to the virus is difficult.
The figure mentioned by Prime Minister Boris Johnson was that the variant can be up to 70% more transmissible. He said this may be increasing the R number, which indicates whether an epidemic is growing or declining, by 0.4.
That 70% appeared in a presentation by Dr. Erik Volz of Imperial College London on Friday.
During the talk, he said: “It really is too early to say … but from what we see so far it is growing very fast, it is growing faster than [a previous variant] once grew up, but it is important to be aware of this. “
There is no “precise” figure for how much more infectious the variant can be. Scientists, whose work is not yet public, have told me figures much higher and much lower than 70%.
But questions remain as to whether it is more infectious.
“The amount of evidence in the public domain is woefully inadequate to draw strong or firm opinions on whether the virus has actually increased transmission,” said Professor Jonathan Ball, a virologist at the University of Nottingham.
How far has it spread?
The variant is believed to have arisen in a patient from the UK or was imported from a country with less ability to control coronavirus mutations.
The variant can be found throughout the UK except Northern Ireland, but it is highly concentrated in London, the South East and the East of England. Cases in other parts of the country do not appear to have taken off.
Data from Nextstrain, which has been monitoring the genetic codes of viral samples around the world, suggests that the cases in Denmark and Australia come from the UK. The Netherlands have also reported cases.
A similar variant that has emerged in South Africa shares some of the same mutations, but appears to be unrelated to it.
Has this happened before?
The virus that was first detected in Wuhan, China, is not the same that you will find in most corners of the world.
The D614G mutation emerged in Europe in February and became the globally dominant form of the virus.
Another, called A222V, spread across Europe and was linked to people’s summer holidays in Spain.
What do we know about the new mutations?
An initial analysis of the new variant has been published and identifies 17 potentially important alterations.
There have been changes in the spike protein: this is the key that the virus uses to open the door to the cells of our body.
A mutation called N501Y alters the most important part of the peak, known as the “receptor-binding domain.”
This is where the beak first makes contact with the surface of our body cells. Any change that makes it easier for the virus to enter will likely give you an advantage.
“It looks and smells like an important adaptation,” said Professor Loman.
The other mutation, an H69 / V70 deletion, in which a small part of the ear is removed, has occurred several times before, including the famous one in infected mink.
The work of Professor Ravi Gupta of the University of Cambridge has suggested that this mutation doubled infectivity in laboratory experiments.
Studies from the same group suggest that removal makes the antibodies in the survivors’ blood less effective at attacking the virus.
Professor Gupta told me: “It is increasing rapidly, that is what worries the government, we are worried, most scientists are worried.”
Where it comes from
The variant is exceptionally highly mutated.
The most likely explanation is that the variant arose in a patient with a weakened immune system that was unable to defeat the virus.
Instead, his body became a breeding ground for the virus to mutate.
Does it make the infection more deadly?
There is no evidence to suggest that it is, although this will need to be monitored.
However, just increasing transmission would be enough to cause problems for hospitals.
If the new variant means that more people are infected more quickly, that in turn would lead to more people needing hospital treatment.
Will vaccines work against the new variant?
Almost certainly yes, or at least for now.
All three leading vaccines develop an immune response against the existing peak, which is why the question arises.
Vaccines train the immune system to attack several different parts of the virus, so even though part of the beak has mutated, the vaccines should still work.
“But if we let him add more mutations, then he starts to worry,” Professor Gupta said.
“This virus is potentially on its way to escape the vaccine, it has taken the first steps towards that.”
Vaccine leakage occurs when the virus changes, thus avoiding the full effect of the vaccine and continuing to infect people.
This may be the most concerning element of what is happening with the virus.
This variant is just the latest to show that the virus continues to adapt as it infects more and more of us.
A presentation on Friday by Professor David Robertson of the University of Glasgow concluded: “The virus will probably be able to generate vaccine escape mutants.”
That would put us in a flu-like position, where vaccines must be updated periodically. Fortunately, the vaccines we have are very easy to modify.
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