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The COVID-19 variant in India: what we know so far

As the coronavirus continues to dangerously mutate, we're in a vaccination arms race against it.

Mihai Andrei
April 29, 2021 @ 2:08 am

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A new variant of concern has recently emerged from India. The variant is technically called B.1.617 (the ‘Indian variant’) exhibits two mutations similar to those in the Brazil variant and the South African variant. But we’re still just starting to understand what this mutation could mean.

Where it came from

For starters, we don’t even know exactly where it came from. It’s most prevalent in India (in the Indian state of Maharashtra, more than 60% of all coronavirus infections have been linked to the new B.1.617 variant) and it quite possibly emerged there, but we don’t know for sure where it first appeared.

“B.1.617 has 13 mutations that result in amino acid changes. B.1.617 has been described as a ‘double mutant’. This term is used to refer to two mutations in spike (E484Q and L452R) but is inaccurate, has no specific meaning and should be avoided. The variant has also been referred to as the ‘India variant’ but this should also be avoided – it is unlikely to be able to say definitively where the variant first arose,” says Sharon Peacock, Director of COG-UK, and Professor of Public Health and Microbiology at the University of Cambridge, UK, in a brief for Science Media Centre.

The World Health Organization and other health bodies have warned against naming viruses and variants after locations due to potential stigma.

What’s so special about it?

The two mutations Peacock is referring to (E484Q and L452R) are what make this variant particularly concerning. Viruses mutate all the time, but the vast majority of these mutations are irrelevant in the grand scheme of things and don’t make the virus more dangerous. But every once in a while, a mutation can make the virus more contagious or more capable of evading treatment or vaccination.

The E484Q and L452R mutations have been associated with other variants of concern. For instance, L452R is present in the California variant of interest, and is associated with weaker neutralization of the virus by convalescent plasma from people who have been infected with SARS-CoV-2, and/or some antibodies (at least according to preliminary lab experiments).

The E484Q mutation may help the virus evade hosts’ immune systems, similarly to the South African and Brazilian mutations. Although it’s not clear just what this means, both the above-mentioned variants have been linked to some ability to evade immune systems. So far, however, real data is lacking to confirm whether or not this variant is especially concerning.

“This variant has a couple of potentially concerning mutations but these are probably not as serious as some of the mutations present in the variants first seen in Kent, South Africa and Brazil. This could be because we have had less time to study them, so these mutations should be watched carefully. And in terms of spread, clearly this variant has increased in frequency in India around the time of their very large and tragic recent wave but I don’t think we yet know how much B.1.617 is driving that spread versus its spread coincidentally happening at the same time,” says Jeffrey Barrett, Director of the Covid-19 genomics initiative at the Wellcome Sanger Institute in the same brief.

“It can be difficult to get virus samples to do experiments on internationally as you need fairly recent samples, but I’m sure various international authorities are collaborating as best as they can to get these samples to be able to do the experiments,” he adds.

Can the virus escape vaccine protection?

This is one of the most pressing questions. Unfortunately, we don’t know just how effective existing vaccines are against the variants.

In a recent intervention, Anthony Fauci, the US leading immunologist, has quoted a recent study that found that the Indian vaccine Covaxin works on the variant. However, we’re not sure at this point what this means for other vaccines.

But the variant itself may give us a helpful break.

Researchers have started to signal (as in the reply of this tweet) that the virus seems to be losing the E484Q mutation in some cases (something called a reverse mutation). If this is the case, it would make the variant less concerning.

Where has the variant been reported?

Despite travel restrictions, the variant seems to have spread to several countries. So far, the variant has been detected in Germany, Switzerland, the UK, the US, Australia and Singapore. The British health ministry has reported several dozen cases, spreading concerns that it may already be starting to spread.

There isn’t much evidence that it could break through the existing vaccine defenses, but it is an option authorities are keeping in mind.

Is this variant driving India’s surge in cases then?

India’s current COVID-19 crisis matters for the entire world. Currently, around one-third of all reported cases in the world come from India.

“India is currently witnessing a surge in COVID-19 cases. The question is whether this is associated with the variant, with human behaviour (for example, the presence of large gatherings, and/or lack of preventive measures including hand washing, wearing masks and social distancing) or whether both are contributing. It is not clear at the present time whether B.1.617 is the main driver for the current wave,” says Peacock.

Several other factors play an important (and potentially decisive role). Despite its remarkable economic rise, India remains plagued by poverty and patchy public health services, across a vast and often inaccessible country. Overcrowding and a premature relaxing of lockdown could have also sparked the surge of the virus.

How can we prevent variants from appearing

It is becoming increasingly likely that we won’t manage to squash the coronavirus, but instead, we’ll be forced to wage a long-term “war” with it — much like we do with the flu virus. Influenza vaccines are necessary every year not just because immunity wanes, but also because the virus constantly mutates.

Thankfully, the coronavirus doesn’t mutate as fast as the influenza pathogens, but we’ve seen that dangerous variants can emerge. Our best bet against them is vaccinating as many people as possible with the effective vaccines we have on hand.

Vaccine companies are already working on tailored booster shots, and we’ll probably be engaged in an arms race with the virus for years to come. But for now, the first step towards containing and limiting the emergence of variants is ensuring that as many people as possible are immunized.

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