7 Things You Probably Didn’t Know About New COVID Variants in RI

Thursday, April 29, 2021

Nick Landekic, Guest MINDSETTER™

 

Data reported on Monday by the Rhode Island Department of Health showed that variants now account for 87% of COVID cases recently sequenced, up from 66% three weeks ago. These new variants are potential game-changers that in some ways are like a different disease because they will likely require new strategies for vaccination and treatment.

If we want to be the winners in this war and not the coronavirus, there are a few things we need to face up to and do.

1. The virus is always changing – and we have to change our ways along with it.

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The SARS-CoV-2 virus is always evolving and changing. It has been estimated about 12,700 mutations and 4,000 variants have been identified to date. While most of these are irrelevant, mutations that improve the virus’s ability to reproduce and survive will quickly displace previous strains.

Mutations are changes in the virus’s nucleotide sequence, the RNA code that determines how it is assembled. A variant is a strain of the virus that contains one or usually several mutations. The most concerning variants are ones with mutations in the shape of the spike protein the virus uses to attach itself to our cells. Vaccines and antibody drugs also target this spike protein.

Dangerous changes in the spike protein include those that make it ‘stickier’ and let it attach to our cells more easily. These kinds of changes can make a variant more easily transmitted, since it can take fewer viral particles (virions) to cause infection, or cause more serious disease since it can enter our cells more easily. Another threatening change in the spike protein can make it harder or impossible for antibodies from vaccines or some drugs to attach to it and thus no longer be effective.

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Source: Cai Y; et al. Science Jul 21, 2020

Some variants have multiple mutations that can do all of these things, making them especially dangerous.

Variants are important to you because…

2. Variants Are Now The Majority of Cases in Rhode Island.

The latest data from RIDOH show that 87% of new COVID cases in RI are now due to variants. If you were to become infected today, it would almost certainly be a variant. This in some ways makes COVID a different disease than it was a year ago, because many of these variants behave in ways that are more dangerous to us. They can be more easily transmitted, or cause more serious illness, or be resistant to vaccines and some drugs – or all of these.

The Center for Disease Control identifies strains that can be more hazardous to us as Variants of Interest or Variants of Concern. RIDOH is testing for 9 different variants of interest or concern, 7 of which have been found in Rhode Island.

These are a problem because…

3. Some Variants Are More Dangerous Than The Virus We Faced Last Year.

The danger of variants is that some have been shown to be more contagious and easily transmitted, some have been shown to cause more serious illness and be more lethal, some have been shown to be resistant to vaccines and antibody drugs – and some are all of these.

The B.1.1.7 (“U.K.”) variant, which accounts for about 41% of variant cases in Rhode Island, has been shown to be 60% more contagious than the original strain, and at the same time is also 67% more lethal.

The B.1.1.7 variant may also be spreading more easily among children and making them sicker. Everyone wants children to have the benefit of in-person learning in schools. But isn’t it even more important for children to stay healthy? Or alive? 

As long as children are spreading infection between each other, the virus will also then be brought home to infect parents and grandparents. The pandemic will never be contained until this cycle of transmission is broken.

The P.1 (“Brazilian”) variant is both more contagious and against which vaccines appear less effective. Twenty-one cases of P.1 have been identified in Rhode Island, but since this is only a small sample the likelihood is there may be hundreds or more P.1 infections here already.

The B.1.351 (“South African”) variant is able to defeat vaccines that cause infection in people vaccinated with the Pfizer vaccine.

Then there is this new variant…

4. A new variant has just arrived in Rhode Island – B.1.526.1.

An alarming but not unexpected development is the arrival of another new variant in Rhode Island, B.1.526.1. This is related to the original “New York” variant, of which there are now three - B.1.525, B.1.526, and B.1.526.1. This latest variant contains multiple mutations that have been associated with the reduced effectiveness of vaccines and antibody drugs.

This variant was first observed in March. RIDOH just started testing for this variant within the past week – and the first findings show it to already account for 23% of variant cases, and thus 20% of all COVID cases, in Rhode Island.

This is important because…

5. The tragedy happening right now in India shows how fast variants can completely change things.

Just four weeks ago, India was considered a ‘success story’ in containing the pandemic, with about 10,000 cases a day.

Then, seemingly because of a combination of declaring ‘mission accomplished’ and reopening too soon (sound familiar?), and the appearance of a new variant, B.1.617 combined with the B.1.1.7 variant, things changed dramatically and quickly.

The heartbreaking catastrophe in India stands as stark evidence how fast things can change due to variants. India is now reporting over 360,000 infections daily. As terrible as this is, the actual numbers are thought to be 10 times higher. Hospitals are running out of oxygen and bodies are piling up faster than they can be cremated.

India is a painful lesson in the risks of…

6. Reopening Too Soon Is More Dangerous Now Than Ever.

The rules of contagion in pandemics are simple: higher levels of infection let the virus survive and spread, and promote the creation of new variants.

Rhode Island has consistently experienced high levels of infection since the start of the pandemic. According to data on covidactnow.org, since March 1 2020, Rhode Island has had an Extreme or Critical level of infection for 218 days – the highest of any state in the country.

The Governors of Rhode Island have also – repeatedly – relaxed safety measures and allowed reopenings that in retrospect were too soon and too fast, and resulted in surges of infection. The more safety measures are relaxed, the more easily a variant could rip through us - as is happening in India. Why do we keep making the same mistakes, when the cost is our health and lives?

Both as a country and especially in Rhode Island, we have given up on the possibility of eradication. We are not willing to do what it takes to eliminate the virus from our borders, despite the successful exemplars of countries like Australia, New Zealand, Taiwan, South Korea, Israel, even China and poor countries such as Bhutan, Nigeria, and Vietnam.

This means the only answer is…

7. We all need to get vaccinated, as soon as possible - or else the virus wins.

It’s better to prevent a tragedy than to be part of one. Wouldn’t you rather avoid being run over by a truck than to experience it?

Not getting vaccinated is not a ‘personal choice’. A personal choice is something that only affects you alone and no one else. Anyone might want to do whatever they wish in a vacuum, but not if it harms other people. Not getting vaccinated puts many people at risk of illness or death.

It’s like the difference between choosing to drive your car into a stone wall vs. driving the wrong way in the oncoming lane on the highway. The former might be your own personal choice to take your life (notwithstanding damage to property). But the latter immorally puts many people at great risk against their will.

If you saw someone going the wrong way coming at you in your lane on the highway, you probably would not cheer them on for exercising their ‘personal choice’. Not getting vaccinated imposes a similar risk on anyone that a non-vaccinated person comes in contact with.

As a society, we accept smoking restrictions to protect people from the risks of second-hand smoke. COVID is a far more serious threat.

Everyone needs to get vaccinated now and keep wearing masks and maintaining other safety measures until we are, before variants have a chance to continue to evolve in ways that could render vaccines ineffective. Evolutionary pressures are already selecting for variants less susceptible to vaccines. If this pandemic has shown us anything it’s that the virus always moves much faster than we expect.

Either we do something about the pandemic, or the virus will do something about us. Regardless of beliefs, preferences, or opinions, we would all likely be happier if humans and not the SARS-CoV-2 virus emerge as the dominant species in Rhode Island. 

Nick Landekic a retired scientist and biotechnology executive with over 35 years of experience in the pharmaceutical industry.

 

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