While the vaccination drive is ongoing in India, sudden spikes in fresh COVID-19 infections in some states have raised concerns. Amid these, another aspect has added to the fear of fresh outbreaks – that is the emergence of mutant variants of SARS-CoV-2, the virus causing COVID-19.
The director of the All India Institute of Medical Sciences (AIIMS), Dr. Randeep Guleria, rang the alarm bell when he said that the new variants that have emerged in the country can be more contagious and they can also re-infect those who have developed antibodies due to previous infection.
As per reports, two leading experts have said that new strains of the novel coronavirus have been detected in Maharashtra. This was claimed by Shashank Joshi and T.P Lahane, both renowned medicos.
However, nothing much is known about the new variants that have emerged in India. Anothers study by the Centre for Cellular and Molecular Biology (CCMB), Hyderabad, said that there are more than 7,000 mutations of the novel coronavirus that have taken place in India. But, all the mutations don’t lead to a new variant, most of them are random changes in the genome of the virus. For becoming new strains or variants, mutations have to confer significant changes in the virus in terms of its activity or survivality. The CCMB study also revealed that one variant named the N440K is widely circulating in Southern India.
NewsClick approached noted immunologist Satyajit Rath, adjunct faculty at the IISER Pune for his comment on the new strains in India. Prof. Rath said, “This refers to the news release et cetera from CCMB, I presume. It would be useful to see this in context. All virus populations, everywhere, give rise to variations, in the sense that virus DNA or RNA sequences show small changes each time they are copied as the virus population grows. With a virus growing as widely as SARS-CoV-2, it is expected that virus 'variants' with some sequence variations will be detectable when we look carefully. This level of variation is being seen in every country.”
He further added about the unknowns of the strains, “As yet, nothing at all seems to be known about these variations seen in India, apart from the unsurprising fact that they occur. If any of these variations provide an advantage for virus spread, they will become more and more visible (and can then be called 'strains'); - this is what is likely to have happened with the B117, B1351 or P1 variants worldwide. A few changes are likely to let the virus infect cells more efficiently and therefore to spread faster. It will likely take many changes before the virus becomes properly resistant to immune protection due to prior infection or vaccination.”
“In either case, changes that are advantageous to the virus will become more and more prominent over time in the virus population, since those variants/strains will spread more efficiently. The only such possibility that the recent Indian analysis seems to have brought up is the N440K variation, but it is not as yet clear if it does in fact spread more easily. The extent of variations in any one virus isolate seen in that India analysis seem to be relatively limited as yet,” he added.
Also read: COVID-19: India Records 10,584 New Cases
However, the possibility of the new strains being more contagious cannot be ignored seeing the global scenario where the new strains in UK, Brazil and South Africa created sudden spikes in cases in those countries. In the wake of such dangers, Prof. Rath added that it is essential to monitor the emerging genomic changes of the virus.
“SARS-CoV-2 variants have been emerging from the earliest time of the pandemic. It has always been essential to monitor virus sequence variations carefully by subjecting many more virus samples to full sequencing than has been done so far (India seems to have done just over 6,000 virus sequences so far, while globally, over five lakh sequences have been done). This sequencing needs to be done with careful planning, rather than haphazardly,” he said.
What Prof. Rath said can serve as an indicator for the government to come out with immediate planning and this has to be linked with actual testing and contract tracing. “Further, this sequencing effort needs to be linked to actual testing to see if the variations detected have any significance or importance for the virus spread. And finally, this testing in turn needs to be connected to the next-generation vaccine design pipeline to ensure that variants that may be resistant to protection by current vaccines can be rapidly subjected to new vaccine design, testing and rollout. This has to be an ongoing process, not just an on-again-off-again knee-jerk response to a perceived 'crisis',” Rath added.
On being asked if there needs to be an immediate strategy change that the health authorities should think upon, Prof. Rath remarked, “Apart from the points I have said, further, we need to stop pretending that we have 'won' a 'decisive victory' over 'corona', and that life can 'go back to normal'. Continued care and vigilance is needed, and it is the government that needs to stop giving mixed signals and get down to the long and uncertain road ahead with evidence-based policies and strategies.”
The possibility of the new strains interfering with vaccines can also not be ignored. There might be a situation where the vaccines currently used might prove ineffective against the new strains, which Dr. Randeep Guleria also pointed towards in his statement.