Covid-19 variants in SA: Your questions answered

One of the main buzzwords at the moment is undoubtedly “Covid-19 variants”, however, there is still a lot of confusion surrounding the different mutations and the impact they may have on society.

There are currently four variants of concern and five variants of interest, and yes, there will be more. In fact, researchers say new Covid-19 variants are detected each week.

But – and this is important – there is no reason to be concerned by the mutations as researchers continue to closely monitor new strains, and continue to test whether vaccines are still effective.

Covid-19 variants: FAQ

Why do viruses mutate?

Viruses – especially ribonucleic acid (RNA) viruses – constantly change and adapt through mutation. When a virus’ gene has one or more mutations, it’s called a variant of the original virus.

Dr Robert Bollinger, the Raj and Kamla Gupta Professor of Infectious Diseases at the Johns Hopkins University (JHU) School of Medicine, explains:

“All RNA viruses mutate over time, some more than others”.

“For example, flu viruses change often, which is why doctors recommend that you get a new flu vaccine every year,” he says.

Difference between a variant and strain?

A variant is a subtype of a microorganism that is genetically distinct from the main strain, but not sufficiently different to be termed a distinct strain.

A variant is referred to as a strain when it shows distinct physical properties. A specific variant may also undergo additional mutations.

Alpha currently has 17 genetic changes, with each change is referred to as a new strain. Lara Herrero, lead researcher in virology at Griffith University, says:

“Put simply, a strain is a variant that is built differently, and so behaves differently, to its parent virus. These behavioural differences can be subtle or obvious.”

Are there different types of variants?

Yes. The World Health Organisation (WHO) divides variants into two different categories:

• Variants of Interest (VOI)
• Variants of concern (VOC)

What is a Variant of Interest?

According to the WHO, a VOI is a variant “which may become of concern”, but hasn’t reached that point yet. VOI may cause an outbreak in one region without spreading to other parts of the global population.

VOI also contain specific genetic markers which are predicted to affect transmission, diagnostics, therapeutics, or immune escape.

There are currently five VOI monitored by the WHO and Centers for Disease Control and Prevention (CDC):

WHO label	Pango lineage	Classified as VOI	Region
Eta	B.1.525	17 March 2021	Multiple countries
Iota	B.1.526	24 March 2021	The United States
Kappa	B.1.617.1	4 April 2021	India
Lambda	C.37	14 June 2021	Peru
Mu	B.1.621	30 August 2021	Colombia

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What is a Variant of Concern?

A VOC is more serious than a VOI as it has already caused severe illness. It may also spread faster. It may be more difficult to prevent and may be resistant to existing vaccines as well.

There are currently four dominant variants of concern in the global population:

WHO label	Pango lineage	Classified as VOC	Region
Alpha	B.1.1.7	18 December 2020	United Kingdom
Beta	B.1.351	18 December 2020	South Africa
Gamma	P.1	11 January 2021	Brazil and Japan
Delta	B.1.617.2	VOI: 4 April 2021 VOC: 11 May 2021	India

Then there are also variants classified as ‘Alerts for Further Monitoring’, meaning it’s not of interest or concern yet, but will be monitored and re-classified, if necessary.

Alerts for Further Monitoring

• B.1.427 and B.1.429, first detected in the United States.this mutation was reclassified from a VOI (5 March 2021), to an Alert on 6 July 2021.
• R.1, detected in multiple countries and classified as an Alert on 7 April 2021
• B.1.466.2, first detected in Indonesia and classified as an Alert on 6 July 2021
• B.1.1.318, detected in multiple countries and classified as an Alert on 2 June 2021
• B.1.1.519, detected in multiple countries and classified as an Alert on 2 June 2021
• C.36.3, detected in multiple countries and classified as an Alert on 16 June 2021
• B.1.214.2, detected in multiple countries and classified as an Alert on 30 June 2021
• B.1.1.523, detected in multiple countries and classified as an Alert on 14 July 2021
• B.1.619, detected in multiple countries and classified as an Alert on 14 July 2021
• B.1.620, detected in multiple countries and classified as an Alert on 14 July 2021
• C.1.2, first detected in South Africa and classified as an Alert on 1 September 2021

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Do Covid-19 vaccines work on new variants?

FDA-approved and/or authorised vaccines do work on the Alpha, Beta, Gamma and Delta variants.

Some breakthrough infections in fully vaccinated people are expected but remain rare. All vaccines are particularly effective against severe illness, hospitalisation and death.

Preliminary evidence suggests fully vaccinated people who do become infected with the Delta variant, however, can spread the virus to others, according to the CDC.

Two-dose vaccines (such as Pfizer) have been shown to be more effective – especially against the Delta variant – than single-dose vaccines (Johnson and Johnson).

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