File picture. Dr Anike Baptiste, a specialist doctor at the Steve Biko Academic Hospital, gets her injection of the Johnson & Johnson Covid-19 vaccine. Picture: Jacques Nelles
The discovery that at least two “new” variants of SARS-CoV-2 have crept into South Africa are no cause for immediate concern, but citizens are warned though not to lose their heads, and continue acting responsibly.
The emergence of new variants locally have been attributed to factors such as travel and high transmission rates of endemic mutations such as 501Y.V2,
A study published in Nature earlier this week may read as though it is cause for alarm, but KwaZulu-Natal Research and Innovation Sequencing Platform (KRISP) group leader Dr Richard Lessells emphasised that the detection of the two additional variants, B.1.1.7 and A.23.1, are “not major cause for concern”.
“These are not new variants, but are now being detected for the first time in South Africa. Both are different from the 501Y.V2 variant, which was the first detection anywhere in the world.”
B.1.1.7 was first detected in the UK, and has since spread to almost 100 countries. In many countries, B.1.1.7 is now the dominant virus, much like 501Y.V2 is for South Africa.
B.1.1.7 is more transmissible, with Lessells explaining that there is now evidence to prove that it also causes “more severe disease than viruses circulating before.”
This is not very different from 501Y.V, however, which has also proven to be more transmissible and deadly.
There is also no clear evidence that B.1.1.7 is circulating nearly as widely as 501Y.V2 has.
“It’s certainly thong different in terms of precaution and prevention, but rather another reminder that these variants will spread and be introduced into different countries – so we need to keep an eye on it,” Lessells said.
The only difference is that unlike 501Y.V2, only three cases have been detected, all of which are in the Western Cape.
“We don’t have the full information about those cases yet. We don’t know if all three were independently imported into the country, or if it may be a sign of local transmission That is something we need to keep an eye on over the next few weeks.”
Lessells assured that B.1.1.7 will also not “create a third wave”, but is something that warrants continued efforts to keep transmission as low as possible.
A.23.1 is of least concern at the moment, despite being discovered in East Africa.
This variant is currently affecting Rwanda, Kenya and especially Uganda, Lessells continued.
The rapid spread in Uganda prompted researchers and collaborators in the UK to flag it. It has since spread to 21 countries, including the UK, other European countries, and the US.
“Nothing is making A.23.1 a major concern at the moment. We believe the case that we have to sequence from was someone who had contact with a person who was travelling in East Africa. It is almost certainly a variant that would be imported into South Africa through travel, but did not emerge here.”
Lessells said that the emergence of B.1.1.7 in the UK and the subsequent vaccine rollout has shown that vaccines are able to offer good protection against B.1.1.7.
“We don’t know which vaccine is the most effective, but all vaccines tested and rolled out where B.1.1.7 is predominant has shown to be highly effective,” he explained.
Less is known about A.23.1, but Lessells said this particular variant is not concerning regarding “immune escape and problems.”
Stopping the third wave is in our hands, Lessells emphasised.
He explained that a third wave would be driven mostly by increased transmission rates.
The scientific community has anticipated SARS-CoV-2 mutations, but the virus will only mutate further should transmission rates be ramped up again.
Lessells said that the worst case scenario would be B.1.1.7 spreading more widely, increasing the possibility of getting both this variant and 501Y.V2.
Another factor that could drive the third wave is waning natural immunity from people who were infected in the first wave.
“If we start doing all the things we shouldn’t and give the virus a chance to spread, it will find people that are still unexposed to the virus and have no immunity, or people with immunity starting to wane.”
Public gatherings are real cause for concern, especially indoor gatherings, Lessells said.
“If people gather in poorly ventilated spaces, they are just thinking of the now and not of the future. By the time you have a problem, you’re already steps behind the virus, and it’s harder to get on top of it.”
He also warned that the reopening of borders also creates an environment for the virus to “creep in from other places”, which was why it is essential that scientists continue to monitor what variants are spreading in other parts of the world.
“The basic calculation is that if we drop our guard, do the things we shouldn’t, it will evolve in some way.”
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