Infectious Disease

Variants might complicate the pandemic within the coming months, “however we need not panic”.

January 21, 2021

3 min read

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Disclosure:
Edwards reports receiving CDC and NIH grants, advising Bionet and IBM, and serving on the data security and monitoring committees for Merck, Moderna, Pfizer, Sanofi, Seqirus and X-4 Pharma. Galloway does not report any relevant financial information. Salvatore reports that he was the principal investigator on a Verily Life Sciences LLC / Brin Foundation study on predictors of serious COVID-19 outcomes (PRESCO) and the principal investigator on a Genentech-sponsored study on combination therapy for influenza.

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CDC researchers recently reported that a more highly transmittable SARS-CoV-2 variant, first discovered in the UK, could soon become the dominant variant in the United States, potentially making it difficult for the US to respond.

This week, scientists in South Africa said tests had shown that a variant first reported in that country was “largely resistant to neutralizing antibodies caused by infection with previously circulating lines.”

Kathryn Edwards

“This suggests that despite the many people who are already infected with SARS-CoV-2 worldwide and have presumably acquired a certain level of immunity, new variants … pose a significant risk of re-infection,” they wrote Scientist A paper that has not been peer-reviewed and published on the bioRxiv preprint server.

In addition, they said the results “may predict decreased effectiveness of current spike-based vaccines”.

During an Infectious Diseases Society of America press conference Thursday Kathryn Edwards, MD, Although COVID-19 vaccines may need to be modified to accommodate future variants, this measure is not currently required. Edwards, head of the Vanderbilt vaccine research program, said some tests were modified because of mutations in the virus’ spike protein.

“We will move forward and respond to these issues,” she said.

The British variant B.1.1.7, which was first reported in the United States last month in a man from Colorado, is more transmissible than the original virus, but it doesn’t cause more serious symptoms, according to scientists. It can be 50% transferable, Summer E. Galloway, PhD, a senior global health policy advisor to the CDC and colleagues listed on the MMWR.

The Pfizer BioNTech vaccine has been shown to be effective against both the UK and South African variants of the virus, and Moderna expects its vaccine will work against them too. Still, the increased portability of the UK variant increases “universal and improved adherence to mitigation strategies, including distancing and masking,” wrote Galloway and colleagues. “A higher vaccination rate may need to be achieved to protect the public.”

In their study, Galloway and colleagues used a two-variant compartment model to estimate the potential impact of B1.1.7 growth on the US population. The model assumed that 1 million doses of vaccine had been administered per day from January 1, 2021, and that immunity of 95% would be achieved 14 days after administration of two doses. Immunity to infections with the B.1.17. Variation was also accepted.

They found that while the B.1.1.7 prevalence is low, its portability will lead to “rapid growth” in early 2021, making it possibly the dominant variant in the US by March.

Mirella Salvatore, MD, FIDSA, Assistant Professor of Medicine and Population Health Sciences at Weill Cornell Medicine, said: “Worry and panic [about the variants] shouldn’t be the priority. “

“We are facing a virus that may be more transmissible and we have started to worry about what we cannot change. Each of us should follow the preventive health care we know works – masking, dissociating, washing hands and getting vaccinated. This will help prevent the virus from spreading, ”Salvatore said during the IDSA briefing.

According to Salvatore, the transferability of variants depends on the location of the virus, the level of immunity in the population, and people’s behavior. She said the US has the ability to spot variations, but that more funding and better organization are needed to do it effectively. (The CDC recently announced that it has stepped up its efforts to sequence more samples so that variants can be identified more quickly.)

Salvatore said that while the current variants are not inherently more deadly, they “do affect overall lethality” if they spread through the population. She said more research is needed to properly address variants and that “we still need a lot of basic research to show how this virus replicates in the cell.”

Salvatore noted that another preprint study, also published on bioRxiv, gave more encouraging results, showing that there appears to be a diminished effect, “but the vaccine neutralization against the sera of vaccinated individuals is still going on.”

“We have to follow the studies,” said Salvatore, “but we don’t have to panic.”

References:

Wibmer CK et al. bioRxiv. 2021; doi: 10. 1101 / 2021.01.18.427166.

Wang Z. et al. bioRxiv. 2021; doi: 10.1101 / 2021.01.15.426911.

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