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SA variant and UK variant. Vaccinations and mutations. A thread:
The South African variant (B1.351) was recently found in 8 places across the UK with no history of travel to South Africa or contact with people who had travelled there. (1/n)
The South African variant (B1.351) was recently found in 8 places across the UK with no history of travel to South Africa or contact with people who had travelled there. (1/n)
We need to consider second or third generation infections which means that the variant is currently spreading across the UK and is probably in many more places than these two. (2/n)
Regardless of that, we should try to restrict the spread of this variant to where we have already detected it because we just simply already know that it is there. (3/n)
Also, there is no evidence that the SA variant is more transmissible or causes more severe illness than the UK variant already present here. (4/n)
The South African variant does however have a mutation which helps it to evade our antibodies to some extent (E484K - we scientists like to make our lives more difficult so we give things names which are hard to remember). (5/n)
We have seen already that vaccinations (with two doses) generate a very high level of antibodies, and even if this variant can evade some of them the levels are still well beyond those needed for neutralization. (6/n)
BUT this variant probably can infect some people after just one dose, or people from the risk groups who have received a vaccine (older people or immunocompromised people might have a lower response to the vaccine)(7/n)
or even people who were previously infected but have low levels of antibodies (like in asymptomatic infection) so we really need to try to stop the spread of yet another variant. (8/n)
I need to remind you all as well that nothing, not even the vaccines, provides absolute 100% guaranteed protection. (9/n)
Additionally, there is evidence that the UK variant (B.1.1.7) seems to have gained E484K too independently. Some B.1.1.7 viruses have already been found in the UK with that very mutation - the same mutation which helps the SA variant to evade immunity. (10/n)
This sounds scary. But don’t panic, because it just might help us. This means that the virus might be becoming more predictable for us. We already know those mutations, we know more or less how they work. (11/n)
Also, remember that there is a finite number of mutations which can happen in viral proteins to give it more fitness. At some point, new mutations might render the virus less and less infectious. (12/n)
It simply might mean that the virus has a limited number of routes to change to still gain some fitness over other variants so we may see a rise of the same ones over and over again. This is however just a hypothesis and we cannot confirm it at that point! (13/n)
Government document reporting detection of the new mutation:
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/957504/Variant_of_Concern_VOC_202012_01_Technical_Briefing_5_England.pdf?fbclid=IwAR1rv06ygnHe1UPZJRiBX-wlB4Ewl_AyFuDRyv8j3RkBM93BpFDu8R7iaN0
Here is data showing that Pfizer vaccines still work in case of mutations seen in all three variants:
https://www.biorxiv.org/content/10.1101/2021.01.27.427998v1
https://science.sciencemag.org/.../01/28/science.abg6105
(14/n)
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/957504/Variant_of_Concern_VOC_202012_01_Technical_Briefing_5_England.pdf?fbclid=IwAR1rv06ygnHe1UPZJRiBX-wlB4Ewl_AyFuDRyv8j3RkBM93BpFDu8R7iaN0
Here is data showing that Pfizer vaccines still work in case of mutations seen in all three variants:
https://www.biorxiv.org/content/10.1101/2021.01.27.427998v1
https://science.sciencemag.org/.../01/28/science.abg6105
(14/n)
But the case of B.1.1.7 gaining new mutations is something which we should expect if we will let the virus spread freely. The virus cannot evolve and gain any mutations if it cannot replicate. And it cannot replicate when there are no available hosts. (15/n)
If we want to make sure no more mutations will emerge we need to stop community transmission. So please, follow the restrictions because otherwise we will be locked in this circle of lockdowns and re-opening for a very long time(16/n)
To finish this post on a little bit of a happy note: Israel’s early vaccination data looks extremely promising. In the past two weeks, they have seen a 35% drop in cases, a 30% drop in hospitalizations and 20% drop in critical illness in the 60+ age group (17/17)
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