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COVID-19: Variants of Interest & Concern

The COVID-19 pandemic has had an impact on all our lives and it has certainly changed and evolved since late 2019. The coronavirus is currently responsible for over 4 million deaths worldwide, with overall cases nearing 200 million. COVID-19 changed the way many of us lived our lives, whether it was having to wear a mask, not being able to see our family or many of our favorite restaurants being closed. But as we learned more about the virus, the science behind it was able to evolve, vaccines were created and administered, which allowed many states to lift these restrictions and allow us to get back to a sense of normalcy.

However, just as science evolves so does the virus and this explains why we have seen an uptick in cases recently and the emergence of the Delta variant. The World Health Organization (WHO) breaks COVID-19 variants down in two categories, variants of concern and variants of interest, which help identify the potential risk of each variant and how it might impact things.

In this Health Journal, we will speak to variants in both categories, what they mean for now and what they might mean for the future.

What are variants?

At the beginning of the pandemic, we understood that the virus spread through droplets of saliva, cough particles or nasal discharge from an infected person. However, over the course of the year or so that has followed, COVID-19 variants show the virus has adapted which makes it as contagious as ever, for those who are unvaccinated.

Changes in the variants occur when there is a mutation in the genes of the virus and these mutations occur naturally. RNA-based viruses all mutate and change over the course of time, which is why we have seen many different variations of the influenza (flu) virus over the years as well.

The CDC breaks down COVID-19 and it variants using a tree example which helps give a visual representation of how it works. A virus is similar to a tree and as it grows branches, each of them are slightly different from the next, but being able to compare the branches to one another helps give a better understanding of how each “branch” or variant will behave.

Below we have broken down some of the variants and explained them in detail, to help give our patients and readers a better understanding of variants of concern and variants of interest.

Variants of concern:

The WHO describes a variant of concern as one that will translate to a rise in transmissibility, an increase in disease severity/fatalities and/or a significant decrease in effectiveness of vaccines, therapy and other health measures. A list of these variants has been listed below, with the current information on each and the possible consequences they might have.

  • 1.617.2 or Delta Variant: This variant was first found in India in late 2020 and the strain spread rapidly, soon becoming the dominant strain of the virus in both India and Great Britain. Toward the end of June 2021, Delta had already made up 20% of the cases in the United States according to CDC estimates. By the end of July, Delta has been the cause of almost 80% of the new cases, showing just how fast and wide it is spreading. Dr. F. Perry Wilson, MD, a Yale epidemiologist said, “Delta is spreading 50% faster than Alpha, which was 50% more contagious that the original strain of SARS-CoV-2.” He went on to say, “in an environment where there are no masks and no vaccinations it was estimated that the average person would infect 2.5 other people with the original coronavirus strain, but now in that same environment, Delta would spread to approximately 3.5 to 4 people.”                                                                                                                                                                                                                                    It is recommended that the best thing you can do to protect yourself from Delta is get fully vaccinated. In the U.S. certain states like Alabama and Mississippi have lower vaccination rates then say California and in some of these states with lower vaccination numbers, cases are on the rise more than in states with higher vaccination rates. For more information on how we can help at NextCare, visit https://nextcare.com/covid-19-vaccine/.
  • 1.1.7 or Alpha Variant: Johns Hopkins data lists this variant as being first detected in Southern England in 2020. Patients who suffered from the Alpha variant were at greater risk of CCU admission and a 28-day mortality, compared to those who did not have this variant. This means that patients who had the Alpha variant of COVID-19 were more likely to die in 28 days than those infected with alternative strains of COVID-19. It was also found that people with the Alpha variant were notably often younger.
  • 1.351 or Beta Variant: This variant first appeared in South Africa and according to Johns Hopkins, this particular strain of COVID-19 may have the potential to re-infect individuals who have recovered from earlier strains of the virus. The variant may also be resistant to some vaccines and the CIDRAP stated it had a greater viral load than its previous strain.
  • P.1 or Gamma variant: The first cases of the Gamma variant were found in the U.S. in January 2021. The CDC reported that the initial cases were identified in a group of travelers from Brazil who had undergone routine screenings at an airport in Japan. This variant tends to escape from the immune responses of the body and with each new mutation, the virus become more contagious then the previous strain.

Variants of Interest:

According to the CDC, a variant of interest is one with “specific genetic markers that have been associated with changes to receptor binding, reduced neutralization by antibodies generated against previous infection or vaccination, reduced efficacy of treatments, potential diagnostic impact or predicted increase in transmissibility or disease severity.”

Other possible attributes of a variant of interest are evidence that it is the cause of an increased proportion of cases or a limited prevalence or expansion in the U.S. or in other countries. We have included some examples and information down below.

  • Kappa variant: According to the WHO, the first samples of the Kappa variant were found in India, in October 2020. This variant is a double mutant virus, but is not nearly as widespread as the Delta variant discussed above.
  • Lambda variant: This variant is of interest because of the possibility that the Lambda strain may be resistant to vaccines. There’s no reason to sound the alarm just yet but at some point down the line, there may be cause for concern. Peru has the highest COVID-19 death rate of any country in the world and nearly twice as many deaths as Hungary, who has the second most. The WHO says that the Lambda variant has been the Covid carrier in about 81% of the infections in Peru since April and it has also spread to about 30 other countries, including the UK. The first case of Lambda in the United States was spotted at Houston Methodist Hospital recently and there have been reports of an overall increase in cases in the Houston area as of late. So as we stated above, there is no need to panic just yet, but the Lambda variant is one to watch.

 

Sources:

https://www.thehindu.com/sci-tech/health/covid-19-variants-of-concern-and-variants-of-interest/article35301681.ece

https://www.cdc.gov/coronavirus/2019-ncov/variants/variant.html

https://www.worldometers.info/coronavirus/

https://www.yalemedicine.org/news/5-things-to-know-delta-variant-covid

https://www.infectioncontroltoday.com/view/lambda-variant-of-covid-19-might-be-resistant-to-vaccines

https://healthpolicy-watch.news/lambda-new-variant-interest-29-countries/

 

 

 

 

 

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