The process of replicating genetic material is inherently error-prone. This is true for your skin cells as they divide to replace dying cells, for bacteria in your gut as they grow, and for viruses that replicate themselves by infecting a host. The SARS-COV-2 virus carries genetic material, called RNA, that serves as replication instructions – allowing it to make copies of itself once it infects a human cell. As the virus continues to replicate in an infected individual, the error-prone replication machinery occasionally makes a mistake while it copies the RNA instructions. The vast majority of these errors, called mutations, either do not affect the genetic instructions (“silent” mutations) or negatively affect the ability of the virus to replicate. However, these mutations can sometimes lead to changes in the RNA that encode for more efficient viral replication or an increased ability to bind to, and infect, human target cells. These different “versions” of the mutated virus are referred to as variants or strains. Given enough time and sufficient spread of any viral pathogen across a population, as is the case with the spread of SARS-COV-2 virus around the world, the emergence of variants is almost biologically guaranteed.

How do the SARS-COV-2 variants compare?

The three main SARS-COV-2 variants of concern are the B.1.1.7, the B.1.351, and the P1 variants, also know respectively as the United Kingdom, South Africa, and Brazil variants based on where they were first observed. All three of these variants have been observed to have higher transmissibility – meaning they can be passed on from one infected person to another more easily. The UK variant, in particular, is up to 50% more contagious than the original unmutated (or parental) SARS-COV-2 strain. Preliminary data also suggests that while it does not increase the severity of disease (patients infected with the UK variant are not sicker compared to those infected with the parental variant), it is linked to an increased risk of death.

Will the variants affect vaccine efficiency?

Some preliminary studies have suggested that the mutations these variants carry make them less likely to be detected by pre-existing antibody immunity from patients who have previously been infected by the virus. However, the immune response to SARS-COV-2 is complex and multi-faceted. This enables other immune cells to compensate, and preliminary data suggests that cell-mediated immunity to the variants remains strong.

These mutations, however, raise concerns about continued vaccine efficacy. Indeed, some early indications suggest that the efficacy of the J&J vaccine could potentially be lower against the South African strain. Pfizer has also reported slightly lower efficacy in protecting against this strain. Given the recent emergence of these variants, more time and data are needed to paint a more complete picture. Yet, even if these concerns are verified, the approved SARS-COV-2 vaccines provide very potent antibody and cellular immune responses. Vaccination remains your best bet for pre-emptively fighting off the virus – particularly when compared to the alternative: no vaccine at all!

Should you be worried?

This is a rapidly evolving situation receiving a lot of attention from researchers around the world. While the early indications suggest the variants are indeed concerning, the route of transmission remains unchanged. Ultimately, the SARS-COV-2 variants are spread like any other respiratory virus. The best protection against the variants is the best protection against all respiratory viruses:

• Wash your hands frequently and thoroughly, avoiding touching your face.
• Practice social distancing
• Avoid indoor gatherings – particularly those involving crowds, exercise, loud vocalizations, or unmasked individuals
• Wear masks during any necessary indoor activities
• Get vaccinated as soon as possible

B117 – Commonly Referred to as the United Kingdom Variant:

B117 spreads more easily and more rapidly than other variants. Back in January, experts in the UK believed this variant may be associated with an increased risk of death compared to other variants of the COVID-19 virus. The variant has been detected in other parts of the world.

B1351 – Commonly Referred to as the South African Variant:

Originally detected in early October 2020, The B1351 COVID-19 variant shares some mutations with the B117 variant.

P1 – Commonly Referred to as the Brazil Variant:

The P1 COVID-19 variant contains a set of additional mutations that may affect its ability to be recognized by antibodies.

Infectiousness of New COVID-19 Variants

These new variants of COVID-19 virus tend to spread more easily than the original strain and are therefore much more contagious. Although we do not know if the diseases are more severe, the impact on communities is definitely alarming.

Increased COVID-19 infections would result in more illness, hospitalizations and deaths. New strains can spread simply by being in the wrong place at the wrong time.

Disproportionate Rate of Infections Among Minorities

According to the CDC, COVID-19 hospitalization rates among people from Black, Hispanic and Latino communities are nearly four times greater than that of other groups.

Although here is no evidence to suggest genetic or other biological factors as the cause, the following factors may contribute to the disparity:

Occupation: People in work settings such as healthcare facilities, farms, factories, grocery stores, and public transportation are more likely to be exposed to the virus.

Limited Healthcare access: Health care access can also be limited due to lack of transportation, childcare, being uninsured, or the inability to take time off of work.

Housing: People living in crowded conditions or with extended families are unable to adhere to prevention strategies.

Educational, income, and wealth gaps: Having limited access to quality education means limited job options, decreasing the chances of people leaving jobs that put them at higher risk of COVID-19. This makes them more likely to be at a higher risk of being exposed to the virus.

Effectiveness of Vaccine on these Variants

To date, experiments suggest that antibodies produced from currently approved vaccines do recognize these variants. These findings are being closely examined and additional research is being conducted.

To limit the spread of COVID-19 and to protect public health, rigorous and increased compliance with public health mitigation strategies such as vaccination, physical distance, use of masks, hand washing, isolation and quarantine remains imperative.

About Dr. Faiza Tahir

Dr. Faiza Tahir is a specialist in Infectious Diseases in the Webster and Baytown areas of Texas.

She is double board certified in Internal Medicine and Infectious Disease with specialized fellowship training from UTMB Galveston.