One year after the virus first emerged, new strains of COVID-19 have been detected across the world. Whilst mutations have occurred over the past twelve months, a graph from this study shows that the new version spreading throughout the UK is markedly different.
The new strain, known as B.1.1.7, has mutated enough that it only sets off two of the three indicators of viral presence in the PCR test. This is one of the unique features that have allowed local scientists to track the new mutation. Britain has the most complete viral surveillance network of any country in the world, and some suspect that significant mutations have appeared elsewhere but have simply not been detected.
The same mutation which characterises B.1.1.7, deletion of two parts of RNA, has also evolved independently in South Africa and Denmark. The latter virus was incubated among mink kept in densely-packed farms and led to a resurgence of questions over the nation’s fur industry. However, with the 69-70del mutation now having been detected in multiple places, some are suggesting that its emergence is to do with its effect on infectivity.
Animal trials in South Korea have indicated that the mutation decreases the rate of transmission, but elsewhere, the evidence is to the contrary. Ewan Birney, deputy head of the European Molecular Biology Laboratory, suggested that the rates of hospitalisation we are now experiencing in the UK are in line with the severity of the previous strain. This indicates that the increasing death rate is due to a higher R number rather than a more severe disease. Other publications have touted the headline that B.1.1.7 is no more deadly than its predecessor, which is what the clinical evidence seems to suggest.
A greater worry is that the virus will mutate faster than we are able to create vaccines for it. This is the case with the flu, which for the past century has been evolving from its Spanish Influenza form. Every year new vaccines must be engineered to tackle the latest strains but regular changes in the virus limit their efficacy. Recently there has been a shift towards a six-monthly cycle in an attempt to improve results – vaccines in the southern hemisphere are used at a different time of year due to their flipped seasons.
However, the most publicised vaccines released so far have been made in a way that allows them to be adaptable. If another markedly different strain of COVID emerges next year, less research will need to be done to bring immunity to populations. Countless resources have been poured into genome sequencing and new manufacturing techniques, and the biggest hurdle has already been cleared. According to Birney and Calum Semple, a leading academic on the study of the pandemic, the mutations that could appear are not likely to increase the lethality of the coronavirus.
However, the relative mildness of the disease for so many is what makes it such a public health issue. If the virus killed every patient it touched, there would be a lower rate of transmission. There would also be less room for mutation. It is the fact that many coronavirus patients keep the pathogen for weeks on end that allows changes to occur. Those unfortunate enough to contract it when they have weakened immune systems fight the disease over long periods of time, rather than dying or getting better. Through this protracted battle, the virus learns how the body works, and can more effectively mount attacks. Adam Kucharski compares it to the inefficacy issues with antibiotics that have stemmed from people taking incomplete courses of the drugs.
The second part of this dynamic is the asymptomatic spread. Once these new variants of the virus have been gestated in vulnerable patients, they can be picked up by young, healthy individuals and transmitted. Because coronavirus does not incapacitate them, these individuals will continue to travel and socialise even once they have the virus. Whereas a bad case might keep you bedridden and show you to be an infectious danger, outward signs of health do nothing to tell that individual or others that they may be an epidemiological threat. This property of the pandemic is what drives some of the mental health issues that have resulted from it. When you cannot trust your own senses for an indication of disease-presence, increased suspicion and the threat of death keep you on edge, unable to put healthy trust in other places.
In his interview with Tom Chivers, Birney points out that the logical progression of any virus is towards infectivity but not lethality. As hospitalisations within England reach a new high, this is hardly a reassurance for those with immediate concerns for their vulnerable or dying close ones. But in the long view, the new mutations are a sign that COVID will become commonplace like the flu, a part of the regular rituals of disease avoidance like chickenpox or AIDS. The only question is how many people will suffer before we get there.