The light at the end of the tunnel may be near for the coronavirus pandemic, but new mutations of the original COVID-19 virus spreading across the country may make it more challenging to achieve a semblance of normalcy without the maintenance of mitigation measures, according to USF Health experts.
With variant strains from the U.K., South Africa, Brazil and India becoming more prominent among the viral spread across the U.S., maintaining mitigation measures and increasing the amount of vaccinations remains a key part in keeping on track toward herd immunity, according to professor at the College of Public Health Thomas Unnasch.
“What we’re seeing here on campus is that the U.K. variant … that’s much more infectious is now the predominant virus that’s circulating here in the Tampa Bay area and at USF on the Tampa campus as well,” said Unnasch. “This could cause another real big spike in infections.”
The Centers for Disease Control and Prevention (CDC) has classified the B.1.1.7 strain as a “variant of concern,” with increased transmissibility of 50% and more severe disease effects that require hospitalization or pose risk of death. It made up 44.1% of reported coronavirus cases in the U.S. as of March 27.
The U.K. variant, B.1.1.7, is currently the most dominant variant strain in Florida, according to Associate Dean of the College of Medicine and virologist Michael Teng, and could become the most dominant variant strain nationally. There have been 3,150 cases of the B.1.1.7 variant, 27 cases of the B.1.351 strain and 126 cases of the P.1 strain reported in Florida as of April 12, according to the CDC.
“B.1.1.7 is the biggest risk right now, because it’s the dominant variant, and … if the data that we have holds up, that it is causing more disease, then it’s going to be a problem,” said Teng. “I think the one thing we have going in our favor is that the vaccines still cover the B.1.1.7 pretty well and we’ve vaccinated a large majority of our most vulnerable people.”
Variants are familiar in the world of virology. In terms of the coronavirus, approximately 30,000 variants are born from each person that is infected, according to Unnasch. The ones becoming more prevalent have done so because they are the ones spread the most initially.
“It’s kind of a numbers game,” said Unnasch. “They’re out there and they need to win the lottery, but they bought an awful lot of lottery tickets. So that’s how these variants start to arise.”
The COVID-19 mutant strains arise each time an alteration is made to its spike protein, which can change its ability to affect and infect hosts.
Mutations make viruses more advantageous in the viral jackpot, not because of their ability to inflict severe symptoms or detriment their hosts, but because they can easily infect as many hosts as possible, according to associate professor in the College of Public Health Jill Roberts.
“Evolutionarily speaking, [a virus making itself more severe] is a bad idea. That’s not, evolutionarily speaking, a very good thing. But [a virus making itself infect faster], that’s a great idea,” said Roberts. “And so what’s going to actually make some of these strains take a hold … is being able to spread faster.”
While the current vaccine versions out for distribution are effective against coronavirus variants that are gaining traction in infection rates, there are others that have managed to fall out of that realm, such as the B.1.351 variant that originated in South Africa.
Although its hosts aren’t yet shielded by the immune response provided by the current coronavirus vaccines available on the market, a turnaround time for vaccinations that will be effective against the B.1.351 variant won’t be long compared to other vaccination technologies like the flu vaccine, according to Unnasch.
“It takes a really long time,” said Unnasch. “The first thing you got to do is guess what that new [flu] strain is going to be and then you’ve got to get yourself literally millions of [chicken] eggs, and you’ve got to inject all those eggs, and then you got to purify the egg white out of there and you activate the virus and then it goes into people’s arms. That takes like six or seven months.”
The mRNA technology used by the Pfizer-BioNTech and Moderna vaccinations allow for some flexibility in updating its technology to adapt to newer strains of coronavirus with abilities to change its sequences more quickly than the half-year long flu process.
By the end of April, National Institute of Allergy and Infectious Diseases (NIAID) investigators anticipate to have fully enrolled a phase I clinical trial for a vaccine modification that protects against the B.1.351 variant.
It’s only taken Moderna’s vaccine developers around six weeks to adapt the mRNA vaccines to the B.1.351 mutation, according to Unnasch.
“[The mRNA technology] is really clean. It’s not an egg white that’s been infected that we’ve treated with formaldehyde. This is just a single molecule that’s encased in a liquid coat to get it into your cells. And the thing is, you can make that molecule any sequence that you want,” said Unnasch.
Discovering more variants that are affected or unaffected by current virus vaccines would be unheard of in earlier years, according to Unnasch. Modern technology has not only made virologists able to update vaccines more efficiently, but also be aware of variants that escape the protection provided by them faster.
“If this was three years ago, we wouldn’t be hearing about this at all because the technology wasn’t to the point where we could do this. The only reason that they’re doing this is because the sequencing technology has gotten so good that they can sequence millions and millions and millions of the isolates that are out there now, so we have a really good idea in real time how the virus is changing,” said Unnasch.
“Five years ago, we wouldn’t even know that this was happening, all of a sudden it would be, ‘Oh crap, we’ve got a problem because it seems like people we vaccinated are still getting infected.”
Knowing about variant strains and adapting technology to them won’t do much good without dispelling the misconception that having contracted the coronavirus since the pandemic started means indefinite immunity, according to Roberts. To prevent variant strains such as the U.K. variant from causing another surge, Roberts said the key is for more people to get vaccinated, especially college students.
Roberts said opting out of getting vaccinated won’t just affect people on an individual basis but could lead to a regression in the control over the virus, especially for college students as “major spreaders” of the coronavirus right now.
The “18 to 29” age group is the top age group for cases of COVID-19, making up 22.4% of total coronavirus cases, according to the CDC.
“My biggest concern I would say … is college kids not taking the vaccine. So if we have your age group especially who are the major spreaders right now decide that, ‘Oh, I’ve already had COVID, I’m not going to get vaccinated,’ you should get vaccinated, even if you’ve had COVID,” said Roberts.
“Or ‘It’s not that bad for you, my friend had it, they were fine, I’m not going to get vaccinated,’ it’s going to spread and spread and spread and spread and mutate and eventually we’re going to get a strain that just escapes the vaccine, the vaccine doesn’t work, and we’ll be right back where we were in 2019.”
As of April 19, 28.6% of people ages 18 through 29 in the U.S. have received at least one vaccination dose and 13.9% are fully vaccinated, according to the CDC, compared to people ages 65 through 74, of which 81.2% have at least one vaccination dose and 65% are fully vaccinated.
“We’re really in a race right now with the vaccine, to try and get that out as fast as possible, versus how fast that virus can spread with this new [U.K.] variant. But we control both of the runners. We can speed up our good guy, which is the vaccine, by getting more vaccines out there and getting to as many people as possible as fast as possible,” said Unnasch.
“And we can tie the shoelaces of that damned virus together by wearing masks and doing social distancing. And if we do both, if we cheat and we tie the shoelaces together, and we increase the speed of our runner, we’re going to win this thing.”