What the super strain mutants mean for the world in 2021

First it was COVID-19.

Now we have B.1.1.7 and 501Y.V2, two new fast spreading mutations of the deadly coronavirus.

Both mutations, not unexpected but certainly concerning, were first detected near the end of last year.

B.1.1.7 emerged as the pandemic surged in the southeast of England, and South African researchers found 501Y.V2 circulating in the country's Eastern Cape Province.

Though so far not deemed more virulent or deadly, the two new super strains represent an increased transmission risk, and that has undeniable consequences.

And while early indications are positive, it's not yet certain if the COVID-19 vaccines now being deployed globally will be effective against the mutations.

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All viruses mutate, so scientists weren't ambushed by the tiny changes they began to observe in COVID-19, as the virus spread around the world last year.

Mutations are a virus' way of copying itself, to spread and survive.

Most of the time, mutations have little impact. But sometimes, a variant can make a virus more contagious or deadly.

As of last week, the World Health Organisation reported the UK coronavirus variant had been detected in 41 countries and territories, including Australia.

The 501Y.V2 South African variant had been found in at least six other countries - Australia, Finland, the UK, Switzerland, Japan, and Zambia.

The mutated strain rapidly became the dominant variant in South Africa, representing about 80 per cent of all newly diagnosed cases.

Some experts estimate the UK mutation may be up to 50 per cent – and possibly 70 per cent - more transmissible.

The South African mutant virus shares some mutations with the UK variant. Both super strains have the same mutation on their spike protein - N501Y.

Will vaccines work against UK and South African strains?

In theory, but not yet conclusively proven, the mutations on the spike protein make the UK and South African strains more infectious.

The spike locks onto a human protein to allow infection.

The big question now is whether the vaccines successfully developed and approved for rollout will work against the mutant strains.

Research released on January 8 showed the Pfizer vaccine protects against new strains of the virus detected in both the UK and South Africa.

In the study, which is yet to be peer reviewed, blood samples were taken from 20 people who received the Pfizer vaccine.

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Facing an ever-changing threat, Moderna has expressed confidence that its vaccine will still work.

But even if the vaccines do work against 501Y.V2 and B.1.1.7, there is no guarantee that a mutation won't emerge that renders this round of vaccinations useless.

Drug companies can quickly tweak and adjust their vaccines to combat mutations, if necessary.

Retooling in labs to combat the COVID threat

UNSW epidemiologist Professor John Kaldor said pioneering mRNA technology, which has been used to develop the coronavirus vaccines, was ideally suited to a virus which can rapidly change and mutate.

"There are several new technologies which have never been used to develop vaccines before. Those new technologies are much more amenable to rapid retooling," he said.

The mRNA vaccines are different from traditional vaccines. Instead of having a viral protein injected, a person receives genetic material – mRNA – that encodes the viral protein.

The result is mRNA vaccines can be very nimble, with scientists able to configure new variations based on the viral sequences of mutations.

Influenza, which continually sweeps around the world each year, is an example of how viruses change, and vaccines continually tweaked and adapted.

"The influenza virus shifts very markedly from season to season, and does require different vaccines," Professor Kaldor said.

"There is a process every year to identify the profile of the dominant influenza viruses around the world and rapidly developing vaccines that match, as far as possible, those dominant strains.

"My understanding is that the biological shifts taking place [in the coronavirus] are not doing so in ways that are likely to affect the preventability of the vaccines, so far."

Nonetheless, the South African super strain, 501Y.V2, has more mutations than the UK strain.

"I would worry a lot about the South African strain," John Bell, the Oxford University scientist who worked on the Oxford AstraZeneca vaccine, told The Times.

He said mutations in the 501Y.V2 "are really pretty substantial changes in the structure of the [virus's spike] protein."

More virulent or not, deaths will jump

So far, the scientific community has seen no evidence the COVID-19 mutations cause more severe illnesses.

But changes in transmissibility nonetheless sends shivers down the spines of health authorities.

More infections mean more people hospitalised, and a greater drain on resources and life-saving medications and devices.

This all adds up to deaths likely jumping.

Scientists typically estimate that a vaccination rate of about 70 per cent is needed for herd immunity, where entire populations are protected against a disease.

But some fear that the extremely infectious nature of COVID-19 could require a significantly higher threshold.

"Herd immunity on a global scale is a long way off," Professor Kaldor said.

The three key vaccine factors that will forge global herd immunity against coronavirus are effectiveness, durability and the epic logistical challenge of deployment.

Some key details, including how long the vaccine could work, remain unknown.

It will be easier for some individual countries to achiever herd immunity that protection for almost eight billion humans, worldwide.

Australia and New Zealand, developed island nations with small populations, are in prime position.

"We're still learning to what extent the vaccines actually prevent transmission," Professor Kaldor said, "but the signs are good.

"The other thing that is a complete unknown, and it will take a long time to find out ... is the degree of durability of the protection."

According to data from Johns Hopkins University, 1.93 million people have died from coronavirus.

More than 90.2 million people have contracted the coronavirus worldwide.

Contact: msaunoko@nine.com.au

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