17th April 2021

 Musings.......

B. 1. 617

This seeming incoherent set of alphabet and numbers is literally the reason for the so called second wave of the Pandemic in India. 

Believe it or not, B. 1. 617 is the name given to the Double Mutant strain which is now the prevalent strain in India, according to National Institute of Virology (NIV) data from 10 states. 

The B. 1. 617 variant of SARS- CoV-2 carries two mutations E484Q and L452R. 

The two mutations are found in the virus spike protein, which helps to bind the virus to the human cells receptors and gain entry into the host cell. 

The E484Q and L452R mutations have been found separately in many variations, but now have been found together for the first time in India making it a double mutant. 

The E484Q mutation is similar to mutations found in UK and the South African variant. 

The L452R mutation is found in California variant which is a fast spreading variant. 

The mutation has the inherent capability to increase the binding power of spike proteins with ACE2 receptors oh human cells, making it more transmissible. 

These mutations can also enhance viral replication. 

Hence, we now know that these mutations together can be more infectious and can evade antibodies. 

The Union Health Ministry has said that the new variant could increase infection rates and that the Double Mutant variant is capable of “ Immune Escape”. 

Immune Escape - This is the phenomena where simply put, having antibodies (IgG) to Coronavirus will not ensure protection from getting infected for a second time. Mutation will ensure that the virus can evade and bypass the immune system to infect a person who has antibodies to the virus, either through previous infection or through vaccination ! 

So what is the way ahead for the humanity which was so reliant on achieving “herd immunity” through mass vaccination ? 

According to “The Lancet” article on Public Health “ Immune evasion means we need a new COVID19 social contract” co- authored by Scientists of the French COVID19 Scientific Council - 

“the prominence of herd immunity being touted as a solution to the pandemic might be about to change with the emergence of immune evasion” 

According to the article, dealing with immune escape will require a re- evaluation of public health strategies, and the creation of a new evidence based social contract. 

The virological game changer has numerous consequences, not only for vaccines and treatment, but also for prevention and control strategies. 

The fervently awaited end of this global health crisis might be continually postponed, as new variants emerge and immune evasion reduces vaccination effectiveness in the short and medium term. 

According to them, it is time to abandon the present approach of waiting patiently until full vaccination is achieved and herd immunity is reached. 

The impact of general confinement on economies has been devastating with worsening unemployment levels and national debt. 

Social and health ( including mental health) consequences are huge especially in the younger generation.  

Different age groups are not affected similarly by the virus. From March to June 2020, 96% of additional deaths related to COVID19 in Europe occurred in patients older than 70 years. 

Hence, Governments need to integrate available measures in a more targeted way catering to different age groups. 

This is where, according to Lancet article, the new approach has to be based on a “ Social Contract”. 

- [ ] The younger generation could accept prevention measures such as mask and physical distancing - on the condition that 

- [ ] Older and vulnerable groups adopt not only these measures, but also more specific steps like voluntary self isolation to reduce risk of infection. 

Implementation of these measures should go hand in hand with mass vaccinations targeting various population targets. 

Political leadership world over should not hesitate to change their COVID19 management strategies fearing political backlash and should work hand in hand immediately with the Medical community to save the world from an impending “double mutant” disaster. 

Food for Thought.......

RC 

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