Last week a team of researchers in Seattle released a pre-publication article on the effect of existing antibodies on the new strains of COVID. The results are deeply concerning. They found that the antibodies produced in the blood of those who have recovered from COVID are often ineffective on the new variants from South Africa and Brazil. This suggests that, as far as the body is concerned, these new variants aren’t COVID-19, they are more like COVID-20. The virus is vaguely recognised by the immune system, but not enough to be able to neutralise it. Of course this is a small lab based study; it is possible in the human body this vague recognition is enough to prevent significant disease. But even if that is the case for these variants, it may not be true for the next variants. This is a warning we must listen to.
The three concerning virus mutation types
Mutations in viruses happen frequently and most are of no significance to humans. However there are three types we need to care about, as they will affect the spread and effects of the disease:
The logic of evolution suggests if a virus spreads more effectively it will overtake those that spread less well. Concerningly, as current more contagious strains in the UK and South Africa have shown, there is no reason to assume they will be less lethal either.
If the virus mutates into a less lethal form that spreads more than traditional COVID, this is the best outcome for humanity as it will overtake and eliminate the more lethal variant. With H1N1 Influenza, this pattern of mutation seems to occur increasingly over time, leading to a natural end to the pandemic.
Sadly it could easily go the other way. More lethal variations can occur as well and that may not slow the spread if victims have long asymptomatic or mildly symptomatic phases before decline and death.
3. Evading immune defences
This is the new scary mutation type that the Seattle study points towards. Having immunity to COVID-19 may not protect you against these new strains. These new strains will then have a huge new potential population of victims and as such can spread more widely.
Mutations are happening more frequently
Mutations are happening much more now than earlier in the pandemic. Virus mutations occur randomly when there is an error in the replication process. Most errors make no difference to the way the virus works. Some cause the virus to be inactivated entirely. However, some cause the concerning mutations listed above. The more replicating that is going on, the more chance there is of a concerning mutation. More replicating occurs when more people are infected — and infected for longer before being cured or dying — which is right where we are in January 2021 with millions of people worldwide infected.
To try and reduce the number of cases there are many non-drug measures being taken: social distancing, track and trace, travel restrictions, working from home etc. We also now have vaccination to further reduce cases. However current vaccination attempts are proving slow to roll out and are focused only on developed countries. Non-drug measures are also less likely to work in poorer countries where the population doesn’t have the luxury of reducing social contact. This is deeply concerning given every new case that occurs increases the risk that immune resistant strains will occur.
New vaccines might not help us
If a vaccine resistant strain does occur, thanks to the wonders of modern vaccine development, a new effective version can be produced in as little as 6 weeks. Rolling it out though is not so quick. In the many months it will take to vaccinate enough of the world population to suppress a given strain, there is plenty of time for a new strain to emerge resistant to that vaccine. We could end up with an endless whack-a-mole situation.
There are some causes for hope. The work of the Gates Foundation and GAVI to spread the vaccines we have rapidly worldwide offers the hope that we might vaccinate the world before a vaccine resistant strain can emerge. We might also be lucky; COVID might not be able to mutate enough to resist our defences and still remain lethal or spread. But current evidence seems to suggest we have some serious headwinds.