THE GOOD AND THE BAD

Hindustan Times (Chandigarh) - - News -

DSars-cov2 has stayed rel­a­tively sta­ble – and that is both a good thing and a bad thing. It is good be­cause it means vac­cines cur­rently un­der de­vel­op­ment have a high chance of suc­ceed­ing. It is a bad thing be­cause there were hopes dur­ing the ini­tial weeks of the pan­demic that, like some viruses do, Sars-cov2 would mu­tate into an un­vi­able strain and ta­per off o we know enough about the strains of the Sars-cov2 virus in In­dia? How many strains are there? Is there one dom­i­nant strain? Are there mul­ti­ple strains?

Last week, Malaysia claimed to have dis­cov­ered a strain that was “10 times more in­fec­tious” and “eas­ily spread by a su­per­spreader”, but as re­searchers around the world were quick to point out, while this strain might have been new to that coun­try, it was the pre­dom­i­nant strain in most parts of the world even as far back as March and April (in­clud­ing in Europe). Called the G clade (a bi­o­log­i­cal term mean­ing de­scen­dants of a com­mon an­ces­tor), this strain is the dom­i­nant strain in In­dia. And it is, un­for­tu­nately, a vir­u­lent one, which could per­haps ex­plain the virus’s run through the coun­try; In­dia ended Mon­day with 3.16 mil­lion cases of Covid-19, of which 762,051 were ac­tive. It saw 58,532 deaths till Mon­day night.

Around the same time the Malaysian au­thor­i­ties made their claim – re­sult­ing in sen­sa­tional head­lines around the world – re­searchers in Sin­ga­pore wrote in a study pub­lished in The Lancet that a vari­ant of Sars-cov2 with some of its DNA miss­ing ac­tu­ally caused a milder in­fec­tion than the other strain. In a small study, it was found that peo­ple in whom this strain was found did not re­quire ei­ther oxy­gen sup­port or to be put on the ven­ti­la­tor.

Com­pared to many other viruses, Sars-cov2 has stayed rel­a­tively sta­ble – and that is both a good thing and a bad thing. It is good be­cause it means vac­cines cur­rently un­der de­vel­op­ment have a high chance of suc­ceed­ing. It is a bad thing be­cause there were hopes dur­ing the ini­tial weeks of the pan­demic that, like some viruses do, Sars-cov2 would mu­tate into an un­vi­able strain and ta­per off.

The abil­ity of viruses to mu­tate is one rea­son why some ex­perts are wor­ried about Rus­sia’s Sput­nik-v vac­cine, which hasn’t un­der­gone the kind of rig­or­ous tests any such vac­cine should – an in­ef­fec­tive vac­cine may, far from prov­ing to be a cure, merely cause the virus to mu­tate, per­haps into some­thing far more dan­ger­ous.

Not that Sars-cov2 in its cur­rent form is be­nign. Around the world, re­searchers and doc­tors no longer see Covid-19 as a res­pi­ra­tory dis­ease – it af­fects every­thing from the kid­neys to the brain – and are be­gin­ning, es­pe­cially as they set out to an­swer ques­tions about long-covid, to be­lieve that it could be much more. Long-covid refers to the some­times de­bil­i­tat­ing and long-drawn-out fall­out of Covid-19 that some pa­tients suf­fer – some­times even with­out be­ing se­ri­ously ill. Those try­ing to find out more about long-covid be­lieve that one ex­pla­na­tion for it could be that Covid-19 af­fects at least some pa­tients the same way an au­toim­mune dis­or­der does. An au­toim­mune dis­ease is sim­ply one where the im­mune sys­tem at­tacks the host (or an or­gan of the host), or one where it weak­ens the body’s re­sponse to in­fec­tions. While this (ac­cept­ing Covid-19 as an au­toim­mune dis­ease) could ex­plain some things, more re­search is needed be­fore it can be clas­si­fied as such.

In­ter­est­ingly, one of the most promis­ing lines of treat­ment for au­toim­mune dis­eases in­volves the use of mon­o­clonal an­ti­bod­ies (called so be­cause the an­ti­bod­ies are all made up of iden­ti­cal cells, each of which is cloned from the same par­ent). Sev­eral com­pa­nies (Re­gen­eron Phar­ma­ceu­ti­cals, Eli Lilly) are test­ing mon­o­clonal an­ti­bod­ies for Covid-19. HT’S health edi­tor San­chita Sharma has been writ­ing about them from early July, from around the time Re­gen­eron’s mon­o­clonal an­ti­body REGN-COV2 en­tered Phase 3 tri­als. Sci­en­tists be­lieve that the use of mon­o­clonal an­ti­bod­ies early on in the treat­ment of Covid-19 could save more lives.

An­other treat­ment for au­toim­mune dis­eases in­volves the use of in­ter­fer­ons – pro­teins re­leased by the body’s im­mune sys­tem and which pro­voke, reg­u­late, or am­plify the re­sponse to pathogens. And com­pa­nies are ex­per­i­ment­ing with in­ter­fer­ons, too, in the treat­ment of Covid-19. A study re­ported in July, and con­ducted by the Univer­sity of Southamp­ton and a com­pany Sy­nair­gen, showed that an in­haled in­ter­feron helped Covid-19 pa­tients re­cover faster.

A vac­cine is nec­es­sary and im­por­tant, but we’d do well to keep track of the work be­ing done on in­ter­fer­ons and mon­o­clonal an­ti­bod­ies.

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