The Commercial Appeal

SHOULD WE WORRY ABOUT CORONAVIRU­S MUTATING?

- Your Turn Dr. Manoj Jain Guest columnist

Should we worry about the COVID-19 virus mutating?

Yes, the mutation of the virus is a serious cause for concern. Let’s understand why.

It is in the nature of the virus to mutate. Just as we humans change from one generation to another, so does the virus, yet it does this over minutes and millions of new particles in each generation.

With each replicatio­n cycle, some of the genetic code of the virus is altered, most of these alteration­s are dead-end or irrelevant mutations and the new virus simply dies or continues as before. But one in the billions of replicatio­ns leads to a new virus which is different and it survives.

Can the mutated virus be easier to transmit?

Yes, that is what has happened with the virus in the United Kingdom (UK). A variant strain of virus called the B.1.1.7 has taken over the Southeaste­rn part of the UK and a virus with some of the same mutations has emerged in parts of coastal South Africa. These virus spread to a greater number of people (the B.1.1.7 variant) has a transmissi­on number of Ro that is 0.4 greater than the original one). In South Africa the positivity rate increased from 5% to 20% in just two weeks, in part due to this virus. Luckily, the mutant viruses does not appear to be more deadly than the original ones.

What can we do to reduce the mutations?

We cannot stop the virus from mutating, as long as the virus is with us it will continue to do so. But, we can reduce the number of mutations it makes by reducing the number of times the virus can replicate.

The more we can stop the upstream community transmissi­on of the virus, the less opportunit­y we give the virus to mutate. That means less chances for the virus to do trial-and-error changes to find a variant which can be more lethal or transmissi­ble. Also, if you are positive and have traveled internatio­nally or someone you know may have contracted the virus internatio­nally, let your doctor know, so they can do genetic fingerprinti­ng of the virus.

We can reduce the transmissi­on by simple public health measures of masking, distancing and vaccinatio­ns. If we let the virus multiply unfettered in the community from person to person it may be only a matter of time before a more deadly or more infectious virus may occur.

Will the vaccine protect us from the next strain of virus?

Yes, scientists believe that the current vaccines will protect us from the virus, though more studies are being done.

It is possible that over time – how much time we don’t yet know – the virus accumulate­s enough mutations where the effectiveness of the vaccine may be called into question.

If a new virus occurs can we change the vaccine?

Yes, we have been extremely successful with the new vaccines, and it would only take 6-8 weeks to develop and deploy a new vaccine which can protect us from the mutated strain. Having to add another vaccine into the cocktail would create tremendous disruption in revaccinat­ing. Also, keeping track of who is vaccinated with which vaccine and keeping track of which virus is circulatin­g in which region of the world will be logistical­ly impossible.

Scientists are very familiar with this “cat-mouse” game with the virus and vaccine, because it occurs with the mutated flu virus each season. The flu vaccine is changed frequently in response to flu virus mutations. We do not want to get into that situation with the coronaviru­s. Although coronaviru­ses do not mutate nearly as much as flu viruses, we need to eliminate COVID at this early stage and not make it an endemic virus which comes back again and again.

Much is at stake with COVID mutations. Serious public health action needs to be taken to avoid a creation of a super-spreader and a super-killer virus. A nightmare scenario would be a new mutated virus that killed not 1.3% of persons but 13% (similar to SARS in 2002) of persons and it spread not from 1 person to 3 people but 13 people (similar to measles) Such mutations are entirely possible.

Time to act is now to prevent mutations. Let’s take masking, distancing, and vaccinatin­g seriously. Mutations are no longer a theoretica­l risk but a reality, given the UK experience.

Dr. Manoj Jain, an infectious disease physician in Memphis, is also a member of the City of Memphis-shelby County Joint COVID Task Force.

Please send questions for Dr. Jain to metro@commercial­appeal.com

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