9 key questions answered about the worrying coronavirus variants spreading around the world, including whether vaccines block them, how contagious they are, and when they reached the US

double mask
Brendan Williams, president of the New Hampshire Health Care Association, puts on a surgical mask while carrying another mask.

  • Experts worldwide are urgently studying three coronavirus variants to understand what risks they pose.
  • One variant first identified in the UK, one in South Africa, and one in Brazil are probably more contagious than the original virus.
  • They have caused cases to surge and the three nations to lock down. Here are nine key questions about the variants, answered.

Experts are urgently investigating three different coronavirus variants – found in the UK, South Africa, and Brazil – that have caused explosive outbreaks and are spreading around the world.

Often, small genetic changes that a virus makes when it replicates, called mutations, don’t affect its behavior. But these three coronavirus variants, each evolved separately, appear to have developed similar characteristics that affect how they spread.

Here’s what we know so far

All the variants contain mutations in the code for their spike protein, the part of the virus that it uses to infect cells. Alterations in this area could enable the virus to infect cells more easily, and the spike protein is the target for COVID-19 vaccines developed by Moderna, Pfizer-BioNTech, Johnson&Johnson and AstraZeneca.

With information frequently changing, we’ve compiled a list of everything we know so far about the variants, answering nine key questions, such as whether vaccines work on them and whether they’ve spread to the US.

Read more: What it actually means that a new coronavirus strain is more transmissible – and how that changes your chances of getting sick

The variants were first detected in the UK, South Africa, and Japan 

  • UK – B.1.1.7

B.1.1.7 was first detected in two people in south-east England. It was reported to the World Health Organisation (WHO) on December 14.

B.1.17 has been identified in 82 countries worldwide, including the US.

  • South Africa – 501.Y.V2

501.Y.V2 was first detected in Nelson Mandela Bay, South Africa, in samples dating back to the beginning of October 2020. It was reported to the WHO on December 18.

The UK identified two cases of 501.Y.V2 on December 22, in people who had come into contact with someone who had traveled from South Africa.

501.Y.V2 has been found in 40 countries globally, including the US.

  • Brazil -P.1

The variant found in Brazil was first detected in four people in Japan, who had traveled from Brazil on January 2. It was identified by the National Institute of Infectious Diseases on January 6, and reported to the WHO that weekend.

It has been found in 28 countries worldwide, including the US.

The variants are more contagious

The B.1.1.7 variant, first found in the UK, is thought to be 30% to 50% more contagious than other forms of the virus, according to Public Health England estimates. This means it is 30-50% better at spreading from person to person than other coronavirus variants.

501.Y.V2, the variant found in South Africa, is thought to be 50% more contagious than other variants, because it has spread 50% faster, becoming the most common strain in people with COVID-19 in coastal regions of South Africa.

P.1, found in Brazil, is probably more contagious –it was initially detected in Amazonas, north-west Brazil, on December 4 and by January 21, 91% of people with COVID-19 in the region were infected with P.1, according to the World Health Organization

It’s not known precisely why the variants are more contagious

Research is ongoing, but working theories are that both variants have changes in the spike protein, meaning they can potentially infect cells more easily.  The swabs of people infected with B.1.1.7 and 501.Y.V2 also appear to have more viral particles than the original virus, known as a higher viral load. The more viral particles an infected person expels, the more likely they are to infect others.

The variant first found in South Africa – 501.Y.V2 – has been shown in early lab studies to sometimes avoid antibodies, produced by the body to fight off infection. If this happens in humans, it could mean it infects people more easily and could increase the likelihood of catching coronavirus more than once.

Mutations called E484K and K417T could be responsible for this – the variant found in Brazil have them too. B.1.1.7, the variant first found in the UK, doesn’t have this particular mutation.

pfizer covid 19 vaccine distribution
Medical assistant April Massaro gives a first dose of Pfizer BioNTech’s COVID-19 vaccine to nurse Alice Fallago at Desert Valley Hospital on Thursday, December 17, 2020 in Victorville, California.

They could be more deadly

The variants first found in the UK and South Africa at present do not seem to cause more severe disease, the WHO said on January 11. However, a more contagious variant could cause more deaths, because more people get sick.  

It is unclear whether or not P.1. is more deadly. This is “under investigation”, according to the WHO on February 21.

Adam Kucharski, an associate professor at the London School for Hygiene & Tropical Medicine, has explained to Insider why the ability to spread more easily could make the variant more dangerous than a deadlier strain.

There is evidence from South Africa that when hospitals became under pressure, the risk of death increased.

The UK government’s New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) reported a model on January 21 that showed someone infected with B.1.1.7 is 30 to 40 per cent more likely to die than someone with a different variant, but there is a lot of uncertainty around the numbers.

Human behavior can help stop them spreading

The WHO has said that because the variants are more contagious, everyone should double down on precautions that stop their spread, such as social distancing, hand-washing, mask wearing, and avoiding crowds.

“Human behavior has a very large effect on transmission – probably much larger than any biological differences in SARS-CoV-2 variants,” Paul Bieniasz, a virologist at the Howard Hughes Medical Institute, previously told Insider.

Vaccines will probably work

It is too soon to know for sure, but it appears unlikely that the mutations will render vaccines totally useless. 

The vaccines available all target the coronavirus spike protein. The spike protein has multiple sites that all cause different immune responses in the body. Mutations could affect some of the sites, but are unlikely to affect all of them.

Pfizer said January 29 that its vaccine should work against some particular mutations that the variants found in South Africa and the UK have, after it tested its vaccine on lab-made variants. Further lab studies on February 18 have shown that Pfizer-BioNTech’s COVID-19 vaccine worked less well against lab-made viruses that mimicked the variant in South Africa.  The lab-made variants were not the exact variants found in the UK or South Africa.  

Moderna ran similar tests, and announced January 25 that its vaccine held up well against the mutations found in B.1.1.7, but less well against the mutations found in 501.Y.V2, the variant found in South Africa. Again it used lab-made variants.

The one dose COVID-19 vaccine developed by Johnson&Johnson was less effective in clinical trials in South Africa, where 95% infections are caused by 501.Y.V2. 

Existing vaccines could also be updated and tailored to a new variant within weeks or months. Or you may require a booster shot.

Moderna said January 25 that it will develop a new version of its COVID-19 shot to fight 501.Y.V2, the variant found in South Africa. Pfizer said January 26 that it is already working on booster shots that protect against coronavirus variants. 

  • B.1.1.7 – first found in UK

Experts think the COVID-19 vaccines from Pfizer-BioNTech, Moderna, and AstraZeneca will protect people against the B.1.1.7 variant found in the UK. The vaccines haven’t been tested against real-life coronavirus B.1.1.7 variants yet.

  • 501.Y.V2 – first found in South Africa

Studies suggest that the variant can escape some antibodies in the lab – researchers don’t yet know how, or if, this will affect how well vaccines work in people. 

The vaccines haven’t been tested against real-life coronavirus 501.Y.V2 variants yet.

Tulio de Oliveira, who is leading South Africa’s scientific effort to understand the variant, told the Financial Times that his group thinks a vaccine could be a little less effective, but is optimistic. “Between all the varieties of vaccines that are coming to the market, we still have strong belief that some of them will be very effective,” de Oliveira said.

Read more: What’s coming next for COVID-19 vaccines? Here’s the latest on 11 leading programs.

The variants could affect more young people 

Experts have said that the B.1.1.7 variant could affect kids more than previous variants, but evidence is still emerging. 

Public health experts in the Western Cape, South Africa have said that the proportion of young people who have been hospitalized and died from COVID-19 in South Africa has remained the same, but there are more young people in hospital, because more people overall are sick.

COVID-19 treatments could still work

There is no evidence currently to suggest the B.1.1.7 mutations mean that COVID-19 treatments are less effective against this variant.

Scientists think that a mutation found in the variant first identified in South Africa could mean that certain antibody drugs do not work as well.

But dexamethasone, a steroid, would probably still work just as well.

All three variants have been identified in the US

In the US, 2400 cases of B.1.1.7 –  the variant first found in the UK – have been identified, according to the CDC. The variant has been found in 46 US states, including New York, Florida, and California. 

The variant identified in South Africa, 501Y.V2, was first detected in the US on January 28.

There is are ten known cases of P.1 in the US, the variant found in Brazil first identified in Japan. It was first detected in Minnesota on January 24. The Minnesota resident who got infected with P.1 had recently traveled to Brazil, the Minnesota Department of Health said.

Read the original article on Business Insider