- James Gallagher
- BBC health and science editor
We are back in familiar territory, an area of growing concern about a new coronavirus mutator.
The newest variant is the most mutated version yet discovered, and has a long list of mutations that one scientist described as “shocking”, while another told me it was the worst mutant they had seen.
The new mutation is still in its early days, and confirmed cases are mostly concentrated in one province in South Africa, but there are hints that it may have spread further.
There are urgent questions about how quickly the new mutation can spread, its ability to bypass some of the protection offered by vaccines, and what should be done about it.
There is a lot of speculation, but few clear answers.
So what do we know?
The mutant is called B.1.1.529 and the World Health Organization (WHO) on Friday will likely give it a Greek codename (such as the alpha and delta mutant).
It was also subjected to severe mutations significantly. Professor Tulio de Oliveira, director of South Africa’s Center for Epidemiological Response and Innovation, said there was an “extraordinary set of mutations” and it was “totally different” from other mutations that had circulated.
He said, “We were surprised by this mutant, it has made a great leap in evolution [و] Much more surges than we expected.”
In a briefing, Professor de Oliveira said there are 50 mutations in total and more than 30 on the spinal protein that surrounds the virus, which is the target of most vaccines and the key that the virus uses to open its entrance into the body’s cells.
Zooming in further beyond the receptor binding domain (the part of the virus that makes first contact with our cells) it contains 10 mutations compared to just two for the delta mutant that swept the world.
It is possible that this level of mutation was caused by a single patient who was not able to overcome the virus.
A lot of mutations doesn’t necessarily mean a bad thing. It is important here to know what these mutations actually do.
But the concern is that this virus is now radically different from the original that emerged in Wuhan, China. This means that vaccines designed using the original strain may not be effective.
Some mutations were seen in other mutant, which gives an idea of its possible role in the evolution of this mutant.
For example, the N501Y mutant appears to facilitate the spread of the coronavirus. Others make it more difficult for the antibodies to recognize the virus and may make vaccines less effective, but there are other types that are entirely new.
Professor Richard Lisels, from the University of KwaZulu-Natal in South Africa, said: ‘They scare us that this virus may have enhanced transmissibility, enhanced the ability to spread from person to person, but may also be able to circumvent parts of the immune system.
There were many examples of mutants that looked scary on paper, but didn’t achieve anything. The beta mutant was at the forefront of people’s concerns at the beginning of the year because it was the best at escaping the immune system. But in the end, the delta mutant was the fastest spreading and the resulting strain dominated the world.
Professor Ravi Gupta, from the University of Cambridge, said: “The beta mutant strain was focused on the ability to escape from the immune system and nothing else. Delta has the ability to infection and modest immune escape, and it is possible that this new mutant has these two traits.”
Scientific studies in the laboratory will give a clearer picture, but the answers will come faster by monitoring the virus in the real world.
It is still too early to draw clear conclusions, but there are already worrying signs.
There were 77 fully confirmed cases in Gauteng province, South Africa, four cases in Botswana and one case in Hong Kong (which is directly related to travel from South Africa).
However, there is evidence that the variant has spread more widely.
This mutation appears to give strange results (known as a gene S leak) in standard tests and can be used to track the mutation without a full genetic analysis.
This indicates that 90% of cases in Gauteng may already be caused by this type and “may already be present in most provinces” in South Africa.
But that doesn’t tell us whether the new mutant spreads faster than the delta mutant, or is more dangerous, or how far it can evade the immune protection that comes from vaccination.
Nor does it tell us to what extent the variant will spread in countries with vaccination rates much higher than the 24% in South Africa who have been fully vaccinated, even though large numbers of people in the country have contracted the coronavirus.
So right now we have a variant that raises major concerns despite the huge gaps in our knowledge about it, something that needs to be monitored closely and raises deep questions about what to do and when. The lesson of a pandemic is that you can’t always wait for all the answers.