The threat COVID-19 presents is nothing new to the world as we sit a year into a deadly pandemic, but a new challenge has emerged in recent weeks as variants from the UK, Brazil, and South Africa continue to dominate international headlines.
The global community is asking itself what this will mean for transmission rates, vaccine efficacy, and more coming out of the difficult year that was 2020.
It turns out, it’s not the new variants of the virus that pose the greatest threat to recovery — it’s the continued spread of COVID-19 itself.
As the situation unfolds, we spoke to experts to break down what we know about the variants, what we still need to figure out, and how the world must adapt in this ever-changing climate of COVID-19.
Virus Variants Were Expected From the Start of the Pandemic
“[RNA] viruses are notorious for having variants because every time they copy themselves inside a new infected person, they're sloppy,” Dr. Robert Bollinger, Raj and Kamla Gupta professor of infectious diseases at Johns Hopkins University and expert in SARS-CoV-2, told Global Citizen.
Bollinger said there have been variants of COVID-19 from the start and that we’re just hearing about them now as the health community is doing more genetic sequencing.
“Back in December 2019, we saw the viruses mutating as we would expect it to,” he said.
When a virus spreads, it has the opportunity to mutate with every transmission — essentially, it’s just making a copy of itself and it can make mistakes when doing so.
Over time, if you have enough transmission (like, say, more than 100 million cases), the virus will get lucky and a mutation will occur that gives it a sort of advantage. In the case of the UK variant of COVID-19, for instance, that advantage seems to be that it’s more infectious, Bollinger said.
If you follow that logic, it also means that if the spread were to be brought under control, so too would the virus’ ability to mutate because it could not keep copying itself.
In a Johns Hopkins Medicine piece he was recently featured in, Bollinger also pointed out that it’s not advantageous for a virus to become more deadly, as a virus cannot spread effectively if all its victims die — but that’s not to say that he is not concerned about these new variants.
“I knew this was going to happen, [but] I didn't expect us to have such a hard time getting this spread under control,” he said, with regards to the United States’ current state.
By letting COVID-19 rage on in the US, the current epicenter of the virus, it’s being given ample opportunity to mutate.
Today's Vaccines Are Less Effective Against Variants — But Not Useless
“And we're starting to see some suggestion that it's mutating to a point where it might avoid the immune response of some of the vaccines,” Bollinger said, adding that it would also be a big problem if the virus were to begin to mutate in such a way that it started making people sicker.
“We need to stop the transmission before those things happen or at least slow it down so that we have time,” he said. “I have confidence in the vaccine programs … [They] were designed to be able to quickly be tweaked.”
He also added that the world has had decades of experience with tackling mutating respiratory viruses like this because of influenza.
“We know how to do this. We just need to make sure we have the time to do it,” he said.
Despite this positive news, the variants from the UK, South Africa, and Brazil do seem to spread more easily — so even if they aren’t more lethal, they could lead to an increase in cases, which could lead to an increase in deaths, according to the Centers for Disease Control and Prevention (CDC).
So far, research seems to indicate that antibodies created through the Moderna and Pfizer vaccines do recognize these variants, but it also seems that they are less effective.
Still, while the vaccines appear to be less effective, they have not been rendered useless by any means, and as Bollinger put it, the industry is poised to adapt as needed.
And, the CDC points out, it is now more important than ever for the world to comply with public health mitigation strategies — vaccination, social distancing, mask wearing, handwashing, and quarantining as needed, in order to bring COVID-19 to an end.
The Key to Fighting Variants Is Tackling COVID-19 Itself
Scientists are working quickly to learn more about these variants — something infectious disease specialist Dr. Barbara Rath, co-founder and chair of the Vienna Vaccine Safety Initiative, said is of utmost importance.
“Vaccine development is important, but we need to not forget the importance of epidemiological and really very good basic science research,” she told Global Citizen.
Something that both Rath and Bollinger noted was that the reason we found the South African variant is because they were looking for it.
“Because they were very good at developing a surveillance system in South Africa,” Rath said. “But we don't know what's happening in Zimbabwe or Mozambique, for example,” she added, noting the importance of establishing good practices in emerging settings.
To that end, Bollinger said it’s likely there are more variants in the US that just haven’t yet been discovered.
Even though RNA viruses like COVID-19 mutate all the time, Rath explained that when they spread, they often actually make themselves less viable — and if multiple antivirals or measures are combined strategically, you can essentially back these viruses into a corner, in a sense, if you manage to turn them into a less advantageous version of themselves.
Virologists can simulate this in a lab — they will test treatments that essentially force the virus to become weaker. This is how antiretroviral therapies are combined to tackle HIV, for example.
This is the goal of antiviral therapies. If a person has a virus and takes effective antiviral therapy (or various combinations), the virus gets attacked, infections end sooner, and the virus becomes less likely to spread to another person. Less virus means less opportunity for resistance development.
That means that if we’re able to develop treatments — and specifically antiviral therapies — for those who do catch COVID-19, they will not only work to cure the patient but also make it more difficult for new variants to arise.
Tackling COVID-19 Will Require Global Cooperation — and Funding
Rath advised that treatment alone is not enough. It would need to be part of a holistic approach that incorporates surveillance of variants, proper use of diagnostics, infection control, and vaccination efforts. All of these measures, working together, would help to contain the spread of COVID-19 and ultimately slow down the emergence of new variants.
“What that means is everything that we have to control the virus has to be thrown at it, basically,” Rath said, referencing vaccines, medical treatments, and surveillance systems being developed worldwide.
But more than this, research needs to continue on how COVID-19 impacts people on an individual level, according to Rath.
The virus expert says it is essential to study the individual symptoms, the immune responses, the transmissibility, its severity, and the body parts it impacts — the assessment of the virus in new people must become routine and comparable around the world.
“And this is all lessons learned, partly from the flu, but mostly from HIV … where we have achieved a greater level of international consensus on what we need to monitor when we see a patient in front of us,” she explained.
Rath said we need cheap and efficient testing and diagnostics that have the ability to further determine what kind of COVID-19 a person might have, on top of surveillance capacity, and an understanding of when the right intervention — like giving a vaccine — is needed.
Vaccines are important, but so is the infrastructure needed to test, monitor, and decipher information on the virus and its transmission — worldwide.
The mRNA vaccines are encouraging to Rath, who said she was very enthusiastic about them when the first regulatory approvals were announced, as this technology was in the making for years.
COVID-19 vaccines were approved quickly in the eyes of the public, not due to lack of diligence, she said, but due to being prioritized, which is significant in the world of public health advancements.
“The technology that makes the adjustment of vaccines much more efficient and much easier,” she said. “Technically, it takes about 30 days to update an mRNA vaccine to a new virus variant, if necessary.”
So what do we really know about tackling new variants of COVID-19?
For starters, we know that while potentially less effective, vaccines still seem to have an impact on these variants — and that vaccine companies are up to the challenge of altering their vaccines or providing booster shots, as needed.
We also know that in order to tackle these new variants, we need to tackle the spread of COVID-19 itself by adhering to public health guidelines and investing in research.
And lastly, we know from past disease outbreaks that international efforts are vital to eliminating disease. A vaccine can be a sort of silver bullet, but only if it acts as an integral part of an overarching global health plan — which is why funding and cooperation are crucial amid this global health crisis.
“You have to keep your finger at the pulse always with RNA viruses to make sure you understand when they start changing,” Rath said.