This mutant is anything but a teenage ninja turtle.
It was only a matter of time. Efforts to thwart the state’s recovery have existed since the start of the pandemic. From anti-maskers to anti-vaxxers, some Coloradans seem determined to prolong the virus’ impact. Sadly, their petulance is everyone’s loss.
Enter B.1.351 — the South African variant lineage recently confirmed in Colorado.
While most mutations are of little concern, this is not one of those variants. Having been confirmed in at least three individuals in the state — alongside at least 68 other cases in 17 locations across the United States — it’s likely indicative of larger community spread. Unfortunately, it’s difficult to know to what extent, as even though America has ramped up genetic sequencing efforts under President Biden, we marked 43rd globally in sequencing efforts as recently as December 2020.
This lack of sequencing continues to be echoed locally.
Despite state epidemiologist Dr. Rachel Herlihy claiming in February that Colorado is “quite impressive compared to other states across the country,” the Centers for Disease Control and Prevention shows Colorado ranking 25th of 50 states in percentage of cumulative cases sequenced. This amounts to a paltry 0.443% of cumulative tests in Colorado being evaluated with genetic sequencing, meaning it’s extremely difficult to say with any real accuracy what extent the variant has already spread.
Understanding community spread of variants is critical. Unlike other variants, B.1.351 has already been documented to reduce efficacy of multiple first generation vaccines. For Johnson & Johnson’s vaccine, efficacy for mild to moderate symptoms fell to 57% for the South African variant. For Novavax, efficacy dropped to 60%. While initially hopes were high that the Moderna and Pfizer vaccines would fare slightly better, a new study published on March 8 in Nature demonstrated concern, as these vaccines were 10.3 (Pfizer) to 12.4 (Moderna) times less effective against B.1.351 as measured by vaccine sera.
Most critically, researchers of the recent study concluded these variants do in fact show signs of antigenic drift — a common viral phenomena whereby mutations accumulate and impact antibody response. This indicates a strong potential for mutations that will ultimately evade current vaccines — and certain therapeutics — entirely.
In many ways, this was expected after the virus ran wild. It’s also similar to the annual flu, so seasonal or annual drift is not unprecedented. However, as we well know, COVID-19 is not the flu — it’s far more infectious and deadly — and the researchers made it a point to highlight that the time scale for mutations like B.1.351 could prove a significant barrier to overcoming the initial hurdle of the pandemic.
Under this scenario, if the virus continues to run rampant, a strain like B.1.351 could easily become dominant and further mutate to become fully vaccine-evading before we even achieve vaccination for the current strain. This would prompt a sort of “Catch Me If You Can” sequel, with scientists attempting to chase down the subsequent mutants faster than we can vaccinate against them.
This scenario is particularly problematic when you consider that prior infection with COVID-19 does not seem to prevent reinfection with a variant like B.1.351. In combination, a vaccine-evading mutation is ripe to rip through a population that has lowered its defenses, falsely assuming immunity. Suddenly a new wave of cases would be unleashed, and a full year of safety efforts all but erased.
There are preparations underway to rapidly develop and deploy a booster vaccine for new variants. It’s also possible the virus does not mutate in this fashion, or that our immune systems could overcome these challenges with the aid of T cells and more. However, until we get the initial pandemic under control, there’s little doubt it’s risky. Particularly as the first recombination of the virus, and the first combined mutation of two variant strains have also now been documented, the need to double down on reducing spread could not be more clear.
The ramifications of failing to contain SARS-CoV-2 early on are only just beginning to be felt in entirety. While we all certainly hope for a speedy return to normal, it’s imperative we not become overeager and let our guard down too soon.
Our baseline still hovers at peak levels of 2020. Combined with pandemic fatigue, spring break, states reopening in full, removal of mask mandates and a CDC notice for partial ease in restrictions for vaccinated populations, it’s not a stretch to see how these could easily lead to a new peak of infections fueled by high-risk mutations such as B.1.351.
We’ve made it this far — let’s not lose in the fourth quarter.