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The US and the 7 variants of the covid: why will we never return to ‘normality’?

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New strains could be just as contagious and lethal as variants discovered in the UK and South Africa, compromising vaccination efforts in some way.

Advisers to US President Joe Biden advise him not to be too specific in his predictions. But the people want to know: when will we return to normality? And Biden, answering questions from the audience at an event organized by CNN, declared that “within a year” there will be “significantly fewer people who have to maintain social distance and wear a mask.” Some words that, due to their inaccuracy, perhaps his advisers approved.

Despite the fact that infections are decreasing and the United States plans to vaccinate the entire population before August, it is inevitable to perceive a sense of caution and circumspection. Especially since seven new strains of SARS-CoV-2 have just been detected in North American territory. Strains that could be just as contagious and lethal as variants discovered in the UK and South Africa, compromising vaccination efforts in some way.

The study, published on the Medrxiv portal does not draw conclusions about the transmissibility of these seven variants. Among other reasons, because the United States only does the genome sequence of 1% of the tests carried out, which makes it impossible to take a clear picture of the origin of these strains. But since mutations often respond to the virus’ need to survive and proliferate, virologists are concerned.

The modification of the seven variants found occurs in the amino acid 677, the “crown” of the virus that allows it to engage in human cells. “Something is clearly happening with this mutation,” Jeremy Kamil, a virologist at Louisiana State University and one of the study’s authors, told the Times. “I think there’s a clear sign of an evolutionary benefit.”

The researchers speculate that it could be a case of “convergent evolution“: when the virus (as has happened with animal species) evolves separately, but in a similar way, since the environmental conditions to which it adapts are practically same. These mutations are particularly prevalent in the vast Midwest region of the United States.

The find is reminiscent of the British, Brazilian and South African strains, which have been circulating around the world since the late 2020s. The United Kingdom, known as B.1.1.7, is up to 45% more infectious than the original virus and between 30% and 70% more deadly. According to the same study, this variation doubles its presence in the United States every 10 days and may become the dominant strain next month.

The Centers for Disease Control and Prevention, the US agency responsible for developing pandemic recommendations, has been calling for double masks to be used for a few days instead of one. Protecting the nose and mouth properly, it says, can reduce transmission by up to 95%.

Doctors also recommend getting the flu shot, which can limit covid damage. “The reason we continue to recommend the flu vaccine, and the reason I continue to recommend people to get any of the covid vaccines available, is because they are all going to be effective in preventing serious illness,” says Dr Azza Elemam of the University of Richmond. “If you get covid and have a cold, or have moderate flu symptoms, I’d take you to the ICU.”

Meanwhile, daily infections in the US have dropped 43% in the last two weeks, and deaths by 29%. The declines are mostly among those over 60: the demographic group, for weeks, has been in the forefront to get the vaccine. The national rate has reached 1.66 million daily doses, and vaccinations are expected to open to the bulk of the population in May, finishing work at the end of July. Data that encourage different states to relax winter restrictions and reopen, for example, public schools.

Here is the tension between the obvious improvement in numbers and the uncertainty posed by the new strains. The British, according to a study by Public Health England, could get around the defenses of current vaccines. Mutations cloud one of the most popular disciplines of the last year: futurology. Hopes that the viral landscape will clear up in 2021, with vaccination and the consequent group immunity, have cooled and been replaced by a midway stage; a kind of semi-normality.

“Unfortunately, as [the virus] spreads it can also mutate,” Alex Gorsky, CEO of Johnson & Johnson pharmaceuticals, told CNBC

“Every time it mutates, it’s almost like another click of the dial so to speak where we can see another variant, another mutation that can have an impact on its ability to fend off antibodies or to have a different kind of response not only to a therapeutic but also to a vaccine.”

Gorsky added that this could cause the disease to become endemic, forcing the population to be vaccinated annually, as happens with the flu. The virus would continue to circulate, although in a more deaf and minority way; scientists would continue looking for possible mutations and pharmaceutical companies renewing their vaccines. 

Johnson & Johnson is waiting for the US regulator to give the green light, which would join Moderna and Pfizer-BioNTech.

Even if there were no mutations, vaccines wouldn’t be the panacea either. When we read about the 95% efficacy ratio, for example, the number refers to the probability of the vaccinated showing covid symptoms. Another different issue, which has not been rigorously measured, is the extent to which the vaccinated person can continue to transmit the coronavirus to others, and how often.

The ordeal of the richest country in the world can still be put into the global context of the fight against the pandemic. The Biden Administration is on track to secure about 600 million doses: enough to vaccinate the country’s adult population more than twice. Meanwhile, 130 nations around the world have yet to apply a single dose, and others vaccinate at a rate hundreds or thousands of times less than the American giant. According to the World Health Organization, 75% of vaccines have been distributed in 10 countries.

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