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New C-19 strains challenge where we stand

Published : Sunday, 4 April, 2021 at 12:00 AM  Count : 614
ZUBAIR KHALED HUQ
New variants of the coronavirus have spread in Bangladesh, particularly in Dhaka and Chittagong. The two cities have recorded some of the sharpest increase in cases last week, with Dhaka contributing more than half the new cases, recorded across the country daily. Health authorities have held off on concluding that the variants are responsible for the surge, but experts believe a correlation is likely, given what the world knows about Sars-CoV-2 mutations. In several countries, most notably in the United Kingdom (UK), at the outset of winter last year, a variant set off a runaway outbreak not unlike what appears to be in Bangladesh at the moment.   

We must step up genome surveillance, to double on vaccine production and perhaps even come up with more resilient doses; and citizens to arm themselves with the two tools that can stop the virus, no matter what the variant vaccines and Covid-19 appropriate behaviour. It will be likely if the current trend of new cases arises, the new strain will spread in other districts as well. So, along with vaccination, we must go with proper etiquette to give us double protection.

Any indifference shown by mass people will enforce the government to go for further stringent action. The economy will be jeopardised, for saving lives. If we are a bit concerned along with the government we can save the economy and life together.     

We do not need nor has worry; science has given us the tools that make adapting to this new normal possible. The process of identifying these mutations, their behaviour and prevalence, can help the vaccine producers, planners to find out the more appropriate vaccine type, and dose for vaccination. We are seeing more new cases among children. Thanks to global scientific collaboration, it will be easy to determine, if proper tools of research are used. Determining how far a variant has spread and its particularly difficult containment. This will require the government to step up genome surveillance; if we get help from GAVI, WHO it can help in detection and containment in this region.

It is natural for viruses to mutate when they replicate as they spread within a population. Molecular clock calculation estimated that the Sars-Cov-2 picked up two mutations on average every month. But the virus also picks up a combination of mutations that could change how it affects individuals it can become less or more infective or lethal. In August, scientists in Singapore said they found amputation that was milder but in line with laws of evolution, it was overtaken by variants that were "fitter" in spreading. In mid-November, the first such significantly fitter variant arose in the UK, triggering a wave that the country took months to surmount. Scientists believe this sort of evolution will become a large part of the new normal.  

The transmission trend of the virus and the ICU occupancy in hospitals needs to be watched closely. Another important factor is ICU bed occupancy. The severity of the illness can be measured by the increase in ICU admissions rather than hospital admissions. The vaccination drive too should be speeded up so that the spread of the disease can be curbed. Under the circumstances, wearing masks, maintaining social distancing and following a healthy lifestyle continue to be the best way to tackle the virus.

The recent spike in the number of Covid-19 cases calls for more responsibility from the people. Each citizen must take all necessary precautions and stay vigilant. In case anyone experiences Covid-19 related symptoms, they must immediately get themselves quarantined and tested. The current situation demands strict adherence to the safety protocol to prevent the virus from spreading any further.    

The days ahead will be challenging for the healthcare sector. Moreover, the evidence right now suggests that masks, social distancing, avoiding groups, washing hands and other measures urged by public health officials will still effectively slow the new strain until mass vaccinations provide herd immunity sometime this summer. No one is sure why children remain so resistant both to the initial infection and then to serious side effects if they do get infected.    

Resistance to a virus is likely to stem from characteristics of our immune systems, as well as other key factors, according to a summary of the research from Nature, a peer-reviewed scientific journal. Children have fast-acting immune systems that respond quickly to new viruses. Older people devote more of their immune system effort to developing immune system T-cells that remember viruses from past exposures.

Something in the speed of the response among children coupled with their inexperienced T-cells apparently marshals a response so quickly that the virus has a harder time getting a foothold. Besides, children breathe in much less air per lungful which might mean they get a smaller dose when exposed. Their noses also have fewer ACE2 receptors, which is one of the types of cells COVID latches onto and infects.   

Finally, children are much more exposed to the common cold which is also caused by a coronavirus. Perhaps that exposure to a far less harmful relative of Covid-19 leaves their immune systems better prepared. The Covid-19 vaccines that are currently in development or have been approved are expected to provide at least some protection against new virus variants because these vaccines elicit a broad immune response involving a range of antibodies and cells. Therefore, changes or mutations in the virus should not make vaccines completely ineffective. If any of these vaccines prove to be less effective against one or more variants, it will be possible to change the composition of the vaccines to protect against these variants.      

While we are learning more, we need to do everything possible to stop the spread of the virus to prevent mutations that may reduce the efficacy of existing vaccines. Also, manufacturers and the programmes using the vaccines may have to adjust to the evolution of the Covid-19 virus: for example, vaccines may need to incorporate more than one strain when in development, booster shots may be required, and other vaccine changes may be needed.

Trials must also be designed and maintained to allow any changes in efficacy to be assessed, and must be of sufficient scale and diversity to enable clear interpretation of results. Studies of the impact of vaccines as they are deployed are also essential in order to understand their impact. Current measures to reduce transmission  including frequent hand washing, wearing a mask, physical distancing, good ventilation and avoiding crowded places or closed settings  continue to work against new variants by reducing the amount of viral transmission and therefore also reducing opportunities for the virus to mutate.    

Scaling up vaccine manufacturing and rolling out vaccines as quickly and widely as possible will also be critic always of protecting people before they are exposed to the virus and the risk of new variants. Priority should be given to vaccinating high-risk groups everywhere to maximize global protection against new variants and minimize the risk of transmission.
Dr Zubair Khaled Huq is Family Medicine, Gerontologist, Public Health Specialist





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