The Other Way That COVID-19 Could End Without Vaccine: Mutation

Right now, the only chance of getting out of the Covid-19 pandemic unscathed seems to be getting a vaccine.

In fact, Singapore seems to be intent on being able to get at least one vaccine for our country as fast as possible.

But is there no way out of Covid-19 other than a vaccine?

We now know that herd immunity is practically impossible, at least for Covid-19.

One, because getting everyone infected to get herd immunity could lead to unimaginable collateral damage.

Just look at the UK.

And two, no one is sure that protection against Covid-19 after recovering will last forever.

But how about the coronavirus mutating itself into history?

How Virus Mutation Works:

Viruses tend not to stay in the same state as they first came in, like a kitchen knife.

Instead, think of them like your iPhone, where it constantly updates itself until it dies on you.

And when these viruses mutate, they typically go down either of these two routes:

• The symptoms become less severe, allowing the virus to live long enough to reproduce
• or the symptoms become more severe, so the virus dies out quicker since the hosts will die before it has a chance to spread

Coronaviruses are said to be slower in mutating, which is good news because it means any vaccines developed will be able to deal with it for a long time.

But in August 2020, news started appearing about how Covid-19 might have mutated.

The ‘G’ Variant

On 16 Aug, Malaysia announced that they’ve found a mutated strain of the Covid-19 virus, the D614G, within the country.

They added that the new strain seems to be 10 times more infectious than the original strain.

Then, the Philippines also chimed in to say that they found the mutated strain within their own country too.

Before Singaporeans could worry themselves into a frenzy and send their foreign domestic workers home, it turns out that the mutated Covid-19 strain is in Singapore as well.

And it has been here for quite a while.

Associate Professor Hsu Liyang, an infectious diseases specialist and epidemiologist, said this mutation has been circulating here since February.

Speaking to The Straits Times, Prof Hsu said that Singapore sequences a sampling of the virus from Covid-19 patients here, and has found more than 100 patients with the D614G strain.

Since only a fraction of virus samples are sequenced, this could mean that there are thousands of patients here infected with the D614G mutation.

Expert: It’s Actually Better

Remember the point about coronaviruses mutating to have less severe symptoms so it can spread to more people?

Well, that’s what this expert was thinking when he said it’s better if the dominant strain of Covid-19 here in Singapore is D614G.

Dr Paul Tambyah, the president-elect of the International Society of Infectious Diseases, said the rapid growth of the D614G mutation in some parts of the world has coincided with a drop in death rates.

This could mean the D614G mutation is less lethal.

“Maybe that’s a good thing to have a virus that is more infectious but less deadly,” Dr Tambyah said in an interview with Reuters.

Dr Tambyah, who’s also a senior consultant at the National University of Singapore, said that viruses tend to become less potent as they mutate.

“It is in the virus’ interest to infect more people but not to kill them because a virus depends on the host for food and for shelter,” he said.

Although it’s not like the coronavirus has a grand plan or anything, of course. It’s simply a random mutation, much like how some people have the ability to listen to Donald Trump without rolling their eyes.

Erica Ollmann Saphire, PhD, a professor at the La Jolla Institute, says that while a virus can’t ‘want’ anything, a virus that survives is one that spreads further and more efficiently, as Covid-19 did.

It’s almost similar to the common cold, she added.

According to Healthline, the Sars-CoV-2 is an RNA virus, and RNA viruses usually mutate to become a weaker version of the original.

Vaccine Effectiveness

Now, the biggest question of the day: will the mutation lead to vaccines becoming ineffective?

According to Healthline, Covid-19 vaccines currently in development will still be effective against new strains of the coronavirus.

To understand why, one has to grasp how mutations form.

See, the new coronavirus is an RNA virus: a collection of genetic material packed inside a protein shell.

When an RNA virus finds a host (a human or animal body) it starts to make new copies of itself that can infect other bodies.

Think of it as the Starbucks of the virus world.

Though RNA viruses are more prone to changes and mutations, these mutations occur at a very slow pace, according to Healthline.

And when it does mutate, the new copies aren’t that different from the original virus.

So, even if a new strain were more infectious or deadly, it would likely not impact the efficacy of vaccines.

This is because vaccines target an early version of the virus, and since the new strains are not that far off, it will be effective against them too.

Usually, an older strain of a virus will “preserve enough features” that it will provide immunity against a whole group of variants,” said Dr Benjamin Neuman, the head of the biology department at Texas A&M University-Texarkana.

So, what happens now?

Nothing.

The mutation has proven itself to be more transmissible but there was no (official) indication whether it was deadlier or milder compared to the dominant strain the original coronavirus.

Researchers are keeping a close eye on the Sars-CoV-2 genetic makeup, making sure that another mutation wouldn’t lead to a deadlier variant.

It should be noted, however, that the mutated Covid-19 variant is suspected to be even more infectious, which means that social distancing measures and mask-wearing now becomes even more important than ever.

This includes wearing masks whenever you’re out of your home, wash your hand frequently with soap and only socialising in a group of up to 5 people.

Mr Lawrence Wong has also asked for help from the members of the public to keep Covid-19 transmission down.

The latest move by the task force is to implement new rules for F&B outlets; businesses can only play background music at a soft volume because if the music is too loud, diners will have to shout over the music to be heard.

This results in more spittle (aerosol) droplets in the air which heightens the chance of Covid-19 transmission.

Treating The Disease

What’s the second prize if we fail to obtain a vaccine?

Understanding how to treat the disease that occurs from Covid-19 infection, just like what we did with HIV.

While no HIV vaccine has been developed yet, the disease is not the death sentence it once was thanks to preventative treatments.

“In HIV, we’ve been able to make that a chronic disease with antivirals. We’ve done what we’ve always hoped to do with cancer,” Offit says.

Pre-exposure prophylaxis, or PrEP, is a preventative pill that has protected thousands of people at risk of contracting HIV from the disease.

In the absence of a vaccine, we could manage Covid-19 in a similar manner.

And hopefully, the treatment can be found soon with the weaker variant of Covid-19 that was discovered just recently in Singapore.

S’pore Researchers Found New Strain of Coronavirus That is ‘Weaker’ 

On 21 Aug 2020, Singapore reported discovering a new ‘weaker’ variant of Covid-19 in Singapore.

Researchers say this latest strain emerged early in the pandemic in Wuhan and was exported to Singapore and Taiwan.

In fact, it was detected soon after the coronavirus reached Singapore’s shores, as confirmed patients were found to have the variant in January and February.

The good news is that those infected with the new variant had better clinical outcomes than those infected by other strains, suggesting this new strain could be less deadly.

ST reported that a smaller percentage of these patients experienced hypoxia (where the body is short of oxygen), where supplemental oxygen would be required.

While the variant is no longer circulating in Singapore, the research community in Singapore is excited as this is the first time a difference in genes results in different clinical outcomes.

So what’s different between the dominant variant of Covid-19 and the weaker version?

According to CNA, there is a deletion (or missing genes) within the variant that leads to patients suffering from milder symptoms.

Here’s a simple example by a non-medical student:

• Dominant strain: A-B-C
• Weaker variant: A-C

So since it appears that a dominant strain could be made weaker by removing ‘B’, researchers could develop a treatment using medication that targets the ‘B’ segment of the dominant strain, potentially lessening the severity of symptoms faced by patients, saving more lives.

Of course, that’s just a simple example and the real work is definitely harder.

Further studies are now being carried out on how to understand the deletion region and remove it from the dominant strain.