Dr Mohammad Didare Alam Muhsin :
Recently, COVID-19 pandemic has taken a very dangerous turn in India. The case numbers and death toll had started to drop in India last September, after a high of around 100,000 infections and 1,000 deaths per day, and by mid-February this year it dropped to an all-time low of about 10,000 and 100, respectively. But they began to rise again in March, and according to the latest statistics, the number of daily infections has crossed 400,000 and the number of deaths per day has exceeded 3,500.
While scientists are working tirelessly towards developing drugs and vaccines against corona virus, the virus also keeps changing its forms and challenging their efforts. The virus is changing forms — one after another. It constantly changes through mutation to give new variants of themselves. In the last year and a half since the emergence of the coronavirus, more than 4,000 mutations have occurred in the spike protein alone. However, most of these variants caused by mutations do not carry any special significance.
The latest addition to this list may be a new variant detected in neighboring India — the Indian variant, B.1.617. However, although this variant seems to be worrisome, its status has not yet been confirmed and so it is still considered a variant of interest. The UK regulatory authority, Public Health England, have categorized it as a ‘variant under investigation’.
What makes this variant unique is the combination of two ‘infamous’ mutations in its spike protein that were found separately in some of the previously identified dangerous variants, but not in any one together. That is the basis of dubbing it as ‘double mutant’. This does not necessarily mean that it contains just two mutations; it has rather more than a dozen. One mutation, E484Q, is similar to the E484K mutation in the Brazilian variant, the South African variant and some strains of the UK variant. Studies suggest that this mutation reduce the effectiveness of antibodies produced by previous infections or vaccinations. The second mutation, L452R, has previously been detected in the Californian variant. This mutation increases viral transmission by around 20% and reduces antibody efficacy by more than 50%, says Dr Anurag Agrawal, the director of CSIR-IGIB, India. So, it is clear that the presence of these two mutations together makes the virus more infectious and may let it evade antibodies produced by vaccination or previous infection. So, in theory, there is enough ground to consider it as a ‘variant of concern’. “The B.1.617 variant has all the hallmarks of a very dangerous virus,” William A. Haseltine, a former professor at Harvard Medical School wrote in a recent article in Forbes.
The question now is whether the practical evidence suggests this variant to be responsible for the recent surge in infections in India. There is good reason to believe so, as far as the genome sequencing data published in media are concerned. According to outbreak.info, a website tracker for COVID-19, the average prevalence of the variant in India surged to as high as 52% of samples sequenced in April from almost nothing in January. Meanwhile, the National Institute of Virology (NIV) in Pune, India reported that of 361 samples taken and sequenced in Maharashtra, the epicenter of recent outbreak, from January to March, 220, i.e., 61 per cent had the double mutation E484Q and L452R.
Experts, however, think it would be too early to conclude that this variant was responsible for the recent surge. One reason is that the number of samples sequenced so far was very small compared with the number of cases. “This sample size (i.e., 361 samples) is too small to conclude as Maharashtra has been conducting nearly two lakh tests per day.” — said a senior genome sequencing expert to PTI.
The virus has already been detected in Bangladesh. However, we need to consider that most of Bangladesh’s borders are with India. People are constantly moving across borders. So, it is quite sure that this variant has already entered Bangladesh. Therefore, it is necessary for Bangladesh to come up with an action plan right now. Amid devastating surge in COVID-19 infections in India and concerns over the new variant, Bangladesh like many other countries in the world imposed restrictions on the entry of travelers from India. However, it is not enough to impose such restrictions, quarantine returnees or sequence their samples. There is a need for massive sequencing initiatives by collecting samples from different parts of the country so that the variant can be quickly identified
One more thing needs special attention. The recent resurgence in COVID-19 infection in Bangladesh and India, after apparently having come down under control, showed with a finger in the eye that this deadly germ is very cunning, deceitful. After going on the backfoot for a while, it can change its form and hit back again with renewed vigor. So, there is no chance to be complacent even for a moment by looking at the statistics or thinking that I have been vaccinated. Remember, this deadly germ can attack you at the very moment of momentary carelessness. Therefore, you should always carry protective armor, such as hand washing / sanitization, wearing a mask, maintaining physical distance, and avoiding public gatherings, until you receive a convincing message that the killer has been completely eradicated. There is no chance of even minimal relaxation here.
(Dr Muhsin is Professor of Pharmacy, Jahangirnagar University).
