Healthcare
Explained: The 3 Major COVID-19 Variants
Explained: The 3 Major COVID-19 Variants
As billions of people gear up for widespread vaccination against COVID-19, another issue has reared its head. Three major COVID-19 variants have emerged across the globe—and preliminary research suggests these variants may be cause for concern.
But what makes them different from the original strain?
The following visualizations answer some key questions, including when these variants were first discovered, how far they’ve spread worldwide, and most importantly, their potential impact on the population.
Some Context: What is a Variant?
Before diving in, it’s important to understand why viruses mutate in the first place.
To infect someone, a virus takes over a host cell and uses it to replicate itself. But nature isn’t perfect, and sometimes, mistakes are made during the replication process—those mistakes are called mutations.
A virus with one or more mutations is referred to as a variant. Most of the time, variants do not affect a virus’s physical structure, and in those instances, they eventually disappear. However, there are certain cases when a mutation impacts part of a virus’s genetic makeup that does change its behavior.
According to the U.S. Centers for Disease Control (CDC) a change in behavior can alter:
- Rate of transmission
- Deadliness
- Ability to potentially infect someone with natural or vaccine-induced immunity
Preliminary research has detected some of these changes in the three major COVID-19 variants—B.1.1.7, B.1.351, and P.1.
The 3 Major COVID-19 Variants
The three major variants emerged at different times, and in different parts of the world. Here’s an overview of each variant, when they were discovered, and how far they’ve spread so far.
B.1.1.7
The B.1.1.7 variant was detected in the UK in the fall of 2020. By December 2020, it had spread across the globe, with cases emerging across Europe, North America, and Asia.
Currently, the variant has been reported in roughly 94 countries.
Early research suggests it’s 50% more transmissible than other variants, and potentially 35% more deadly than the standard virus. Luckily, studies suggest that some of the existing vaccines work well against it.
B.1.351
In October 2020, the second major variant was discovered—B.1.351. It was first identified in South Africa, but by end of the year, it had spread to the UK, Switzerland, Australia, and Japan.
There are approximately 48 countries with reported cases, and research suggests several of the existing COVID-19 vaccines may not be as effective against this variant.
P.1
The P.1 variant was the last to arrive on the scene.
It was first discovered in January 2021, when Japan reported four cases of the variant, which was found in travelers who had arrived from Brazil.
Approximately 25 countries have reported cases of the P.1 variant, and early research suggests this variant is not only more contagious, but could also have the ability to infect people with natural immunity who had already recovered from the original strain.
Still Early Days
While there have been preliminary studies showing a dip in vaccine effectiveness, some experts emphasize that it’s too early to tell for certain. More data is needed to gain a deeper and more accurate understanding.
In the meantime, experts are emphasizing the importance of following our current public health strategies, which include physical distancing, vaccination, washing your hands, and using masks.
Misc
Explainer: What to Know About Monkeypox
What is monkeypox, and what risk does it pose to the public? This infographic breaks down the symptoms, transmission, and more.
Explainer: What to Know About Monkeypox
The COVID-19 pandemic is still fresh in the minds of the people around the world, so it comes as no surprise that recent outbreaks of another virus are grabbing headlines.
Monkeypox outbreaks have now been reported in multiple countries, and it has scientists paying close attention. For everyone else, numerous questions come to the surface:
- How serious is this virus?
- How contagious is it?
- Could monkeypox develop into a new pandemic?
Below, we answer these questions and more.
What is Monkeypox?
Monkeypox is a virus in the Orthopoxvirus genus which also includes the variola virus (which causes smallpox) and the cowpox virus. The primary symptoms include fever, swollen lymph nodes, and a distinctive bumpy rash.
There are two major strains of the virus that pose very different risks:
- Congo Basin strain: 1 in 10 people infected with this strain have died
- West African strain: Approximately 1 in 100 people infected with this strain died
At the moment, health authorities in the UK have indicated they’re seeing the milder strain in patients there.
Where did Monkeypox Originate From?
The virus was originally discovered in the Democratic Republic of Congo in monkeys kept for research purposes (hence the name). Eventually, the virus made the jump to humans more than a decade after its discovery in 1958.
It is widely assumed that vaccination against another similar virus, smallpox, helped keep monkeypox outbreaks from occurring in human populations. Ironically, the successful eradication of smallpox, and eventual winding down of that vaccine program, has opened the door to a new viral threat. There is now a growing population of people who no longer have immunity against the virus.
Now that travel restrictions are lifting in many parts of the world, viruses are now able to hop between nations again. As of the publishing of this article, a handful of cases have now been reported in the U.S., Canada, the UK, and a number of European countries.
On the upside, contact tracing has helped authorities piece together the transmission of the virus. While cases are rare in Europe and North America, it is considered endemic in parts of West Africa. For example, the World Health Organization reports that Nigeria has experienced over 550 reported monkeypox cases from 2017 to today. The current UK outbreak originated from an individual who returned from a trip to Nigeria.
Could Monkeypox become a new pandemic?
Monkeypox, which primarily spreads through animal-to-human interaction, is not known to spread easily between humans. Most individuals infected with monkeypox pass the virus to between zero and one person, so outbreaks typically fizzle out. For this reason, the fact that outbreaks are occurring in several countries simultaneously is concerning for health authorities and organizations that monitor viral transmission. Experts are entertaining the possibility that the virus’ rate of transmission has increased.
Images of people covered in monkeypox lesions are shocking, and people are understandably concerned by this virus, but the good news is that members of the general public have little to fear at this stage.
I think the risk to the general public at this point, from the information we have, is very, very low.
–Tom Inglesby, Director, Johns Hopkins Center for Health Security
» For up-to-date information on monkeypox cases, check out Global.Health’s tracking spreadsheet
Healthcare
Visualizing How COVID-19 Antiviral Pills and Vaccines Work at the Cellular Level
Despite tackling the same disease, vaccines and antiviral pills work differently to combat COVID-19. We visualize how they work in the body.
Current Strategies to Tackle COVID-19
Since the pandemic started in 2020, a number of therapies have been developed to combat COVID-19.
The leading options for preventing infection include social distancing, mask-wearing, and vaccination. They are still recommended during the upsurge of the coronavirus’s latest mutation, the Omicron variant.
But in December 2021, The United States Food and Drug Administration (USDA) granted Emergency Use Authorization to two experimental pills for the treatment of new COVID-19 cases.
These medications, one made by Pfizer and the other by Merck & Co., hope to contribute to the fight against the coronavirus and its variants. Alongside vaccinations, they may help to curb extreme cases of COVID-19 by reducing the need for hospitalization.
Despite tackling the same disease, vaccines and pills work differently:
| Vaccines | Pills |
|---|---|
| Taken by injection | Taken by mouth |
| Used for prevention | Used for treatment only |
| Create an enhanced immune system by stimulating antibody production | Disrupt the assembly of new viral particles |
How a Vaccine Helps Prevent COVID-19
The main purpose of a vaccine is to prewarn the body of a potential COVID-19 infection by creating antibodies that target and destroy the coronavirus.
In order to do this, the immune system needs an antigen.
It’s difficult to do this risk-free since all antigens exist directly on a virus. Luckily, vaccines safely expose antigens to our immune systems without the dangerous parts of the virus.
In the case of COVID-19, the coronavirus’s antigen is the spike protein that covers its outer surface. Vaccines inject antigen-building instructions* and use our own cellular machinery to build the coronavirus antigen from scratch.
When exposed to the spike protein, the immune system begins to assemble antigen-specific antibodies. These antibodies wait for the opportunity to attack the real spike protein when a coronavirus enters the body. Since antibodies decrease over time, booster immunizations help to maintain a strong line of defense.
*While different vaccine technologies exist, they all do a similar thing: introduce an antigen and build a stronger immune system.
How COVID Antiviral Pills Work
Antiviral pills, unlike vaccines, are not a preventative strategy. Instead, they treat an infected individual experiencing symptoms from the virus.
Two drugs are now entering the market. Merck & Co.’s Lagevrio®, composed of one molecule, and Pfizer’s Paxlovid®, composed of two.
These medications disrupt specific processes in the viral assembly line to choke the virus’s ability to replicate.
The Mechanism of Molnupiravir
RNA-dependent RNA Polymerase (RdRp) is a cellular component that works similar to a photocopying machine for the virus’s genetic instructions. An infected host cell is forced to produce RdRp, which starts generating more copies of the virus’s RNA.
Molnupiravir, developed by Merck & Co., is a polymerase inhibitor. It inserts itself into the viral instructions that RdRp is copying, jumbling the contents. The RdRp then produces junk.
The Mechanism of Nirmatrelvir + Ritonavir
A replicating virus makes proteins necessary for its survival in a large, clumped mass called a polyprotein. A cellular component called a protease cuts a virus’s polyprotein into smaller, workable pieces.
Pfizer’s antiviral medication is a protease inhibitor made of two pills:
- The first pill, nirmatrelvir, stops protease from cutting viral products into smaller pieces.
- The second pill, ritonavir, protects nirmatrelvir from destruction by the body and allows it to keep working.
With a faulty polymerase or a large, unusable polyprotein, antiviral medications make it difficult for the coronavirus to replicate. If treated early enough, they can lessen the virus’s impact on the body.
The Future of COVID Antiviral Pills and Medications
Antiviral medications seem to have a bright future ahead of them.
COVID-19 antivirals are based on early research done on coronaviruses from the 2002-04 SARS-CoV and the 2012 MERS-CoV outbreaks. Current breakthroughs in this technology may pave the way for better pharmaceuticals in the future.
One half of Pfizer’s medication, ritonavir, currently treats many other viruses including HIV/AIDS.
Gilead Science is currently developing oral derivatives of remdesivir, another polymerase inhibitor currently only offered to inpatients in the United States.
More coronavirus antivirals are currently in the pipeline, offering a glimpse of control on the looming presence of COVID-19.
Author’s Note: The medical information in this article is an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please talk to your doctor before undergoing any treatment for COVID-19. If you become sick and believe you may have symptoms of COVID-19, please follow the CDC guidelines.
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