Who will develop Brazil or India faster?

British, South African, Brazilian variantsHow dangerous are the coronavirus mutations?

When viruses multiply, errors and mutations occur. Around 12,000 mutations of SARS-CoV-2 are registered worldwide. However, so far only a few mutants have developed in such a way that they give the pathogen selective advantages and accelerate the course of the pandemic. According to the RKI, the British B.1.1.7, the South African B.1.351 and the Brazilian P.1 are considered questionable variants (Variants of Concern, abbreviated to VOC).

The variants are known to have changed the structure of the spike protein. With this protein molecule, the virus docks on the surface of body cells and gains entry. Thus, figuratively speaking, the mutations have a better key and get into human cells faster and more effectively.

British variant B.1.1.7

The British coronavirus mutant B.1.1.7 has now established itself in Germany and is the dominant variant. B.1.1.7 is currently found in 93 percent of the positive samples examined in Germany, i.e. in nine out of ten samples. (As of: April 21, 2021)

Differences B.1.1.7 to the wild type

In the British variant, the virus has mutated in several places. The spike protein has been modified in such a way that it can dock better with human body cells. Researchers suspect that this also increases the viral load and extends the course of the disease by several days - instead of eight to more than 13 days. Therefore, 14 days of quarantine are currently imposed in Germany.

What course of the disease can be expected in the event of an infection with B.1.1.7?

The mutant virus is between 43 and 90 percent more contagious than the original virus. According to a study from April 2021, however, it may not be more dangerous in terms of the course of the disease. The scientists could not find a link between the variant and serious illness or death. The infectiologist Clemens Wendtner explained on Deutschlandfunk that the symptoms were the same as with the standard variant - with one exception: children could also become more seriously ill.

How effective are previous vaccines against B.1.1.7?

The vaccines approved in Germany also protect against the British mutant. The vaccine from BioNTech / Pfizer is effective, data on the study were published in the journal "Nature Medicine". Moderna also reports that the variant is highly effective. According to a study that has not yet been completed, the vaccine from AstrazenecaZeneca is as effective as against the wild type - it is 75 percent effective.

Overview on the subject of coronavirus (imago / Rob Engelaar / Hollandse Hoogte)

South African variant B.1.351

The South African variant plays only a very minor role in Germany. According to the RKI, their share is consistently a good one percent of the samples examined.

Differences B.1.351 to the wild type

B.1.361 also contains several mutations, one of which is in the spike protein, which apparently affects the binding of antibodies. This mutant can thus evade the immune response better. Researchers estimate that B.1.351 is about 50 to 60 percent more contagious than the wild type, i.e. not quite as contagious as the British mutant. Here, too, more and more younger people seem to be infected - including children.

What course of disease can be expected in B.1.351?

Because B.1.351 is more contagious than the wild type, only smaller amounts of virus are required to trigger an infection. There is also evidence that people can get infected again with this variant after surviving the infection. According to the K.R.I.S.P. researchers from Durban, South Africa, the new mutant does not appear to be any more deadly than the original virus.

How effective are previous vaccines against B.1.351?

The South African mutant B.1.351 causes concern because it can partially evade the immune response. This could reduce the effectiveness of the vaccines. According to a study, the Astrazenecazeneca vaccine should only offer "minimal protection" against mild and moderate disease courses. "Those who have been vaccinated can become infected and then develop symptoms," explains Dlf science journalist Volkart Wildermuth, adding: "However, they still seem to be protected from a serious course of the disease."

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The vaccines from BioNTech / Pfizer and Moderna, on the other hand, are also effective against the mutations of SARS-CoV-2 that have appeared in South Africa.

Brazilian variant P.1

Variant P.1 has so far only been found sporadically in Germany and, according to the RKI, currently has a consistently low proportion of 0.1 percent.

Differences between P.1 and the wild type

P.1 has several mutations; according to the RKI, it is similar in its changes to the South African variant. Here, too, there seems to be a reduced effectiveness of neutralizing antibodies in those who have recovered or who have been vaccinated. In addition, this mutant also appears to be more contagious than the wild type. Researchers report a 1.4 to 2.2 times increased transferability.

Which courses of illness are to be expected in P.1?

There is little reliable data on this. One study comes to the conclusion that there is an increase in the relative mortality risk due to P.1. there, but they only examined the situation in the Brazilian city of Manaus, whose health system was overloaded. The researchers also come to the conclusion that one can become infected again with the wild type despite surviving an infection.

How effective are previous vaccines against P.1?

So far there have been only a few and contradicting studies. A preliminary report concludes that vaccines against P.1 work better than against the South African variant - but worse than against the wild type. According to another study that has not yet been published, however, the vaccines from Biontech / Pfizer and Modena have a lower protective effect.

Indian variant B.1.617

Hundreds of thousands of new corona infections were recently reported in India within one day. This is the highest increase that has been recorded worldwide to date. The World Health Organization (WHO) has now classified the coronavirus variant as "worrying" - that is, in the highest category. There are indications that B.1.617 is more contagious and possibly also less sensitive to antibodies, according to the WHO. In addition to the virus mutant and the state of the health system, religious, political and sporting mass events are also responsible for the massive increase in the number. 22 cases have been reported in Germany so far (as of May 11, 21).

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Analyzes from Great Britain show that the incidence of the Indian variant there has almost doubled every week over the past few weeks, with the overall incidence falling. This development is also relevant for Germany, because the development in Great Britain is usually two weeks ahead of that in Germany. The Robert Koch Institute has also confirmed in a new report (as of May 12) that the proportion of the Indian mutation has risen steadily in recent weeks. According to the RKi, the proportion of the virus variant in the samples examined has risen steadily recently and is currently around 2 percent. So that's more than the variants from Brazil or South Africa, which have been discovered here a lot longer.

Differences B.1.617 to the wild type

Compared to the original virus, the mutant has 15 mutations, two of which concern the spike protein, which is why the variant is also known as a double mutant. These mutations are already known from other variants when viewed individually. One mutation is supposed to suppress the antibody response somewhat and the other mutation the cellular, the second arm of the immune response. This may result in a mutually reinforcing effect, explains Lars Schaade, Vice President of the Robert Koch Institute. But it is not a cross between two different mutants, emphasized the head of virology at the Berlin Charité, Christian Drosten in the NDR podcast "The Coronavirus Update".

Which courses of illness can be expected with B.1.617?

Because there are too few specialized laboratories in India that can carry out sequencing, it is too early to say whether B.1.617 is spreading faster and whether the Indian double mutant actually undermines the vaccination and immune protection of those who have recovered. Available data from India so far show no higher mortality or more severe symptoms from B.1.617. According to the WHO, the overloading of clinics could also contribute to increased mortality.

How effective are previous vaccines against B.1.617?

Indian researchers assume that vaccinations against this variant help. However, they point out that the amount of data is not yet sufficient to really reliably evaluate B 1.617. "The mutations in the spike protein do not seem to cause a significant weakening of the antibody neutralization, so I do not expect that vaccination protection is endangered by this virus variant," says Leif-Erik Sander, head of the Infection Immunology and Vaccine Research Research Group at the Charité in Berlin. According to fresh data from New York University researchers, which have not yet been verified by experts, it looks like the vaccines are working well against the Indian variant, reported medical journalist Christina Sartori in the Dlf.

Tyrolean variant B1.1.7 + E484K

The variant, which occurs mainly in the Austrian state of Tyrol, does not seem to be spreading any further. The RKI has been classifying Tyrol as a simple risk area again since March 28th. It was previously considered a virus variant area.

Differences between B1.1.7 + E484K and wild type

B1.1.7 + E484K is a combination of the British variant B.1.1.7 and an additional mutation. The Innsbruck virologist Dorothee von Laer describes B1.1.7 + E484K as an "escape variant", which was already in circulation worldwide before, but only spread strongly in the Schwaz district after the first round of vaccination. The partial immunization there was the breeding ground for the outbreak of the variant. Should this be omitted, the British variant could prevail again. B1.1.7 + E484K is also said to be more contagious than the original coronavirus.

What course of disease can be expected with B1.1.7 + E484K?

It is not yet clear whether the variant also leads to more severe courses and higher mortality. The data basis is still too thin. "One can only conclude that the partial immunization reduces the likelihood of severe courses. There are indications," said the virologist von Laer according to the "Tiroler Tageszeitung". As of April 27, only two of 729 people infected with this variant were in the intensive care unit, on Monday 800 people were still infected with the virus. Von Laer estimated that the level of danger was "comparable" to other variants. "It will probably stay with a mortality rate of half a percent."

How effective are previous vaccines against B1.1.7 + E484K?

A European pilot project is to research this. All citizens of the Austrian district of Schwaz can now be vaccinated against the corona virus. With this measure, the EU wants to check the effectiveness of the vaccine from Biontech / Pfizer - also against the South African variant, which has spread widely in the area.

What are the consequences of more infectious variants?

Mutations change a crucial parameter of the model calculations: the risk of infection by the virus. "For the individual it does not matter which variant he is infected with, the risk of a severe course remains the same," explains Dlf science journalist Volkart Wildermuth. "But socially it makes a big difference whether a virus spreads faster. Because then the countermeasures no longer work as well."

Do high case numbers lead to even more dangerous mutations?

High incidence values ​​combined with initially low vaccination rates are like a kind of incubator for mutations. According to a current research project from New York's Rockefeller University, however, it cannot be assumed that the virus can produce any number of new mutations. It is therefore possible that all relevant mutations have already been discovered.

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How do you combat escape variants and can vaccines be adapted?

As long as the virus continues to spread, new mutants can emerge that undermine the immune response and reduce the effectiveness of a vaccination, the escape mutations. However, vaccines can be adapted relatively easily to new mutations, because the central component of most vaccines is genetic information - and this can be changed relatively easily. Almost all known vaccine manufacturers are already working on it. So booster vaccinations will likely be needed.

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Mathias Pletz, Director of Infection Medicine and Hospital Hygiene at the University of Jena, explained in the Dlf that, on the other hand, when the virus circulation is low, fewer viruses replicate. This also reduces the likelihood that new mutants will arise in the process. Because of the basic immunity achieved in the population, the multitude of severe courses will no longer occur, even if there are mutants.

It is still unclear how resistant mutants actually are to coronavirus vaccines, said Dlf science journalist Volkert Wildermuth. Laboratory tests show, for example, that the antibodies of vaccinated people in the test tube against the South African and Brazilian variants are less effective. In reality, however, the immune system still seems to be able to cope with the variants. That means: Infection with the variants is possible despite the vaccination, but the probability of getting seriously ill with Covid-19 is low.

Sources: Dlf, RKI, Volkart Wildermuth, Tiroler Tageszeitung, ORF, jma, og