Press play to listen to this article
Countries across Europe have banned travel from South Africa as fears rise over whether current vaccines will be effective against a new coronavirus variant first identified in the country.
The variant has rapidly replaced other strains in South Africa, with initial research linking it to higher viral loads and possibly increased transmissibility. The rise in cases in South Africa has pushed the country to the verge of another full nationwide lockdown as hospitals struggle to cope.
Much is still unknown about the new variant, but researchers in South Africa and elsewhere are rapidly investigating everything from whether it results in more severe COVID-19 to whether it will curb the efficacy of a vaccine.
Is it more dangerous than other variants?
Changes to the virus’ genetic makeup aren’t new. There are many other variants of COVID-19 — some more infectious, some more deadly. For example, the newly identified U.K. variant is considered significantly more infectious but not more deadly.
The first (as yet unpublished) paper documenting the South African variant found it spread rapidly and, within weeks, was the dominant variant in several regions in the country. The researchers suggest the variant may be associated with increased transmissibility.
Eminent South African infectious diseases epidemiologist Salim Abdool Karim, co-chair of the country’s advisory committee on COVID-19, wrote in a briefing on December 18 that the higher viral load in swabs of the new variant may translate into higher transmissibility — and that this variant is transmitting more quickly. This could mean that South Africa’s second wave is larger than the first, he noted.
What’s not yet known is whether the variant makes for more severe disease. In fact, the World Health Organization (WHO) said on December 31 that there’s “no clear evidence of the new variant being associated with more severe disease or worse outcomes.” However, as the WHO notes, more cases could mean more hospitalizations and ultimately more deaths.
U.K. Health Secretary Matt Hancock said Monday that he’s “incredibly worried” about the South African variant, telling the BBC that it’s a “very, very significant problem.”
When announcing the U.K.’s travel ban on South Africa on December 23, Hancock claimed the strain was “yet more transmissible and appeared to have mutated further than the new variant that has been discovered here.” John Bell, regius professor of medicine at the University of Oxford, told Times Radio on January 3 that he’s more worried “by some margin” about the South African variant compared to the British one.
How far has it already spread?
The South African variant was first detected in the Nelson Mandela Bay region in South Africa in October, with research indicating it could have been in circulation from as early as the end of August. The variant then spread across the country, including to Cape Town, a popular tourist destination. South Africa’s international travel ban was lifted on October 1 for holidaymakers in possession of a negative COVID-19 test, meaning that people could have been bringing the new variant to other countries since then.
According to reports, the variant has been detected in the U.K., Finland, Switzerland, Japan and Australia.
Will vaccines work on the new variants?
The major question now is whether the new variants’ mutations may render a vaccine ineffective. While both the U.K. and South African variants have mutations on the all important receptor-binding domain — which allows the virus to gain entry to human cells — Oxford’s Bell is particularly concerned about the mutation that the South African variant has in this part of the virus.
Bell said he and his team at Oxford are looking at this right now, but his “gut feeling” is that the vaccines will still be effective against the U.K. strain. However, he warned, there’s a “big question mark” over whether the same can be said about the South African one.
Work is also currently being undertaken by several research institutions in South Africa as well as the U.K.’s Porton Down laboratory to determine whether existing vaccines will be effective.
Jonathan Van-Tam, England’s deputy chief medical officer, said in response to a question from POLITICO on December 30 that this work can take 12 to 14 days, and that it may be a couple of weeks before scientists can give “a solid steer” on whether the vaccines will be effective on new variants.
However, Van-Tam said there’s cause for optimism, explaining that work was underway by scientists across the world “looking at a whole range of variant strains and they are showing, by and large, that the neutralization is quite cross-reactive.”
“In other words, the vaccines will cover quite a large range of variants,” he said.
Van-Tam added that because the vaccines produce many different types of antibodies, the variants would have to have “very, very substantial mutations” to “outwit these vaccines altogether.”
Meanwhile, BioNTech has said its vaccine developed with Pfizer is “relatively likely” to work on the U.K. variant.
Are travel bans effective?
The most effective way to reduce the spread of the new variants is to limit people’s interactions, which includes travel restrictions, according to a joint December 23 paper by the U.K.’s independent scientific groups looking at transmission.
The WHO, which has been cautious about calling for outright travel bans, has issued interim guidance recommending a risk-based approach to travel bans, looking at, among other things, local transmission, health service capacity and the level of transmissibility of specific variants.
It also advises that people residing in areas with community-wide movement restrictions should only travel for essential purposes.
Commenting on the spread of the South African variant to the U.K., Lawrence Young, professor of molecular oncology at the University of Warwick, said the U.K. needed to do “everything possible” to stop it. “Quarantine measures and restricting travel from and to South Africa are imperative,” he said.
But with the new variant already present in several countries, it’s unclear whether travel bans will be enough to prevent its spread. Similar bans on travel from the U.K. were announced in the wake of news that a new, more transmissible variant was discovered, but to date, dozens of countries have reported the presence of the British variant in their countries.
Will there be further mutations?
It’s likely that the U.K and South African variants won’t be the last of their kind, with experts suggesting that we brace ourselves for yet more mutant variants. In fact, there could be other more transmissible variants that aren’t being found because they aren’t being sequenced.
Ravindra Gupta, professor of clinical microbiology at the University of Cambridge, said it’s “no coincidence that the two places with these interesting variants are both places with the most sequencing coverage.”
“That’s a real lesson for the rest of the world,” he warned.
Additional reporting by Charlie Cooper and Jillian Deutsch.
This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.