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It's a Race Between Vaccines and Variants

The fight between COVID-19 vaccines and variants is raging, and its outcome depends largely on us.

This article was first published in The Montreal Gazette.


On the one hand, the vaccine rollout is going quite well. Vaccine deliveries are increasing and more people are getting their shots. On the other hand, the variants are spreading and will soon make up most new cases. Which side will win, vaccine or variant depends largely on us.

There are actually four different variant strains we have to contend with. The U.K., South African, Brazilian and Nigerian variants are all present locally, though the U.K. variant is by far the most common. These variants are largely responsible for the surge in cases in Ontario and there is concern that the same could happen here.

It’s worth remembering, though, that these variants do not materialize out of thin air. Every time the virus infects someone, it makes copies of itself over and over again as it infects more cells. With every new person it infects, with every new copy it makes of itself, there is a potential for an error, that is, a mutation, to be introduced into the virus’s genetic code. When you have uncontrolled spread of the virus in a population, you increase the chances for such an error occurring because more people are getting infected and the virus is offered more opportunities to replicate.

Recent reports have also suggested that immuno-compromised patients who get infected with COVID-19 may not be able to fully clear the virus because of their weakened immune systems. This chronic infection would then give the virus ample time to develop new mutations as it replicates over and over in the patient’s body. Whether this mechanism is responsible for any of the circulating variants of concern, though, is still up for debate.

The important point is that when the virus has fewer opportunities to copy itself, it is less likely to mutate in any dangerous way. As has been quipped by many, that there will likely never be a New Zealand, Australian, South Korean or Taiwanese variant because these countries did rather good jobs at controlling their outbreaks and the virus had no opportunity to evolve.

Going forward, if we are going to contain the spread of the new variants and prevent the development of new ones, we are going to have to rely on the same public health measures that have served us well up until now. Though these are new variants, they are still the same virus. So even if they are more infectious, if you stay home, wear a mask, keep your distance and wash your hands, your risk of being infected decreases substantially. Also, the more we can tamp down the daily case numbers, the less community spread there will be and the lower the overall risk to everyone.

The vaccines will eventually provide broad protection against COVID-19, but we are still a long way from vaccinating the majority of the population. There are concerns that the current vaccines may not protect us against new variants. For now, the data suggests they will, at least against the U.K. variant that is currently causing the surge in cases. The future is always uncertain, and it is possible that six months down the road, much as we do with the flu, we will need updated vaccines against whatever the dominant circulating strain will be at that time. The pharmaceutical companies are already working on this eventuality.

It is in many ways a race between vaccines and variants. Vaccines do not promote resistant viral strains as some claim. In fact, by preventing infections and reducing the daily case numbers, they give the virus fewer opportunities to mutate and thereby prevent new strains from developing. We all want the vaccines to win this race, but there isn’t much that we as a population can do to speed up vaccine development and roll out. But we can do something to slow down the variants. We can stay home.


@DrLabos

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