Viruses may not amount to ‘life’ as we know it, but they have one characteristic in common with higher life forms – they replicate.
But they cannot do this on their own, so they invade and attach to ‘host’ cells in other organisms, where they make copies of themselves. They also have another feature – they evolve, or rather mutate – evolution, but in real time.
With each mutation, a virus generally gets more powerful, more transmissible and more evasive. They are among the most adaptable of organisms, if one can call them that.
The Coronavirus is no exception. Within just 18 months, it has undergone many mutations. The resulting ‘new’ viruses are called variants. New variants were identified in UK, Brazil, India and several other countries.
The media initially referred to these variants on the basis of their country (i.e. British variant) but the World Health Organization (WHO) gave them new names according to the Greek alphabet, to end the stigma experienced by those countries.
Most of these variants are more transmissible and more virulent than the original Coronavirus, but scientists have been particularly alarmed by the Delta variant, which was originally reported from India.
Alarm bells have rung in local health circles too after the revelation of a cluster of Delta variant Covid cases in Dematagoda, Colombo, recently.
Now the WHO has confirmed the worst fears of health planners with its declaration that the highly contagious Delta variant is the fastest and fittest Coronavirus strain yet.
Having already spread to around 90 countries including Sri Lanka, it is certainly looking for more hosts to attach to and replicate rapidly. Worse, Delta itself has mutated further to become Delta Plus.
India’s Health Ministry said it had found around 40 cases of the Delta Plus variant with the K417N mutation.
The Ministry said the Delta Plus variant has three worrying characteristics; increased transmissibility, stronger binding to receptors of lung cells and the potential reduction in monoclonal antibody response which could reduce the efficacy of a life-saving monoclonal antibody therapy given to some hospitalised Covid patients.
The WHO has also warned that Delta and Delta Plus will “pick off” the most vulnerable people, especially in places with low Covid-19 vaccination rates.
We certainly cannot be complacent on this matter, because only around 1.5 million people in Sri Lanka have been vaccinated so far, with less than half of that getting both doses of any vaccine authorised for Emergency use here. The danger here is that Delta spreads very fast and could become the dominant strain here in a very short period, as seen in the UK and India.
World leaders can help defend the most vulnerable through the donation and distribution of Covid vaccines to countries such as Sri Lanka, in the light of WHO’s assertion that “no one is safe until everyone is safe”.
This is a moot point, since some advanced countries have secured enough vaccine doses to inoculate their entire populations several times over, while many developing countries have not given the vaccine even to one person.
These rich countries are inoculating even their children while developing countries are lagging way behind in immunising their vulnerable adult populations. This is indeed a catastrophic moral failure at a global level as pointed out by WHO Director-General Tedros Adhanom Ghebreyesus. Delta is already replacing Alpha, the highly contagious UK origin variant that swept across Europe and later the US earlier this year, in many countries and regions.
No variant has really found the optimal combination of high transmissibility and lethality, but Delta is the most able, fastest and fittest of those virus variants, according to WHO officials.
It is in this context that many countries are debating about the real possibility of needing a third dose or a “booster shot” against the Delta variant.
We might even require annual shots, as no one knows how long the immunity lasts after two full doses of a given vaccine. Since the original vaccines from Pfizer, AstraZeneca, Moderna et al were based on the original Coronavirus version, they could indeed be less effective against variants such as Delta Plus. But it is not difficult to engineer vaccines against particular variants.
In fact, these companies are researching and trialing such vaccines right now.
Sri Lanka should keep an eye on these global developments. President Gotabaya Rajapaksa, who has taken a keen interest in ensuring that all Sri Lankans are vaccinated, has urged health authorities to consider this possibility seriously and place orders swiftly should the need arise. A quick decision on this matter will also help avoid any supply bottlenecks, like the ones we experience now with the AstraZeneca vaccine.
Our health authorities should also follow developments with regard to the approval of new vaccines from companies such as Novavax and countries such as Cuba, which is developing two new vaccines.
Single shot vaccines, developed with the latest variants in mind, should also be considered as the logistics are easier, not to mention the price factor.
As President Rajapaksa has correctly said, vaccination is our way of this pandemic. The authorities should make all efforts to procure vaccines for the entire population from a range of countries and suppliers, including for schoolchildren above the age of 12 (this category is already being vaccinated abroad).
The aim should be to vaccinate all eligible categories of persons possibly at least by the first quarter of 2022. Lockdowns can keep the disease from spreading far and wide, but it is not a permanent solution. Vaccination is, and attention must be focused firmly on that aspect of Covid prevention.