Dr. Robin’s Covid-19 Updates

Q&A On Variants

Ten Questions, Many Answers

How come we are all of a sudden hearing about variants?

Good question. But let’s start at the start.

What is a variant?

A virus’ goal in life is to

a) get into somebody’s cells and

b) reproduce.

When they reproduce they often change a little, aka they “mutate.” If the way they change helps them get better at

a) getting into somebody’s cells and

b) reproducing,

then that version of the virus can become “dominant.”

Cue up any of the many YouTube versions of songs with the words “Only the Strong Survive.” Maybe the original by Jerry Butler.

The viruses who share those new changes are called “variants.” A variant has the potential to behave differently than its original ancestor, maybe more efficiently or fiercer.

Cue up any of the YouTube versions of songs with the words “Harder Better Faster Stronger.”

How do you know if your Covid infection is from the “original” SARS-CoV-2 strain or if it’s from a newer variant?

Good question. So let’s start at the start.

Getting tested for Covid is pretty simple.

You get a swab up your nose or throat and then, usually using a technology called PCR, a lab worker tests your Nose Goop (fancy medical term) to see if you have the SARS-CoV-2 virus — the one that causes COVID-19 in your nose cells.

In order to know if your Covid infection is the original virus or a variant, your Nose Goop has to undergo considerably fancier testing. This additional testing is called “sequencing” or “genomic sequencing.” Genomic sequencing isn’t terribly new. Every year the CDC does genomic sequencing for the flu. It’s done a lot for Covid in England and other countries.

Unfortunately, here in the US we haven’t done much Covid genomic sequencing. Fortunately, it is being rapidly ramped up — Dr Walensky at the CDC wants it done thousands of times per week in the near future.

Do we know if the other variants are here in the US?

Some are definitely already here, and the more we look, the more we’ll find. As soon as they get the sequencing ramped up I have no doubt they’ll find all the variants from other continents and news ones as well. Viruses live to mutate and they don’t read border signs.

How do I keep from catching a variant?

The same old same old: “Face and Space and Don’t Swap Air:”

  • Mask up.
  • Socially distance.
  • Avoid crowds.
  • Wash hands.
  • Stay home when sick.
  • YadaYadaYada.
  • But now we have an additional way to be protected: get vaccinated!

Wait, remind me again why I should get vaccinated?

  • How do you keep from catching Covid? Get vaccinated.
  • How do you keep from catching a variant? Get vaccinated.
  • How do you keep a virus from mutating and turning into a variant? Get vaccinated.
  • How do you protect your grandma and teacher and kids? Get vaccinated.

Do I need to double mask now?

There’s no science yet showing you should double mask. It can’t hurt and it certainly makes intuitive sense but as of today there’s no evidence it helps.

I would certainly never tell anybody not to wear two masks if that helps them feel better. I’m too busy hoping Aunt Petunia will stop wearing her mask on her wrist, and that Uncle Maskless will wear one when he’s at his Dunkin. Or anywhere for that matter.

Amended on 2/10/21 because science marches on: Two methods substantially boost fit and protection, according to a CDC report and updated guidance on its website. One is wearing a cloth mask over a disposable surgical mask. The second is improving the fit of a single surgical mask by knotting the ear loops and tucking in the sides close to the face to prevent air from leaking out around the edges and to form a closer fit.

Is it worse to have an infection from a variant?

We don’t know yet. Several variants might be more contagious, but so far there isn’t clear evidence they’re more deadly. Remember, the virus’ goal is to become “Harder Better Faster Stronger,” not to die. Becoming more fatal is not a smart way for a virus to evolve.

Can you get reinfected with a variant?

We don’t know yet.

Are the vaccines going to stay strong against these variants?

There’s two ways to study this: in the laboratory and in the real world with people getting vaccinated

In both places, it looks like all the vaccines continue to have an impact on all the variants, although it might end up reduced.

Several scientists have done lab studies looking at one facet of the immune system (neutralizing antibodies aka NAb) and these results have led to some concerns the vaccines may not be as high as 95% effective. They’ve also resulted in about six gajillion scary headlines.

We need to remember this test is

a) in the lab only, not the real world and

b) NAbs are only one part of our super complicated immune system response to a vaccine and virus.

There need to be many more experiments, and many more tests of all parts of the immune system, before we will actually know if this spells trouble, or how much trouble.

When you look at vaccine trials (aka the “real world”), the effectiveness is somewhat lower against two of the variants but there’s still a marked decrease in bad disease and that’s a very big deal. (And let us note that the effectiveness is still higher than what we see with the flu vaccine.) So it’s concerning but not catastrophic.

Bottom line: things are going pretty much as expected in the scientific world:

  • Viruses mutate
  • Scientists find them
  • Scientists study them
  • Headline writers scare the heck out of us
  • We buy more newspapers/click more links unless we stop doom scrolling
  • Scientists keep doing science
  • Writers keep writing
  • Scientists figure out if we need to tweak the vaccines.

With regards to vaccines, we are moving in the right direction.

Vaccines are getting out there. We’re getting them at the Yankee and Dodger and Levi and NFL Stadiums and casinos and malls and whatnot.

A million shots a day this week. A couple of days with two million. We’ll hit over 45 million this coming week. Lots more in the pipeline.

Sign-ups are improving, some from state governments and some (like in Massachusetts) through an awesome maternity leave mom/coder project.

Multiple safety screening programs are in place and none of them have revealed any concerns whatsoever. Nobody’s having unexpected new side effects or dying from the vaccine.

In places with a lot of vaccines, we are seeing the magical fantastic drop in cases we’re all yearning for.

It’s the scientific miracle of our time:

  • These vaccines would get an A+ on a report card.
  • Or a 5/5 on a performance review: “Performs above expectations. Delivers on promises.”
  • Or a 10/10 in the Olympics.
  • And some winning score in the Super Bowl.

One final note: despite all the headlines and clicking going on about vaccines and variants and availability and etc., nothing has actually changed in our own lives. The CDC is still asking us to continue to stay “rigorous” with masking, distancing, vaccination, etc.

Bottom line: we just need to keep being the “Harder Better Faster Stronger” versions of our own selves while we wait for our own light at the end of the tunnel.

{Robin Schoenthaler, MD is a Boston-based cancer doctor who has been writing straightforward fact-based no-blame-no-rumors-all-science-all-the-time essays about Covid-19 since March 2020.}

Covid-Translator. Cancer doc: ~Three decades at MGH. Writer and storyteller: Moth Grand Slam Champion. Mom. www.DrRobin.org, @robinshome, robinshome2@gmail.com

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