SARS-CoV-2 Variants - Coronavirus COVID-19 **NO DISCUSSION**

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New Variants of the Virus that Causes COVID-19
Updated Jan. 28, 2021

“Information about the characteristics of these variants is rapidly emerging. Scientists are working to learn more about how easily they spread, whether they could cause more severe illness, and whether currently authorized vaccines will protect people against them.”

COVID-19 and Your Health
 
CDC
Emerging SARS-CoV-2 Variants

Updated Jan. 28, 2021
Coronavirus Disease 2019 (COVID-19)


(Previous update / CDC / Dec. 29, 2020
Interim: Implications of the Emerging SARS-CoV-2 Variant VOC 202012/01)


“Multiple SARS-CoV-2 variants are circulating globally. Several new variants emerged in the fall of 2020, most notably:

  • In the United Kingdom (UK), a new variant of SARS-CoV-2 (known as 20I/501Y.V1, VOC 202012/01, or B.1.1.7) emerged with a large number of mutations. This variant has since been detected in numerous countries around the world, including the United States (US). In January 2021, scientists from UK reported evidence[1] that suggests the B.1.1.7 variant may be associated with an increased risk of death compared with other variants. More studies are needed to confirm this finding. This variant was reported in the US at the end of December 2020.

  • In South Africa, another variant of SARS-CoV-2 (known as 20H/501Y.V2 or B.1.351) emerged independently of B.1.1.7. This variant shares some mutations with B.1.1.7. Cases attributed to this variant have been detected in multiple countries outside of South Africa. This variant was reported in the US at the end of January 2021.

  • In Brazil, a variant of SARS-CoV-2 (known as P.1) emerged that was first was identified in four travelers from Brazil, who were tested during routine screening at Haneda airport outside Tokyo, Japan. This variant has 17 unique mutations, including three in the receptor binding domain of the spike protein. This variant was detected in the US at the end of January 2021.
* Scientists are working to learn more about these variants to better understand how easily they might be transmitted and the effectiveness of currently authorized vaccines against them. New information about the virologic, epidemiologic, and clinical characteristics of these variants is rapidly emerging.

CDC, in collaboration with other public health agencies, is monitoring the situation closely. CDC is working to detect and characterize emerging viral variants. Furthermore, CDC has staff available to provide technical support to investigate the epidemiologic and clinical characteristics of SARS-CoV-2 variant infections. CDC will communicate new information as it becomes available.“
 
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US COVID-19 Cases Caused by Variants
Updated Jan. 28, 2021 / COVID-19 and Your Health

View a map
showing the number of confirmed cases in each state / View Cases


“The emerging variants CDC is closely monitoring have mutations in the virus genome that alter the characteristics and cause the virus to act differently in ways that are significant to public health (e.g., causes more severe disease, spreads more easily between humans, requires different treatments, changes the effectiveness of current vaccines). It’s important to understand that genetic mutations are expected, and some variants can spread and become predominant while others subside.

*The cases identified above are based on a sampling of SARS-CoV-2-positive specimens and do not represent the total number of B.1.1.7, B.1.351, and P.1 lineage cases that may be circulating in the United States and may not match numbers reported by states, territories, tribes, and local officials.

†Numbers will be updated on Monday, Wednesday, and Friday by 7:00 pm.”
 
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“In the United Kingdom (UK), a new variant of SARS-CoV-2 (known as 20I/501Y.V1, VOC 202012/01, or B.1.1.7) emerged with a large number of mutations. This variant has since been detected in numerous countries around the world, including the United States (US). In January 2021, scientists from UK reported evidence[1] that suggests the B.1.1.7 variant may be associated with an increased risk of death compared with other variants. More studies are needed to confirm this finding. This variant was reported in the US at the end of December 2020.“


Source:
CDC
Emerging SARS-CoV-2 Variants
Updated Jan. 28, 2021
Coronavirus Disease 2019 (COVID-19)


B.1.1.7 lineage (a.k.a. 20I/501Y.V1 Variant of Concern (VOC) 202012/01)


  • This variant has a mutation in the receptor binding domain (RBD) of the spike protein at position 501, where the amino acid asparagine (N) has been replaced with tyrosine (Y). The shorthand for this mutation is N501Y. This variant also has several other mutations, including:
    • 69/70 deletion: occurred spontaneously many times and likely leads to a conformational change in the spike protein
    • P681H: near the S1/S2 furin cleavage site, a site with high variability in coronaviruses. This mutation has also emerged spontaneously multiple times.
  • This variant is estimated to have first emerged in the UK during September 2020.
  • Since December 20, 2020, several countries have reported cases of the B.1.1.7 lineage, including the United States.
  • This variant is associated with increased transmissibility (i.e., more efficient and rapid transmission).
  • In January 2021, scientists from UK reported evidence[1] that suggests the B.1.1.7 variant may be associated with an increased risk of death compared with other variants.
  • Early reports found no evidence to suggest that the variant has any impact on the severity of disease or vaccine efficacy.[2],[3],[4]
 
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“In South Africa, another variant of SARS-CoV-2 (known as 20H/501Y.V2 or B.1.351) emerged independently of B.1.1.7. This variant shares some mutations with B.1.1.7. Cases attributed to this variant have been detected in multiple countries outside of South Africa. This variant was reported in the US at the end of January 2021.“

Source:
CDC
Emerging SARS-CoV-2 Variants
Updated Jan. 28, 2021
Coronavirus Disease 2019 (COVID-19)


B.1.351 lineage (a.k.a. 20H/501Y.V2)

  • This variant has multiple mutations in the spike protein, including K417T, E484K, N501Y. Unlike the B.1.1.7 lineage detected in the UK, this variant does not contain the deletion at 69/70.
  • This variant was first identified in Nelson Mandela Bay, South Africa, in samples dating back to the beginning of October 2020, and cases have since been detected outside of South Africa, including the United States
  • The variant also was identified in Zambia in late December 2020, at which time it appeared to be the predominant variant in the country.
  • Currently there is no evidence to suggest that this variant has any impact on disease severity.
  • There is some evidence to indicate that one of the spike protein mutations, E484K, may affect neutralization by some polyclonal and monoclonal antibodies.[4],[5]
 
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“In Brazil, a variant of SARS-CoV-2 (known as P.1) emerged that was first was identified in four travelers from Brazil, who were tested during routine screening at Haneda airport outside Tokyo, Japan. This variant has 17 unique mutations, including three in the receptor binding domain of the spike protein. This variant was detected in the US at the end of January 2021.“

Source:
CDC
Emerging SARS-CoV-2 Variants
Updated Jan. 28, 2021
Coronavirus Disease 2019 (COVID-19)


P.1 lineage (a.k.a. 20J/501Y.V3)

  • The P.1 variant is a branch off the B.1.1.28 lineage that was first reported by the National Institute of Infectious Diseases (NIID) in Japan in four travelers from Brazil, sampled during routine screening at Haneda airport outside Tokyo.
  • The P.1 lineage contains three mutations in the spike protein receptor binding domain: K417T, E484K, and N501Y.
  • There is evidence to suggest that some of the mutations in the P.1 variant may affect its transmissibility and antigenic profile, which may affect the ability of antibodies generated through a previous natural infection or through vaccination to recognize and neutralize the virus.
    • A recent study reported on a cluster of cases in Manaus, the largest city in the Amazon region, in which the P.1 variant was identified in 42% of the specimens sequenced from late December.[5] In this region, it is estimated that approximately 75% of the population had been infected with SARS-CoV2 as of October 2020. However, since mid-December the region has observed a surge in cases. The emergence of this variant raises concerns of a potential increase in transmissibility or propensity for SARS-CoV-2 re-infection of individuals.
  • This variant was identified in the United States at the end of January 2021.
 
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“Why Strain Surveillance is Important for Public Health
CDC has been conducting SARS-CoV-2 strain surveillance to build a collection of SARS-CoV-2 specimens and sequences to support public health response. Routine analysis of the available genetic sequence data will enable CDC and its public health partners to identify variant viruses for further characterization.

Viruses generally acquire mutations over time, giving rise to new variants. For instance, another variant recently emerged in Nigeria.[1] CDC also is monitoring this strain but, at this time, it has shown no concerning characteristics to public health experts.

Some of the potential consequences of emerging variants are the following:

  • Ability to spread more quickly in people. There is already evidence that one mutation, D614G, confers increased ability to spread more quickly than the wild-type[2] SARS-CoV-2. In the laboratory, 614G variants propagate more quickly in human respiratory epithelial cells, outcompeting 614D viruses. There also is epidemiologic evidence that the 614G variant spreads more quickly than viruses without the mutation.
  • Ability to cause either milder or more severe disease in people. In January 2021, experts in the UK reported that B.1.1.7 variant may be associated with an increased risk of death compared to other variants. More studies are needed to confirm this finding.
  • Ability to evade detection by specific viral diagnostic tests. Most commercial reverse-transcription polymerase chain reaction (RT-PCR)-based tests have multiple targets to detect the virus, such that even if a mutation impacts one of the targets, the other RT-PCR targets will still work.
  • Decreased susceptibility to therapeutic agents such as monoclonal antibodies.
  • Ability to evade natural or vaccine-induced immunity. Both vaccination against and natural infection with SARS-CoV-2 produce a “polyclonal” response that targets several parts of the spike protein. The virus would likely need to accumulate multiple mutations in the spike protein to evade immunity induced by vaccines or by natural infection.
Among these possibilities, the last—the ability to evade vaccine-induced immunity—would likely be the most concerning because once a large proportion of the population is vaccinated, there will be immune pressure that could favor and accelerate emergence of such variants by selecting for “escape mutants.” There is no evidence that this is occurring, and most experts believe escape mutants are unlikely to emerge because of the nature of the virus.

[1] Analysis of sequences from the African Centre of Excellence for Genomics of Infectious Diseases (ACEGID), Redeemer’s University, Nigeria, identified two SARS-CoV-2 sequences belonging to the B.1.1.207 lineage. These sequences share one non-synonymous mutation in the spike protein (P681H) in common with the B.1.1.7 lineage but does not share any of the other 22 unique mutations of B.1.1.7 lineage. The P681H residue is near the S1/S2 furin cleavage site, a site with high variability in coronaviruses. At this time, it is unknown when this variant may have first emerged. Currently there is no evidence to indicate this variant has any impact on disease severity or is contributing to increased transmission of SARS-CoV-2 in Nigeria.

[2] “Wild-type” refers to the strain of virus – or background strain – that contains no major mutations.”

Coronavirus Disease 2019 (COVID-19)
 
“Strain Surveillance in the US
In the United States, sequence-based strain surveillance has been ramping up with the following components:

  • National SARS-CoV-2 Strain Surveillance (“NS3”): Since November 2020, state health departments and other public health agencies have been regularly sending SARS-CoV-2 samples to CDC for sequencing and further characterization. This system is now being scaled to process 750 samples nationally per week. One strength of this system is that it allows for characterization of viruses beyond what sequencing alone can provide.
  • Surveillance in partnership with commercial diagnostic laboratories: CDC is contracting with large national reference labs to provide sequence data from across the United States. As of mid-January, CDC has commitments from these laboratories to sequence 6,000 samples per week and is exploring options to increase this number.
  • Contracts with universities: CDC has contracts with seven universities to conduct genomic surveillance in collaboration with public health agencies.
  • Sequencing within state and local health departments: Since 2014, CDC’s Advanced Molecular Detection Program has been integrating next-generation sequencing and bioinformatics capabilities into the US public health system. Several state and local health departments have been applying these resources as part of their response to COVID-19. To further support these efforts, CDC released $15 million in funding, with COVID supplemental funds, through the Epidemiology and Laboratory Capacity Program on December 18, 2020.
  • The SPHERES consortium: Since early in the pandemic, CDC has led a national consortium of laboratories sequencing SARS-CoV-2 (SPHERES) to coordinate US sequencing efforts outside of CDC. The SPHERES consortium consists of more than 160 institutions, including academic centers, industry, non-governmental organizations, and public health agencies.
Through these efforts, anonymous genomic data are made available through public databases for use by public health professionals, researchers, and industry.“

Coronavirus Disease 2019 (COVID-19)
 
Global scientists double down on SARS-CoV-2 variants research at WHO-hosted forum
12 January 2021


“Global scientists are intensifying research into COVID-19, as the World Health Organization (WHO) moves to expand its scientific collaboration and monitoring of emerging variants of SARS-CoV-2, the virus that causes COVID-19.

A day-long virtual meeting of scientists from around the globe, convened by WHO, brought together more than 1 750 experts from 124 countries to discuss critical knowledge gaps and research priorities for emerging variants of the virus.

Welcoming them, Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said: “Science and research have played a vital role in responding to the pandemic since day one and will continue to be the heartbeat of everything WHO does.”“
 
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SARS-CoV-2 Variants
World Health Organization
31 December 2020



“SARS-CoV-2, the virus that causes COVID-19, has had a major impact on human health globally; infecting a large number of people; causing severe disease and associated long-term health sequelae; resulting in death and excess mortality, especially among older and vulnerable populations; interrupting routine healthcare services; disruptions to travel, trade, education and many other societal functions; and more broadly having a negative impact on peoples physical and mental health. Since the start of the COVID-19 pandemic, WHO has received several reports of unusual public health events possibly due to variants of SARS-CoV-2. WHO routinely assesses if variants of SARS-CoV-2 result in changes in transmissibility, clinical presentation and severity, or if they impact on countermeasures, including diagnostics, therapeutics and vaccines. Previous reports of the D614G mutation and the recent reports of virus variants from the Kingdom of Denmark, the United Kingdom of Great Britain and Northern Ireland, and the Republic of South Africa have raised interest and concern in the impact of viral changes.

A variant of SARS-CoV-2 with a D614G substitution in the gene encoding the spike protein emerged in late January or early February 2020. Over a period of several months, the D614G mutation replaced the initial SARS-CoV-2 strain identified in China and by June 2020 became the dominant form of the virus circulating globally. Studies in human respiratory cells and in animal models demonstrated that compared to the initial virus strain, the strain with the D614G substitution has increased infectivity and transmission. The SARS-CoV-2 virus with the D614G substitution does not cause more severe illness or alter the effectiveness of existing laboratory diagnostics, therapeutics, vaccines, or public health preventive measures.

In August and September 2020, a SARS-CoV-2 variant linked to infection among farmed mink and subsequently transmitted to humans, was identified in North Jutland, Denmark. The variant, referred to as the “Cluster 5” variant by Danish authorities, has a combination of mutations not previously observed. Due preliminary studies conducted in Denmark, there is concern that this variant has may result in reduced virus neutralization in humans, which could potentially decrease the extend and duration of immune protection following natural infection or vaccination. Studies are ongoing to assess virus neutralization among humans with this variant. To date, following extensive investigation and surveillance, Danish authorities have identified only 12 human cases of the Cluster 5 variant in September 2020, and it does not appear to have spread widely.

On 14 December 2020, authorities of the United Kingdom reported to WHO a variant referred to by the United Kingdom as SARS-CoV-2 VOC 202012/01 (Variant of Concern, year 2020, month 12, variant 01). This variant contains 23 nucleotide substitutions and is not phylogenetically related to the SARS-CoV-2 virus circulating in the United Kingdom at the time the variant was detected. How and where SARS-CoV-2 VOC 202012/01 originated is unclear. SARS-CoV-2 VOC 202012/01 initially appeared in South East England but within a few weeks began to replace other virus lineages in this geographic area and London. As of 26 December 2020, SARS-CoV-2 VOC 202012/01 has been identified from routine sampling and genomic testing conducted across the United Kingdom . Preliminary epidemiologic, modelling, phylogenetic and clinical findings suggest that SARS-CoV-2 VOC 202012/01 has increased transmissibility. However, preliminary analyses also indicate that there is no change in disease severity (as measured by length of hospitalization and 28-day case fatality), or occurrence of reinfection between variant cases compared to other SARS-CoV-2 viruses circulating in the United Kingdom.1 Another of the mutations in the VOC 202012/01 variant, the deletion at position 69/70del was found to affect the performance of some diagnostic PCR assays with an S gene target. Most PCR assays in use worldwide will use multiple targets and therefore the impact of the variant on diagnostics is not anticipated to be significant. Laboratory evaluation has demonstrated no significant impact on the performance of antigen-based lateral flow devices. As of 30 December, VOC-202012/01 variant has been reported in 31 other countries/territories/areas in five of the six WHO regions.

On 18 December, national authorities in South Africa announced the detection of a new variant of SARS-CoV-2 that is rapidly spreading in three provinces of South Africa. South Africa has named this variant 501Y.V2, because of a N501Y mutation. While SARS-CoV-2 VOC 202012/01 from the UK also has the N501Y mutation, phylogenetic analysis has shown that 501Y.V2 from South Africa are different virus variants. In the week beginning 16 November, routine sequencing by South African health authorities found that this new SARS-CoV-2 variant has largely replaced other SARS-CoV-2 viruses circulating in the Eastern Cape, Western Cape, and KwaZulu-Natal provinces. While genomic data highlighted that the 501.V2 variant rapidly displaced other lineages circulating in South Africa, and preliminary studies suggest the variant is associated with a higher viral load, which may suggest potential for increased transmissibility, this, as well as other factors that influence transmissibility, are subject of further investigation. Moreover, at this stage, there is no clear evidence of the new variant being associated with more severe disease or worse outcomes. Further investigations are needed to understand the impact on transmission, clinical severity of infection, laboratory diagnostics, therapeutics, vaccines, or public health preventive measures. As of 30 December, the 501Y.V2 variant from South Africa has been reported from four other countries to date.”
 
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SARS-CoV-2 Variants
World Health Organization
31 December 2020


“Public health response

The authorities in the affected countries are conducting epidemiological and virological investigations to further assess the transmissibility, severity, risk of reinfection and antibody response to new variants. As one of the mutations (N501Y) – found in both the SARS-CoV-2 VOC 202012/01 and 501Y.V2 variants – is in the receptor binding domain, the authorities are investigating the neutralization activity of sera from recovered and vaccinated patients against these variants to determine if there is any impact on vaccine performance. These studies are ongoing.

Genomic data of the SARS-CoV-2 VOC 202012/01 and 501Y.V2 variants has been shared by the national authorities and uploaded to the Global Initiative on Sharing Avian Influenza Data (GISAID) and genomic surveillance of the virus continues, globally.

The following activities have been initiated:

  • National authorities that have reported virus variants are undertaking intensified sampling to understand how widely these new variants are circulating.
  • National scientific teams are studying the effect of the mutations on reinfection potential, vaccination, diagnostic testing, infection-severity and transmissibility.
  • Researchers and government authorities are working with WHO and collaborating with members of the WHO SARS-CoV-2 virus evolution working group to assess epidemiologic, modelling, phylogenetic and laboratory findings as results become available.
  • WHO is working with countries to identify how current surveillance systems can be strengthened or adapted to evaluate potential virus variations through ongoing systematic clinical and epidemiologic surveillance, establishment of genetic sequencing capacity where possible, and providing access to international sequencing services to send samples for sequencing and phylogenetic analysis.
  • Risk communication and community engagement activities scaled up to explain the public health implications of SARS-CoV-2 variants to the public and emphasize the importance of maintaining ongoing preventive measures to reduce transmission such as wearing face coverings, practicing hand hygiene and cough etiquette, keeping physical distance, ensuring good ventilation and avoiding crowded places.
As part of WHO’s SARS-CoV-2 global laboratory network, which has monitored virus mutations from the start of the pandemic, a specific working group on virus evolution was established in June 2020, composed of experts in sequencing, bioinformatics, and in vivo and in vitro laboratory studies. The Virus Evolution Working Group works to 1) strengthen mechanisms to identify and prioritize (potentially) relevant mutations; 2) identify relevant mutations early and study the potential impacts related to viral characteristics (e.g. virulence, transmission) and effectiveness of available and future countermeasures (e.g. diagnostics, vaccines and therapeutics); 3) evaluate possible mitigation strategies to reduce the negative impact of mutations; and 4) study the impact of specific mutations, including laboratory-controlled in vitro and in vivo studies of variants. Sharing of full genome sequences is facilitating detailed analyses by partners. The Working Group is collaborating with international scientists with a broad scope of expertise in virology in general and coronaviruses specifically to better understand the research findings and support further studies.”
https://www.who.int/csr/don/31-december-2020-sars-cov2-variants/en/
 
SARS-CoV-2 Variants
World Health Organization
31 December 2020



“WHO risk assessment

All viruses, including SARS-CoV-2, change over time, most without a direct benefit to the virus in terms of increasing its infectiousness or transmissibility, and sometimes limiting propagation (see Q&A on COVID-19 and related health topics ). The potential for virus mutation increases with the frequency of human and animal infections. Therefore, reducing transmission of SARS-CoV-2 by using established disease control methods as well as avoiding introductions to animal populations, are critical aspects to the global strategy to reduce the occurrence of mutations that have negative public health implications.

Preliminary data suggest that the growth rate and effective reproductive number is elevated in areas of the United Kingdom with community circulation of the novel variant VOC-202012/01. In South Africa, genomic data highlighted that the 501Y.V2 variant rapidly displaced other lineages circulating, and preliminary studies suggest the variant is associated with a higher viral load, which may suggest potential for increased transmissibility; however, this, as well as other factors that influence transmissibility, are subject of further investigation. Epidemiologic investigations are underway to understand the increase in cases in these communities and the potential role of increased transmissibility of these variants as well as the robustness of implementation of control measures. While initial assessment suggests that 202012/01 and 501Y.V2 do not cause changes in clinical presentation or severity, if they result in a higher case incidence, this would lead to an increase in COVID-19 hospitalizations and deaths. More intensive public health measures may be required to control transmission of these variants.

Further investigations are required to understand the impact of specific mutations on viral properties and the effectiveness of diagnostics, therapeutics and vaccines. These investigations are complex and require time and collaboration among different research groups. These studies are ongoing.“
 
“WHO advice
National and local authorities should continue to strengthen existing disease control activities, including monitoring their epidemics closely through ongoing epidemiological surveillance and strategic testing; conducting outbreak investigation and contact tracing; and where appropriate, adjusting public health and social measures to reduce transmission of SARS-CoV-2.

WHO further advises countries, where feasible, to increase routine systematic sequencing of SARS-CoV-2 viruses to better understand SARS-CoV-2 transmission and to monitor for the emergence of variants. Sequence data should be shared internationally through publicly accessible databases. In countries with sequencing capacity, WHO advises sequencing of isolates from a systematically selected subset of SARS-CoV-2 infections – the amount will depend on local capacities. Genetic sequencing should also be considered as part of investigations of unusual transmission events (e.g. increased transmission in spite of existing control measures) or unexpected disease presentation/severity. Where limited sequencing capacity exists, countries are encouraged to increase capacity in collaboration with public, academic and private sequencing laboratories, and may arrange sequencing at collaborating laboratories in the COVID-19 reference laboratory network.

While mutations of SARS-CoV-2 are expected, it is important to continue to monitor the public health implications of new virus variants. Any increased in transmissibility associated with SARS-CoV-2 variants could make control more difficult. Current disease control measures recommended by WHO continue to be effective and should be adapted in response to increasing disease incidence, whether associated with a new variant or not.

Prevention advice and communications for the public should be further strengthened, including precautions to protect yourself and others such as physical distancing, wearing a mask, keeping rooms well ventilated, avoiding crowds, cleaning hands, and coughing into a bent elbow or tissue. Moreover, infection prevention and control guidance and measures should reinforced, including:

  • Use appropriate personal protective equipment when caring for people suffering from an acute respiratory illness;
  • Practice frequent hand-washing, especially after direct contact with ill people or their environment
  • Practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands)
  • Enhance standard infection prevention and control practices in hospitals, especially in emergency departments
  • Wear masks where appropriate, ensure good ventilation where possible and avoid crowded places
WHO has recently published an interim guidance – "Considerations for implementing a risk-based approach to international travel in the context of COVID-19", recommending the following principles for international travelers in the context of COVID-19 Pandemic:

  • Confirmed, probable and suspected cases, and contacts of confirmed or probable cases should not travel
  • Persons with any sign or symptom compatible with COVID-19 should not travel, unless COVID-19 diagnostic testing has been conducted and SARS-CoV-2 infection has been ruled out as the cause for illness
  • Persons who are unwell should be advised to postpone travel
  • Persons at risk of developing severe disease from COVID-19, including people 60 years of age or older or those with comorbidities that present increased risk of severe COVID-19 (e.g. heart disease, cancer and diabetes) should be advised to postpone travel
  • Depending on local restrictions, persons residing in areas where community-wide movement restrictions are in place should not be allowed to travel for non-essential purposes
  • In case of symptoms suggestive of acute respiratory illness either during or after travel, travelers are encouraged to seek medical attention and share their travel history with their health care provider
Health authorities should work with travel, transport and tourism sectors to provide travelers, including to and from the countries affected by the new variants, with aforementioned information, via travel health clinics, travel agencies, conveyance operators and at points of entry, as well as communities adjacent to land borders with affected countries.

The interim guidance also provides countries with a risk-based approach to decision-making, calibrating travel-related risk mitigation measures in the context of international travel, aiming at reducing travel-associated exportation, importation and onward transmission of SARS-CoV-2 while avoiding unnecessary interference with international traffic. Some countries have recently introduced travel restrictions as a precautionary measure in response to the appearance of new variants. WHO recommends that all countries take a risk-based approach for adjusting measures in the context of international travel, which includes assessing local transmission, health services capacity, what is known about the level of transmissibility of specific variants; social and economic impact of restrictions; and adherence to public health and social measures. National authorities are encouraged to publish their risk assessment methodology and the list of departure countries or areas to which restrictions apply; and these should be updated regularly.

In line with the advice provided by the Emergency Committee on COVID-19 at its most recent meeting, WHO recommends that States Parties should regularly re-consider measures applied to international travel in compliance with Article 43 of the International Health Regulations (2005) and continue to provide information and rationale to WHO on measures that significantly interfere with international traffic. Countries should also ensure that measures affecting international traffic are risk-based, evidence-based, coherent, proportionate and time limited.

In all circumstances, essential travel (e.g., emergency responders; providers of public health technical support; critical personnel in transport and security sector such as seafarers; repatriations; and cargo transport for essential supplies such as food, medicines and fuel) identified by countries should always be prioritized and facilitated.

For more information on COVID-19, please see:

 
Episode #20 - COVID-19 - Variants & Vaccines
8 January 2021 | Science conversation

“Summary
How concerned should we be about the new variants of SARS CoV 2 which cause COVID-19? Is it unusual for viruses to change and mutate? Do vaccines protect against these variants and what can you do to protect yourself? WHO’s Chief Scientist Dr Soumya Swaminathan explains in Science in 5“


17461115
 
New coronavirus variants are fueling a ‘second wave’ in Africa, WHO warns
FRI, JAN 29

  • More than 175,000 new cases and more than 6,200 deaths were reported across the continent in the week leading up to Thursday, the WHO said in an update.
  • The variant first discovered in South Africa is driving record infection rates, and has now been identified in Botswana, Ghana, Kenya and the French Indian Ocean region of Mayotte, Zambia.
  • Meanwhile, the highly contagious strain initially detected in the U.K. has now made its way to Nigeria and Gambia.
 
New coronavirus variant appears to emerge in Nigeria, Africa CDC says
December 24, 2020

““The alert about the apparent new variant was based on two or three genetic sequences, he said, but that and South Africa's alert late last week were enough to prompt an emergency meeting of the Africa CDC this week.

The variant was found in two patient samples collected on Aug. 3 and Oct. 9 in Nigeria's Osun state, according to a working research paper seen by The Associated Press.

Unlike the variant seen in the U.K., "we haven't observed such rapid rise of the lineage in Nigeria and do not have evidence to indicate that the P681H variant is contributing to increased transmission of the virus in Nigeria. However, the relative difference in scale of genomic surveillance in Nigeria vs the U.K. may imply a reduced power to detect such changes," the paper says.”



Another new coronavirus variant found in Nigeria, says Africa CDC
DECEMBER 24, 2020


"”It's a separate lineage from the UK and the South African lineages," John Nkengasong, director of the Africa Centres for Disease Control and Prevention (CDC) told an online news conference from Addis Ababa.“
 
Live Q&A on the new #COVID19 virus variant with WHO, @covidgenomicUK, and @sangerinstitute experts / Dec. 23, 2020
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SARS-CoV-2: Strains, Mutations, Variants:

Are there different strains of the SARS-CoV-2 virus circulating?
June 10, 2020

What is a virus ‘strain’?
When scientists use the word strain, they are referring to a genetically distinct virus lineage, distinguishable by one or more mutations from another strain. Strains may or may not be biologically (functionally) distinguishable from one another and some virologists use the term strain only for the former. Two strains would be biologically different if they elicited different responses from the human immune system, or if they varied in their transmission characteristics.

What are viral mutations?
When a virus infects a cell and begins making copies of itself, it starts by replicating its genetic information, which for the COVID-19 virus is encoded in an RNA molecule. More complex organisms have a variety of “proof-reading” mechanisms to ensure high-fidelity replication; however, these are less developed in RNA viruses where the process is particularly error-prone, leading to a relatively rapid accumulation of mutations over time. SARS-CoV-2 does carry some proof-reading enzymes and its mutation rate is lower than many other RNA viruses, such as influenza virus, norovirus and human immunodeficiency virus (HIV).
—-

June 15, 2020
COVID-19 Will Mutate — What That Means for a Vaccine

“More infectious

A new study from the Scripps Research Institute in Florida suggests the new coronavirus has mutated into a variant that’s more infectious.

The mutation — named “the D614G mutation— occurred on the spike protein, the part of the virus that helps it bind and fuse to our cells. The D614G mutation makes it easier for the virus to infect our cells.

The Scripps researchers aren’t the first to identify the tiny mutation on the spike protein.

In March, researchers from the Los Alamos National Laboratory announced they detected the D614G mutation, and that it was likely responsible for most infections reported in Europe and the United States.

In total, the researchers identified 14 strains of SARS-CoV-2 and released their findings to help those working on vaccines and treatments.

That being said, the new dominant strain identified does seem to be more infectious in laboratory settings. Scientists are now trying to understand how the variation behaves in the body — which may be very different from lab settings.”


June 30, 2020
Mutated COVID-19 Viral Strain in U.S. and Europe 10 Times More Contagious than Original Strain | BioSpace

“The mutation does not appear to make the virus any more deadly than it already is, but it does appear to make it significantly more contagious. The original strain in China is dubbed D614, while the one found in the UK, Italy and North America by May is dubbed G614.


July 16, 2020
Second Coronavirus Strain May Be More Infectious—but Some Scientists Are Skeptical

“The paper indicates that a single amino acid change from D (aspartic acid) to G (glycine) on the SARS-CoV-2 spike protein(which such viruses use to grab onto human cells) is the key to how infectious the pathogen is. “The spike protein has a critically important role in the biology of the virus,” says Bette Korber, a computational biologist at the Los Alamos National Laboratory and lead author of the new paper.

Korber and her colleagues came to this conclusion after employing multiple approaches to examine the two strains. First, they performed a statistical analysis that showed how the mutated virus—often referred to as the “G strain”—achieved dominance across multiple continents, outperforming the coexisting original version of SARS-CoV-2, or “D strain.” Then the researchers tested the amount of the virus in individuals with COVID-19 at the Sheffield Teaching Hospitals NHS Foundation Trust in England. The results showed that the G strain produced more of the virus in the human body than the D strain. But the former did not lead to a higher hospitalization rate, meaning it apparently did not cause more severe illnesses. Lastly, the team members created “pseudotype” pathogens by embedding SARS-CoV-2 spike proteins, containing either D or G amino acids, into other disease-causing viruses...”


Aug. 3, 2020
The six strains of SARS-CoV-2

“Source:
Università di Bologna
Summary:
The virus causing the COVID-19 pandemic, SARS-CoV-2, presents at least six strains. Despite its mutations, the virus shows little variability, and this is good news for the researchers working on a viable vaccine.“


Sept. 8, 2020

“In April, Korber, Montefiori and others warned in a preprint posted to the bioRxiv server that “D614G is increasing in frequency at an alarming rate”1. It had rapidly become the dominant SARS-CoV-2 lineage in Europe and had then taken hold in the United States, Canada and Australia. D614G represented a “more transmissible form of SARS-CoV-2”, the paper declared, one that had emerged as a product of natural selection.“


Oct. 30, 2020
Coronavirus mutation may have made it more contagious

“Source:
University of Texas at Austin
Summary:
A study involving more than 5,000 COVID-19 patients in Houston finds that the virus that causes the disease is accumulating genetic mutations, one of which may have made it more contagious. This mirrors a study published in July that found that around the world, viral strains with the same genetic mutation quickly outcompeted other strains.

A study involving more than 5,000 COVID-19 patients in Houston finds that the virus that causes the disease is accumulating genetic mutations, one of which may have made it more contagious. According to the paper published in the peer-reviewed journal mBIO, that mutation, called D614G, is located in the spike protein that pries open our cells for viral entry. It's the largest peer-reviewed study of SARS-CoV-2 genome sequences in one metropolitan region of the U.S. to date.”

[...]

“A study published in July based on more than 28,000 genome sequences found that variants carrying the D614G mutation became the globally dominant form of SARS-CoV-2 in about a month.”

[...]

“Natural selection would favor strains of the virus that transmit more easily. But not all scientists are convinced. Some have suggested another explanation, called "founder's effects." In that scenario, the D614G mutation might have been more common in the first viruses to arrive in Europe and North America, essentially giving them a head start on other strains.“


RAPID RISK ASSESSMENT
Detection of new SARS-CoV-2 variants related to mink
12 November 2020
https://www.ecdc.europa.eu/sites/default/files/documents/RRA-SARS-CoV-2-in-mink-12-nov-2020.pdf

“The mutation Y453F”


SARS-CoV-2 mink-associated variant strain – Denmark
6 November 2020

“Since June 2020, 214 human cases of COVID-19 have been identified in Denmark with SARS-CoV-2 variants associated with farmed minks, including 12 cases with a unique variant, reported on 5 November. All 12 cases were identified in September 2020 in North Jutland, Denmark. The cases ranged in age from 7 to 79 years, and eight had a link to the mink farming industry and four cases were from the local community.

Initial observations suggest that the clinical presentation, severity and transmission among those infected are similar to that of other circulating SARS-CoV-2 viruses. However, this variant, referred to as the "cluster 5" variant, had a combination of mutations, or changes that have not been previously observed. The implications of the identified changes in this variant are not yet well understood. Preliminary findings indicate that this particular mink-associated variant identified in both minks and the 12 human cases has moderately decreased sensitivity to neutralizing antibodies. Further scientific and laboratory-based studies are required to verify preliminary findings reported and to understand any potential implications of this finding in terms of diagnostics, therapeutics and vaccines in development. In the meantime, actions are being taken by Danish authorities to limit the further spread of this variant of the virus among mink and human populations.“

WHO / SARS-CoV-2 mink-associated variant strain – Denmark / Nov. 6, 2020

https://www.oie.int/fileadmin/Home/...E_on_Sars-CoV-2_in_Denmark_5_november2020.pdf
Nov. 5, 2020
—-

Nov. 13, 2020
Study: New Mutation Sped Up Spread of Coronavirus

“Compared to the original strain, people infected with the new strain -- called 614G -- have higher viral loads in their nose and throat, though they don’t seem to get any sicker. But they are much more contagious to others.“


Dec. 15, 2020
New coronavirus strain spreading in UK has key mutations, scientists say

The new variant, which UK scientists have named “VUI – 202012/01” includes a mutation in the viral genome region encoding the spike protein, which - in theory - could result in COVID-19 spreading more easily between people.”

[...]

“As of Dec. 13, 1,108 COVID-19 cases with the new variant had been identified, predominantly in the south and east of England, Public Health England said in a statement.

But there is currently no evidence that the variant is more likely to cause severe COVID-19 infections, the scientists said, or that it would render vaccines less effective.“


Severe COVID variant detected in South Africa, health minister says

Known as the 501.V2 Variant, it was identified by South African researchers and details have been sent to the World Health Organization, Zwelini Mkhize said in a statement.“

[...]

“The research team, led by Tulio de Oliveira, has shared its findings with the scientific community and alerted authorities in Britain, who have “studied their own samples and found that a similar mutation… was the variant that was driving their resurgence in London,” he said.”


@DrZweliMkhize
Dec 18
Karim: This new 501.V2 variant has become dominant in South Africa. This new variant has 3 mutations. #SARSCOV2MediaBriefing

South Africa identifies new coronavirus strain causing surge in cases

““The evidence that has been collated, therefore, strongly suggests that the current second wave we are experiencing is being driven by this new variant,” Mkhize added.”


New Variant of SARS-CoV-2 Frequently Asked Questions - NICD
Dec. 19, 2020

“Q What is the new SARS-CoV-2 variant?
A This new variant of the virus was discovered through routine genomic surveillance of SARS-
CoV-2 performed by a network of laboratories around the country (Network for Genomic Surveillance South Africa, NGS-SA). The new variant has been identified in almost 200 samples collected from over 50 different health facilities in Eastern Cape, Western Cape and KwaZulu- Natal. The new variant is different from the others that were circulating in South Africa because it has multiple mutations (changes) in the spike protein – this is the very important part of the virus that binds to the receptor on the cells inside our body and that is also the main target for many of the antibodies produced during infection or after vaccination. Work is being done to understand what effect these mutations have on the behaviour of the virus and our body’s response to it - particularly whether it makes the virus spread more easily, whether it might lead to more severe COVID-19, and whether the virus can evade our immune response.

Q What is the geographical distribution of this mutation?
A The variant was first identified in Nelson Mandela Bay but has rapidly spread through the rest
of the Eastern Cape and to the Western Cape and KwaZulu-Natal provinces
. Testing in other provinces is being undertaken to understand the extent of geographical spread but it is likely that this variant has spread to other provinces too.

[...]

Q Is this the same or different to the London variant?
A It is definitely not the same variant, but there are similarities as they both share the same change in the spike protein at the 501 position. What it does tell us is that if we do not control the spread of the virus then it is likely to evolve in similar ways in different parts of the world.”


UK Variant:

“The variant that’s being discussed was first identified in September...” - Alex Azar | source


In the WHO Press Briefing from Monday, Dec. 21, 2020, Dr. Maria Van Kerkhove comments about the UK VUI / source:
  • It has a number of mutations that was identified through genomic sequencing, which is carried out across the country.

  • The Variant Under Investigation was reported to WHO on 14th December, following detail analysis that the UK had done in the southeast of England, looking at their epidemiologic surveillance data and their laboratory data, noting an increase in transmission at the end of Nov/Dec, while interventions were in place.

  • They did some file genetic analysis and identified this variant, they’re calling it theB-117 lineage which includes this mutation at the N501Y site.

  • She also said the reproductive number went up by .4, increasing from 1.1 to 1.5.

  • Also note it was originally referred to as “VUI-202012/01”:
    * From above notes, “Dec. 15, 2020: New coronavirus strain spreading in UK has key mutations, scientists say “The new variant, which UK scientists have named “VUI – 202012/01” includes a mutation in the viral genome region encoding the spike protein, which - in theory - could result in COVID-19 spreading more easily between people.”...“As of Dec. 13, 1,108 COVID-19 cases with the new variant had been identified, predominantly in the south and east of England, Public Health England said in a statement.“
Additionally, the reporter specifically asks if there is a connection between the two new variants from UK and South Africa:

21:00 | Dr. Maria Van Kerkhove:

“So, at the same time, there was another variant that was identified in South Africa, and it has one of the same mutations, this 501Y mutation but a different variant. They have arisen at the same time but it is a separate variant.”


Per this video, “doctors are reporting more young people who are seriously ill”; also, per Matt Hancock, this new South Africa variant is highly concerning because it appears to have mutated further than the one discovered in the UK.
source
 

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