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Thoughts About Covid 19 Variants and the Pandemic

The COVID-19 pandemic seems to be trending in the right direction. Despite the progress, many public health officials and doctors are concerned about the changes that gradually accumulate in the virus. The Coronavirus is an RNA virus that requires RNA-dependent RNA polymerase (RdRP) to produce copies of viral genes. Sometimes the RdRP makes mistakes and slightly changes the viral genes. This change in viral RNA gives rise to a slightly changed virus or variant. A variant can become more infectious or potentially cause more serious illness. Mistakes in viral replication require active viral infections (replication). So the more widespread the infection, the more opportunities for new variants to form. Variants do not care if the infection is in a young fit individual (who, generally, will be asymptomatic or have a mild illness) or an elderly person who might develop a serious disease. All that is required is replicating the virus.

So even though trends look good, variants are a concern. We worry that variants could be less impacted by the vaccines designed to combat the original Coronavirus and that at-risk individuals could once again face serious COVID-19 disease.

So far, it appears that current vaccines are effective against circulating variants. In addition to encouraging vaccination, it is still too early, in my opinion, to give up the mitigation practices that we all hate. I am still going to mask up in stores. I will quietly maintain distance indoors and continue my hand hygiene practices. I will continue to enjoy activities outside unmasked and will begin to socialize with friends who have been fully vaccinated (when they are ready).

Public health officials will need to be vigilant and follow the pandemic's numbers and biology.

I suspect we will see modified variant vaccines at some point. We all hope for an oral antiviral agent that can abort a serious illness.

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Norman Gutmann, MD. All rights reserved.

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