A new COVID variant - more dangerous for kids?
A Q&A with Dr. Z
Amid the swirl of coronavirus news, you may have seen troubling reports of a more contagious variant of the COVID-19 virus, spreading rapidly in the U.K. and beyond. Brave Care pediatrician Dr. Joanna Zamora (“Dr. Z” for short) is answering common questions about the new variant.
Is the new variant in the US? Or just overseas?
One of the new variants, known as the “U.K. variant,” or B.1.1.7, has become the predominant variant of the Sars-CoV-2 virus in the U.K. It was first identified in the U.K. in September 2020, and it was first found in the United States in late December. As of this writing, it has now been found in at least five U.S. states and 33 countries. Even though it is called the U.K. variant, it's not clear where it originated.
The current estimate is that B.1.1.7 represents about 1% of all infections in the U.S. Experts warn that the U.K. variant is most likely already too widespread to be contained in any specific state or region of the country. The CDC plans to launch a national surveillance program this month in order to better monitor the spread of variants of Sars-CoV-2 in the United States. Other variants, most notably from South Africa and Brazil, also appear to be more contagious and it seems inevitable that other variants like these will make their way to U.S. shores.
“Mutation, “variant, “strain,” etc. - What’s the difference between these words?
The term strain is only appropriate when referring to Sars-CoV-2, the virus causing the COVID-19 disease. Sars-CoV-2 is a strain of the wider coronavirus family, including SARS, MERS, and less severe viruses that cause things like the common cold.
The term variant refers to slightly different versions of the Sars-CoV-2 virus that result from frequent mutations within the genome of the Sars-CoV-2 virus.
Viruses are known to mutate very often. It’s kind of their thing. The SARS-CoV-2 virus acquires about one new mutation in its genome every two weeks. These mutations lead to variants of SARS-CoV-2 that behave slightly differently from one another but still cause the COVID-19 disease.
Most mutations are either harmless or make the virus less effective. The mutations that led to the U.K. variant (23 mutations in total) have made the U.K. variant more contagious.
What does “more contagious” mean, practically speaking?
“More contagious” means that the variant infects people more easily and quickly than other strains. Scientists in the U.K. estimate that the U.K. variant is 40-70% more transmissible than the initial predominant Sars-CoV-2 virus based on analysis of affected populations in Britain.
What makes the U.K. COVID-19 variant more contagious?
The U.K. variant has several mutations that affect the “spike protein” on the virus surface that attaches to human cells. The spike protein of the U.K. variant is able to bind to the receptors on human cells more easily, allowing it to be transmitted from person to person more quickly, and making it easier for people of all ages to get infected with the variant. “Stickier spikes,” to put it another way.
Does the new U.K. variant of COVID-19 cause more severe symptoms?
There is no evidence that the U.K. variant causes more severe illness. There is also no indication that the variant is more lethal, except to the extent that hospitals will become more overburdened with cases and thus less able to provide high-level care to every patient. There is some concern that the variant may not be as responsive to some available treatments for COVID-19 such as convalescent plasma and monoclonal antibodies, but this isn’t clear yet.
Are my children and family more at risk from the U.K. variant?
Unfortunately, yes. Because of its increased contagiousness, experts believe that the U.K. variant will become responsible for a majority of all new infections in the U.S. by March. Experts are concerned that the U.K. variant will lead to infection rates even higher than the rates we are seeing now. This will make it much harder to contain the spread of COVID-19 and will overburden our already stressed healthcare system. With this more contagious variant, super-spreader events will be more likely and riskier. The U.K. variant also infects a higher proportion of individuals under age 20, raising concerns about reopening schools and universities.
Are the current COVID tests effective for the new variant?
Now more than ever, frequent rapid testing for COVID-19 within families and communities will be a useful tool to help minimize the spread of the highly contagious U.K. variant. Most currently approved COVID tests are still effective for detecting the new variant.
The FDA reports that no test is perfect and that false-negative results may occur with any molecular test for the detection of COVID-19 if a mutation occurs in the part of the virus’ genome assessed by that test.
The FDA continually monitors the effects of different variants (including the U.K. variant) on authorized molecular tests for the detection of COVID-19 and promptly updates clinical laboratory staff and health care providers accordingly. Your health care provider should be aware of these updates, so talk with your health care provider if you have concerns about the effectiveness of any particular COVID test.
Will the vaccine be effective against the new variant?
Researchers believe current COVID-19 vaccines will continue to be effective, but will still require an aggressive vaccination campaign in order to get the pandemic under control in the face of a highly contagious variant. Studies are currently underway to help confirm that the COVID-19 vaccines will be effective against the U.K. variant. According to the CDC, the virus would likely need to accumulate many more mutations in the spike protein to evade immunity induced by vaccines or by natural infection. The sooner everyone gets vaccinated, the less time the virus will have to accumulate more mutations.
Is there anything I can do to protect my family from the new COVID-19 variant? Do we need to do anything differently than before?
Because the new strain is more contagious and is more easily spread in individuals under age 20, it is more important than ever for families to continue social distancing and to follow routine precautions such as mask-wearing and frequent hand-washing.
It is also recommended to have a low threshold for rapid COVID-19 testing if there are any concerns that someone in your family may have been exposed to or may have contracted the virus.
If an individual has been exposed to COVID-19, it is more important than ever for that individual to follow the recommended 14-day quarantine, regardless of a negative COVID-19 test result within the 14-day quarantine window.
What else should families and communities know about the new variant?
Even though news of a more contagious COVID-19 variant isn’t what anyone wanted to hear at the beginning of 2021, it is important to keep in mind that the end of the pandemic is still on the horizon. In the next few weeks, we will have more information to hopefully confirm that our current vaccines remain highly effective, even in the face of the U.K. variant. Experts still believe that vaccination against COVID-19 is the ultimate solution to this pandemic. The next few months will be challenging and full of complex questions, so please let us know how Brave Care can help.
Joanna Zamora, MD FAAP
Pediatrician at Brave Care