Dr John Foster

Dr. John Foster poses for a portrait Friday (June 5, 2020) at Holy Cross Hospital.

The Taos Community Medical COVID Task Force is a volunteer coalition of local healthcare providers and community partners working to build collaborations to strengthen our local medical response to the global COVID-19 pandemic. In this column, local healthcare providers will be answering common questions about COVID-19 in our community. If you have a question that you would like to submit, please email it to info@taoscovidtaskforce.com. Also, please check out taoscovidtaskforce.com for the latest medical information about COVID-19 in Taos.

What are viral "variants"?

When a virus particle replicates, it usually makes exact copies of itself, like identical twins or clones. But about once in every 10,000-1,000,000 copies, an error occurs in the replication process. This results in a slightly different form of the virus. Most of these variations differ from the original virus by just a single mutation, for example substituting one amino acid for another in a protein that could be over a thousand amino acids long. Sometimes the mutation works against the virus, resulting in a viral particle that cannot reproduce - a dead end. Sometimes the mutation results in a viral particle that acts exactly like the original version - so a new "variant" of the virus will begin to reproduce, but without much consequence to humans. But occasionally a mutation occurs that turns out to be better for the virus, for example making it more transmissible, or hardier. It is also possible the variant could be worse for the host, like cause a more severe illness.

How do we know about mutations of the COVID virus?

To find out what variants are out there, scientists must sequence the SARS CoV2 virus RNA in samples from people who are infected. This is a lengthy process, so most positive COVID tests don't end up getting sequenced. But a sample of them do, and from this information they are able to track variants in the population and look for new ones. Most variants detected do not result in a practical difference. The variants that might be significant are classified by the CDC as either "Variants of Interest," "Variants of Concern (VOC)," or "Variants of High Consequence." Currently there are 4 Variants of Interest, 5 VOC, and no Variants of High Consequence.

What do we know about the "Variants of Concern"?

They have catchy names like B.1.1.7, B.1.351, P.1, B.1.427, and B.1.429. Most people remember them by where they were first identified: England, South Africa, Brazil, and the last two in California. Most appear to be more contagious than the original virus, especially B.1.1.7, which may also cause more severe disease. Some are partially resistant to vaccines and monoclonal antibody treatments.

Does the vaccine protect against variants?

Yes. But probably not quite as well against most of these variants of concern. Fortunately, the vaccines do work well against B.1.1.7, since it is now the most common cause of new COVID cases in the United States. The vaccines do not work as well against B.1.351, although they still appear to protect against severe disease. So far, B.1.351 has not been found in New Mexico.

In the future will there be a variant that is worse?

That depends on luck, and on how we act. The more copies of the virus that are out there replicating, the higher the risk of new mutations and the higher the chance that a dangerous variant will arise. That is why it is important to get as much of the world's population vaccinated as soon as possible. Think globally. What can YOU do? Get vaccinated yourself and encourage your friends and family to get vaccinated - act locally!

You can find more information from the CDC website: cdc.gov

Dr. John Foster is a hospitalist at Holy Cross Medical Center. He has been an active member of the Taos Community Medical COVID Task Force since the beginning of the pandemic.

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