Novel COVID-19 “Double Mutant” Poses New Challenge to India’s Vaccine Rollout

India has identified a new “double mutant” variant of SARS-CoV-2, as the country struggles to avert another full-fledged lockdown and contain a spike in cases that are fanning fears of a second wave.

A total of 226 cases have been linked to the double mutant in the state of Maharashtra and approximately 20% of those cases were found in Nagpur, a major commercial and logistics center. An additional nine cases have been identified in the Indian capital of New Delhi.

The Indian SARS-CoV-2 Consortium on Genomics (INSACOG), which comprises of a group of ten national laboratories under India’s health ministry, has been diligently carrying out genomic sequencing on the latest samples which has led to identifying the novel “double mutant” of the virus. 

 

What is a Double Mutant?

Just like other viruses, the SARS-CoV-2 keeps changing or mutating in minor ways as it goes about infecting people. The vast majority of these mutations are insignificant and do not change the virus’ behavior. 

However, certain mutations which promote changes in the spike protein of the virus, cause havoc by either being more infectious, evading neutralizing antibodies from vaccines or causing higher death rate within the population. 

A “double mutant” variant refers to a virus strain that contains two mutations. The variant in question here comprises of both the E484Q and L452R mutations, the likes of which have been linked to the UK, Brazil and South African strains.

To put this in perspective, the UK variant has 23 mutations compared to the original strain discovered in China while the Brazilian variant is known to have 17. The South African variant also has multiple mutations as reported by US Centers for Disease Control and Prevention (CDC).

The government does not believe that the recent rise in cases can be attributed to the presence of the “double mutant” or that if this strain is more lethal than the ones already prevalent. To err on the side of caution, the Indian government has taken a number of measures to detect and curb the spread including ramping up of testing at shopping malls, railway stations, airports, enforcing curfew in hard-hit states among others.

 

What are Variants?

Recently the INSACOG reported that of the total 10,787 samples analyzed from 18 Indian states, 771 cases of known variants were established with approximately 736 of them categorized as the variant first identified in the UK (B.1.1.7), 34 of them as the variant first identified in South African (B.1.351) and one variant first identified in Brazil (P.1).

Based on their mutations the variants can infect people rapidly and spread like wildfire within the population. Hence it is crucial to get people vaccinated. Scientists feel that if individuals who are vaccinated or recovered from a previous COVID-19 infection get reinfected, it should be mild compared to the primary infection.

However, what remains of concern is that if these variants manage to spread through reinfection, they have the potential to penetrate herd immunity which will put the elderly at risk of severe illness even causing death. 

 

India’s Vaccination Approach

As cases continue to spike across the country, the government is working around the clock to get people vaccinated. 

India has embarked on an ambitious vaccination drive and is administering two vaccines made domestically, namely COVISHIELD, developed by the Oxford University/AstraZeneca and produced by the Serum Institute of India (SII) and COVAXIN, developed jointly by Bharat Biotech and Indian Council of Medical Research (ICMR).

As of now, India has managed to administer greater than 50 million doses of vaccines, with more than 8.1 million people fully vaccinated as per government reports. SII which produces the vaccines for India is halting its exports to other countries to combat India’s rising cases. However, they remain committed to fulfilling their quota of 200 million doses and supplying them to hard-hit countries as per the WHO vaccine alliance. 

With COVID fatigue setting in amongst the masses, it is crucial to get as many people vaccinated as possible to curb the spread of this deadly virus and with the government’s initiatives in place, India should be able to inch back to normal in a slow but steady pace.

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