In late December 2020 and in response to the emergence of a new variant strain of the Coronavirus (COVID-19) identified in the United Kingdom ‘Big Red’ once again demonstrated its commitment to protecting the citizens of Singapore from infectious disease transmission by creating a series of advisory updates on this new, dominant strain of the virus and the risks it poses to the people of Singapore and the local Region.
Over the last four decades, ‘Big Red’ has moved well beyond being just a provider of cleaning, disinfection, and infection control services, but also a trusted source of independent, objective information about numerous Public Health issues such as COVID-19. After the emergence of the new dominant strain of the virus in the UK and the publication of our updates, the team at ‘Big Red’ has once again been inundated with requests for further information and updates.
Therefore, yet again, in response to our customers and the general public’s demand for information, Prof. Martin Blake our own resident Preventive Medicine specialist has been asked to provide a further series of updates on the status of the new dominant variant strains of the COVID-19 virus as well as answering all of the most frequently asked questions.
COVID-19 Situation Update 13th January 2021
In the last Coronavirus update published (on December 20th, 2020) we identified how different mutations in the COVID-19 virus were occurring simultaneously in various parts of the globe due to the ‘adaptive pressure’ that the virus was being subjected to. This adaptive pressure has been exerted first and foremost by social distancing and other public health and hygiene measures. Secondly, and much more recently, by the rolling out of different vaccination programs around the world.
In response to the exertion of this pressure to either ‘adapt or die’, the COVID-19 virus has already mutated and adapted several times and we can now anticipate, with significant confidence, that these new genetically divergent strains will displace the preceding strains and become the new regional dominant strains of the virus.
This natural and highly predictable cycle of events has been occurring simultaneously in different parts of the world, and once again, it can be predicted with great confidence, that in the future, there will be many more mutant strains develop and that some will be much more successful, and therefore dangerous than others. Then, the genetic variant which proves (by having the highest replication rate or ‘R number’) as being the most efficient, the most transmissible, the most contagious, and the most infectious will win the genetic race for survival and become (temporarily) the new globally dominant strain. Then, unfortunately, the cycle of adaptation into even more aggressive strains will continue, with each round of adaptive pressure and genetic refinement causing higher levels of mortality and morbidity.
The UK Variant: In the United Kingdom, roughly a month ago, the first of these new dominant COVID-19 strains was identified, a new strain that has subsequently been proven to be significantly more transmissible and able to spread from individual to individual and location to location more efficiently which in turn, causes the ‘R number’ to rise well above ‘1’ and the disease to begin to spread exponentially again.
Now, a month later, with the benefit of unimpaired 20:20 hindsight, it has become abundantly clear that the new ‘UK Variant’ has, as predicted here a month ago, not just been marginally more infectious, but significantly more infectious. The new ‘UK Dominant Strain’ has now proven itself to be at least 70% more transmissible than its predecessors and despite rigorous lockdown and infection control procedures being adopted almost immediately, has now spread to each and every part of the UK. Despite the stringent control measures, the new strain of Coronavirus has, in the space of just one month, become more efficient, more contagious, and has already succeeded in becoming the new UK dominant strain.
Also, in the space of just one month, the Hospitals within the UK have, for the first time since the pandemic started, become completely overwhelmed with new cases and more overwhelmed than at any time experienced during the first wave. The UK has, also for the first time, experienced more daily deaths than any other country in the entire world.
Furthermore, and also within the last month, we have witnessed this new ‘UK variant’ strain of the virus spread, despite international travel restrictions to the Middle East, India, the Asian sub-continent, and Japan. Because they are more proximate to the UK, Germany, Italy, France and the Netherlands have experienced so many additional cases linked to the new strain that they have been forced to adopt a national curfew-based lockdown approach!
The South African Variant: About three weeks ago and within a few days of the UK new variant strain being identified, another even more transmissible strain was discovered with its origins in South Africa. This South African strain of the Coronavirus has already been deemed by experts to be even more contagious than the UK Variant. In the last three weeks, the South African variant strain of COVID-19 has already reached every country in sub-Saharan Africa, the UK, Spain, Italy, and at least 20 other countries globally.
The Two Brazilian Variants: Finally, within the last two weeks, the emphasis has been given to the emergence and identification of two separate variant strains of the Coronavirus, one of which is considered to the most transmissible variant strain of them all! Indeed, the fear of the most transmissible variant of the Brazilian pair led to the UK banning all travel from the whole of South America and Portugal! However, other countries that have been slower to follow suit have already discovered the virus to be present and circulating within their populations.
The implications for Asia: Although as yet, the three most contagious new variants have emerged in countries outside of Asia, the risk of any of these viruses entering Asian countries and wreaking havoc must not be underestimated. The risk of one or more of these three variant strains reaching each and every country in South East Asia is almost a certainty and in due course. Subsequently, the prevailing dominant strain that has so far caused over 2 million deaths, will be superseded with more contagious variants until, over time, they too are replaced with even more transmissible mutations of the virus. Although these emerging variant strains are new, the medical experts already understand how the virus is transmitted and they already know how to combat them by doing even more of the things we were doing before, but now we have to do them more diligently and without error.
To assist the Citizens of Singapore further, the team at ‘Big Red’ have again asked their resident Public Health expert Prof. Martin A. Blake to give a further update later this week and also answer all the frequently asked questions (FAQ’s) they are receiving from their customers and the public.
At the end of last week, the team at ‘Big Red’ promised a further update on the new emergent strains of COVID-19 that are appearing in different parts of the world and assess the corresponding emerging risk of transmission and infection for the Citizens of Singapore and SE Asia in particular. Therefore, Dr. Martin Blake a specialist advisor to is ‘Big Red’ on all issues concerning Infection Control and Preventive Medicine has drafted a further COVID-19 update based on all the most reliable information and scientific data available as well as answering the most frequently asked questions.
SE Asia COVID-19 Situation Update 18th January 2021
In the last Coronavirus (COVID-19) update published by ‘Big Red’ (on January 14th, 2021) we examined how having been exposed to considerable ‘adaptive pressure’, the virus had responded and mutated, in slightly different ways in different parts of the world, creating emergent and divergent variant strains. We also provided current information on how these new mutant strains have already begun to spread to every part of the world and in some places have successfully started to supersede the original dominant strain.
As indicated in earlier Advisory Notes, the natural processes of natural selection and adaptation are (unfortunately for the human race on this occasion) inexorable and this natural process will ultimately lead (in the short to medium term) to more and more transmissible strains of the virus becoming increasingly adept at by-passing our attempts to defeat them.
This entirely natural phenomenon will become most apparent in response to the ongoing global roll-out of COVID-19 vaccines. However, in the medium to long-term there is every hope that with our ability to create correspondingly new versions of the vaccine, we will, step by step, at least be able to constrain the spread of the dominant strains more effectively than at present. Therefore, the best advice right in the short-term is for the Citizens and residents of Singapore and indeed the Southeast Asia Region, to remain aware, educated, and vigilant.
Therefore, ‘Big Red’ will continue to play its part in protecting all residents of Singapore against infectious disease, as it has done already for over 35 years, by providing current information and advice on the risks posed by these new emergent mutations of the virus.
The UK Coronavirus Variant: it has now been shown that the UK variant of the COVID-19 virus have developed changes in their ‘spike genes’ which is entirely consistent with them becoming more transmissible and therefore, more infectious. However, it must be remembered that the actual spread of the new Coronavirus variants through populations of people is not solely dependent on genetic mutation, but in equal part how we, as members of the human race allow it to spread between us. It is an amalgam of what the virus is doing as a pathogen and what we as humans are doing as potential hosts, that determines how efficiently and quickly it can spread.
Over the last few days, it has become clearer and clearer that there is less and less room for error in controlling the spread of the virus by adhering to social distancing and general hygiene principles. It should be noted, however, that there is no evidence that the new variants can fundamentally evade face masks, social distancing, or any other public health interventions, rather that we just need to apply them more consistently and more diligently.
The ability of the new UK strain of the Coronavirus to opportunistically exploit any weakness in social distancing and hygiene protocols is unequivocally evidenced by the fact that this new mutant strain has, in less than a month (despite widespread awareness and infection control protocols) spread to over 50 different countries around the world.
The South African Coronavirus Variant: the science suggests that the South African variant of the Coronavirus actually emerged as early as October 2020 but went undetected until it reached a country where it could be more effectively identified. The South African variant has potentially more dangerous mutations to the spike proteins than the variant which emerged from the UK. This variant has one of the same genetic mutations as the UK variant, which also makes it more transmissible and thereby more infectious. However, the South African variant also has two other genetic mutations, and one of these, that virologists and immunologists call ‘E484K’ may enable the virus to evade antibodies produced by our immune system. Of course, this is of particular concern as we begin to roll out vaccines that fundamentally depend on the creation of antibodies created in response to the vaccine to combat the virus.
The virologists working on these new variant strains have tested the COVID-19 vaccine against one of the mutations known as mutation ‘N501Y’, which is found within the South African ‘E484K’ variant using blood samples from 20 different infected individuals and the preliminary studies indicate that the vaccination continued to work effectively against this particular strain. Further investigations are still required though, as ‘N501Y’ is not the only cataloged change recorded within the ‘E484K’ variant strain. It appears that the South African variant also has a number of other additional mutations that may enable the virus to gain entry into the human body.
It is also this part of the virus that immunologists use to ensure that viruses are appropriately targeted by vaccines, which is why these mutations are of particular concern as they could help the virus to sidestep the protection gained either by prior infection or vaccination. However, the same experts are certain that if further studies confirm this to be the case, that the existing vaccines can be reconfigured to regain their efficacy in a matter of weeks.
The Two Brazilian Coronavirus Variants: As discussed in the last edition of the ‘Big Red’ (Advisory Note 3), over the last two or three weeks, we have two different variant strains of the COVID-19 virus that have emerged and one variant is considered to represent a far greater risk than any of the other global variants. Eight cases of the first variant, which has a small number of genetic mutations, have already been identified in the UK.
The second, more worrisome variant, has been detected in the Brazilian city of Manaus and in people arriving in Japan, has been detected in Europe already. The second variant from Brazil is already considered to have arrived in the UK despite their Government imposing a travel ban on all South American countries. In preparation for the inevitable, the UK is undertaking significant genetic, epidemiological, and immunological research into these two Brazilian derivatives and we can expect further more detailed information on them in the near future.
The implications for Singapore and Asia: At the moment, there are no published cases of any of the above variants yet being present in Singapore or the other proximate Asian countries. However, it is highly improbable that these more transmissible variants are not already in circulation in the Region. Far more likely, is that they have been present, but have not yet been effectively identified. Also, in preparation for these new viral strains achieving dominant status.
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