OPINION | Sick of Covid-19 variants? You have the power to stop them from happening

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  • We all need to double our efforts to prevent Covid-19 infection in ourselves and others.
  • The idea that 'natural' post-infection immunity is superior to vaccine-induced immunity is dangerous and reckless.
  • We risk prolonging the pandemic if we don't protect ourselves.

Beta, Delta, Lambda. And now C.1.2. One could be forgiven for not being able to keep up with which Covid-19 variant we have to worry about this week, and which ones may be on the rise to send us back into lockdown before Christmas.

Viruses like SARS-CoV-2 (the virus that causes Covid-19 disease) mutate all the time. Not all of these mutations are of benefit to the virus, but viruses with those non-beneficial mutations also do not propagate well, and we typically do not get to see them, other than in a laboratory setting.

The mutations with real benefit to the virus are the strains that become dominant in our population and drive up our infection numbers.

A game of 'spot the difference'

The Network for Genomics Surveillance in South Africa (NGS-SA)* keeps track of new SARS-CoV2 mutations by determining the sequences of viral genomes in patient samples and comparing them with other known variants.

It is a high-level game of “spot the difference”. Scientists differentiate between “variants of interest” (where mutations are identified that could affect virus characteristics such as transmissibility, disease severity or diagnostic escape) and “variants of concern”, where it has been demonstrated that the mutations have strengthened the virus to our detriment.

Unfortunately, by the time a virus strain has graduated from “variant of interest” to “variant of concern”, it already has a strong footprint in our society, and then we have to adjust our prevention and treatment strategies and tools after the fact, which could take months and may only be partially successful.

At the recently held Annual Academic Day of Stellenbosch University’s Faculty of Medicine and Health Sciences (SU-FMHS), members of the NGS-SA described the case of an HIV-positive woman who had active Covid-19 infection for 216 days. Altogether, she had nine positive Covid-19 tests over this period.

She was also poorly adherent to her antiretroviral treatment (ART) regimen. Eventually, within a month of establishing her on a good ART regimen, her HIV viral load was reduced to almost zero and her tenth Covid-19 test was finally negative.

However, during this same time, five different new SARS-CoV-2 variants were detected in her test samples, the first within one week.

'Our luck may run out'

Persons with long-term Covid-19 infection are regarded to be the source of new variants. It is only a matter of time before a variant emerges that will successfully evade our currently available vaccines, which are essentially last year’s vaccines.

We have been lucky so far that these vaccines are still fairly effective against the current set of new variants, but our luck may run out. It will take time to re-develop or adjust vaccines for new variants, and although the mRNA vaccine technology used to develop the Pfizer/BioNtech and Moderna Covid-19 vaccines will shorten that time considerably, it will still take months to determine if a variant will actually become dominant and warrant its “own” vaccine.

Then the updated vaccine still needs to be developed, tested, manufactured and distributed, and of course administered at great cost to people who may rightfully question why they need to get this particular vaccine, if the next variant of concern could just be around the corner anyway.

This is why we all need to double down on our efforts to prevent Covid-19 infection in ourselves and others.

Proven prevention strategies

The idea that “natural” post-infection immunity is somehow superior to vaccine-induced immunity is dangerous and reckless, and will just prolong the pandemic.

“I am young and not at high risk, I will just get Covid and get it over with” is not a rational strategy and will endanger your own health (think of "long Covid") and life, and potentially those of everybody else on earth.

Everybody is at risk. By not protecting yourself against Covid-19 infection, you could be the origin of the next super-variant that may wipe out all the gains that we have made with the currently available vaccines.

For the love of humanity, please don’t. Protect yourself and others against Covid-19 infection by utilising proven prevention strategies such as vaccination and physical distancing.

Otherwise, we may all be playing “Covid catch-up” for decades to come.

*Dr Hanél Sadie-Van Gijsen is affiliated with the Centre for Cardio-metabolic Research in Africa (CARMA) in the Division of Medical Physiology at the Faculty of Medicine and Health Sciences at Stellenbosch University.

*The Network for Genomics Surveillance in South Africa (NGS-SA) is a network of laboratories, scientists and academic institutions that have joined forces to ensure the public health responses to Covid-19 in South Africa have access to the best possible scientific data. Members of the network include scientists at five South African Universities including SU-FMHS, the SA Medical Research Council, the National Health Laboratory Service and others.

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