[Toronto Star]The ‘double mutant’ variant: what we know and don’t know about the COVID-19 strain found in B.C., Alberta and Quebec

Sabina Vohra-Miller wants to cry every time she thinks of the COVID-19 surge that’s devastating India — and fears Canada could face a similar scenario.

“The unfairness. It’s heartbreaking to see what’s happening in India right now,” said Vohra-Miller, who co-founded the South Asian Health Network in Toronto and has a master’s degree in pharmacology.

“And (to see) the parallels with what is happening here in Canada.”

India’s COVID-19 cases are out of control, rising by more than 300,000 in a single day this week. It’s partly due to the B.1.617 variant, sometimes called the “double mutant” variant, which was first detected in India and recently popped up in Quebec, Alberta and B.C.

Canada Thursday banned flights from India and Pakistan for 30 days, partly to contain the variant’s spread.

Vohra-Miller thinks if vaccines had been distributed more evenly worldwide, India’s tragic situation could have been avoided. Only about 10 per cent of its population has been vaccinated. It reminds her of how communities in Toronto with higher proportions of racialized Canadians have also been vaccinated more slowly.

Just how big a role B.1.617 is playing in India’s crisis is unclear as there’s little known yet about the variant.

Since it has now found its way to Canada, we asked experts for what we know and don’t yet know about this strain of COVID-19.

What do we know about the presence of B.1.617 in Canada right now?

The variant was detected Wednesday in a single case in Quebec. On the same day, B.C. announced it had previously identified 39 cases of the B.1.617 variant as of April 4.

On Thursday, Alberta announced the variant had been detected there, too.

Public health officials and experts have said that, typically, one variant will emerge to be the dominant COVID-19 strain — meaning one variant will spread more quickly than the others and eventually account for most COVID-19 cases. In Canada, B.1.1.7, which was first found in the U.K., is positioned to be the dominant variant, as it is in Ontario.

Dr. Peter Hotez, a vaccine expert and doctor based in Texas, said it’s not yet clear whether the B.1.617 variant will spread quickly enough to squeeze out B.1.1.7. But he said it’s clear that both variants exist and are causing severe harm in India.

What makes B.1.617 a double mutant?

It’s not as science-fiction as it sounds.

The B.1.617 variant first discovered in India, in the Maharashtra state where Mumbai is located, basically has two mutations — substitutions of amino acids at a certain location on the virus compared to the original strain of COVID-19 — instead of one.

Here’s where it gets technical.

One of the mutations is in the same location as mutations in variants discovered in Brazil (P.1) and South Africa (B.1.351). Scientists think the reduction in efficacy of vaccines against those COVID-19 variants are related to the location of the mutation, which is in a place called the “484 position.” That makes scientists think B.1.617 could share some of those variants’ characteristics.

“We’ve seen when you’ve got other variants that have mutations in the 484 position you do see a decline in the efficacy of vaccines,” Hotez said.

“It’s not exactly the same but I think we should anticipate that there may be reductions in vaccine efficacy (for the B.1.617 variant).”

Its other mutation may be associated with faster transmission of the virus. Vohra-Miller said early studies show it may transmit 20 per cent faster than regular COVID-19, but more research may paint a clearer picture.

What makes a strain a ‘variant of concern’?

Variants of concern, such as the B.1.1.7 variant that led to an upsurge in COVID-19 cases in the U.K. in December, include small changes on the virus that in some cases may make the virus more transmissible or more resistant to immune responses.

In the U.K., some studies have suggested the B.1.1.7 variant is not only more infectious, but more deadly.

The B.1.351 and P.1 variants that were first found in South Africa and Brazil respectively have also been listed as variants of concern by the World Health Organization.

Even if it’s no more deadly than the original strain of COVID-19, increased transmissibility may lead to more deaths as the health-care system becomes overwhelmed.

“When B.1.1.7 emerged out of the U.K. and we saw the people on gurneys in hospitals our original thought was: It’s not that it’s causing more severe disease but it’s just that the U.K. hospital system is getting overwhelmed,” Hotez said. “But subsequent papers suggested the variant could also cause more severe disease.”

The good news is the available vaccines do appear to protect against the variants of concern. There have been some concerns vaccines may not be as effective against the variants first discovered in South Africa and Brazil, but Hotez said the evidence so far shows they are still effective at eliminating the worst outcomes from these infections.

Why isn’t this “double mutant variant” listed as a variant of concern?

The World Health Organization so far has classified B.1.617 as a variant of interest rather than a variant of concern. It’s a subtle distinction that has to do with how much information scientists currently have.

Right now, they suspect the variant shares some of the concerning qualities of the variants of concern such as B.1.1.7, but scientists don’t yet know for sure how this variant will behave.

Is B.1.617 to blame for the horrendous outbreaks in India right now?

The situation in India is among the worst any country has seen since the COVID-19 pandemic began more than a year ago. On Thursday, the health ministry reported 310,000 new infections in a single day. One month ago, there were just over 40,000 cases reported in a single day.

Vohra-Miller said the variants spreading in India certainly contribute to the grave situation there — but B.1.617 is not the only reason things have gotten so bad.

First of all, the B.1.617 variant isn’t the only variant circulating in India. This variant is dominant in Maharashtra, but B.1.1.7 is dominant in the state of Punjab. And in other parts of the country, the original COVID-19 is the most dominant strain.

“I definitely think the variants are playing a huge role but it’s not the only factor,” Vohra-Miller said.

“I can tell you that India was back to doing large weddings, funerals, parties — all of that has been happening the last few months … I think that guards were let down at that point which was a grave error.”

Some experts in India speculated in early 2021 that, since many people had already been infected, the country may enjoy a degree of herd immunity. Vohra-Miller believes that perception bred a sense of complacency, and led to the exponential growth in cases the country is seeing now.

Is the Canadian government stopping flights from India?

On Thursday, Transportation Minister Omar Alghabra announced flights from India and Pakistan would be banned for 30 days, citing variants as one of the reasons for instituting the ban.

The government initially resisted calls to stop flights from India, saying the border control measures already in place were strong.

According to the Canadian government, there have been 35 flights from India with at least one case of COVID-19 that have arrived in Canada in the last two weeks.

With files from The Canadian Press