Mutations of the SARS-CoV-2 coronavirus are on everyone’s mind these days. Professor Schulz, there are British, South African and Brazilian variants of the SARS-CoV-2 coronavirus in Germany. How dangerous are these variants?

In the case of the English variant called B.1.1.7, it is relatively certain that it is more easily transmissible by about 30 to 50 percent, than the variants we have had in Germany so far. This means that, on average, anyone infected with the new variant will infect more people than someone infected with the ‘conventional’ virus. This increases the risk of a rapid spread of the B.1.1.7 variant. This variant was first discovered in the UK. But its exact origin is unclear; it was detected there due to good surveillance. It has caused massive problems in Ireland, for example, after infection levels there were rather low in early December 2020. It is also widespread in Portugal. In Denmark and Switzerland, this virus variant is currently spreading at a low level.
The B.1.1.7 variant is not only more contagious than the ‘classic’ virus, there is also initial data to indicate that it could be more pathogenic, meaning that more people die on average after infection. However, this needs further investigation.
The speed at which the South African variant called B.1.351 is spreading in South Africa indicates that it is also more easily transmissible. At the moment it is the dominant variant over there, but has been detected occasionally in other countries. For example, cases of infection with variant B.1.351 have been reported several times in recent days at various locations in the UK, without any apparent contact with South Africa. This indicates that variant B.1.351 may have already spread in the UK before having been detected; currently its distribution is still at a low level. Given the rapid potential for spread, this is a cause for concern.
In Brazil, several new virus variants are circulating. The variant known as “Brazilian variant B.1.1.248” first emerged in Japan among travellers returning from Brazil. So far, there is little data on this variant.

How often do these variants occur in Germany so far?

So far, the variants are all relatively rare in Germany. The B.1.1.7 (UK) variant accounts for about 6% of all infections in Germany at the moment, with most likely considerable regional variation. There have for example been a few outbreaks of the English variant in Hanover, but the public health department was able to control them. There have also been ‘outbreaks of infection’ in other cities, for example in Berlin, which could be traced back to the B.1.1.7 variant. Also, the South African variant has caused infections, just as the Brazilian variant has already been detected in Germany. In order to find out more precisely how widespread the new variants are in Germany, between five and ten percent of the reported new infections samples are now being sequenced. This serves the purpose of gaining a better overview of the spread of these and other mutants that may occur in the future.

It is important to keep in mind that the more space you give the virus to multiply – that is, the higher the infection numbers in a population – the faster the virus can mutate and the more variants emerge. The appearance of the three new variants mentioned above in countries where infection rates are or were very high is a striking illustration of this. Furthermore, the appearance of these variants also proves that the vaccination campaign that is now starting is not only about protecting the population in ‘rich’ countries, but that it must be in our own interest in Germany that vaccination is carried out as quickly as possible in poorer countries. Only when everyone is safe are we safe!

Are the vaccines also effective against these virus variants?

Several variants can escape part of the antibody response that our bodies have built up after a vaccination or after surviving an infection. There is a possibility that this could become a problem regarding vaccinations. Early indications are that recently developed new vaccines, for example, do not protect as well against the B.1.351 as they do against ‘classic’ variants. However, according to current knowledge, the new vaccines should still provide at least partial protection against the variants mentioned and prevent severe disease. Perhaps an additional booster vaccination will become necessary for the variants mentioned. We must also be prepared to modify vaccines if necessary. We will be able to assess this better as soon as we have more experience with the vaccines that have already been approved and will be approved in the next few months. In general, we can assume that vaccines that provide a high level of protection will have fewer problems with the new variants than those that already provide only partial protection against the classic virus variants. Nevertheless, at present, a vaccine that provides partial protection is better than no vaccine!

To counter the spread of the virus, scientists have proposed maintaining the lockdown throughout Europe until the incidence falls below 10? What do you think of this “NoCovid strategy”?

I can see that this would be desirable from a virological point of view. Obviously, given the problematic new variants, the lower the incidence figures, the safer we are. So there is no doubt that we still have to significantly reduce the currently still high infection rates in Germany. However, in my opinion it will be difficult to gain sufficient acceptance for the measures required for the ‘No Covid’ goal. To achieve this goal, one would have to close the borders within Europe and – at the current incidence – sustain a hard lockdown for several months. Given the other problems involved (economy, schools, psychological side effects) I don’t think this is realistic.

If – hopefully – the number of COVID-19 deaths and severe illnesses will decrease in the coming months thanks to vaccination of those at particular risk (nursing home residents, the elderly, people with pre-existing conditions, those working in the health care system, etc.), the challenge for politicians will be to communicate that certain restrictions on public life cannot be lifted as quickly as we all would like. Achieving public acceptance for this should be the urgent goal.

Professor Schulz, thank you very much for the interview.

The image shows the structure of the S protein (grey), which enables SARS-CoV-2 to bind to the human cell. The amino acid mutations found in the three SARS-CoV-2 variants discussed in this interview are indicated in red. Left: UK variant (B.1.1.7); center: South Africa variant (B.1.351); right Brazilian variant (B.1.1.248). Source: © Krey

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