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Sat Jan 16, 2021, 12:05 AM

The Coronavirus Is Evolving Before Our Eyes (The Atlantic)

https://www.theatlantic.com/health/archive/2021/01/coronavirus-mutations-variants/617694/



In the final, darkest days of the deadliest year in U.S. history, the world received ominous news of a mutation in the SARS-CoV-2 coronavirus. Scientists in the U.K. had identified a form of the virus that was spreading rapidly throughout the nation. Then, on January 4, Prime Minister Boris Johnson announced a lockdown that began almost immediately and will last until at least the middle of February. “It’s been both frustrating and alarming to see the speed with which the new variant is spreading,” he said in an address, noting that “our scientists have confirmed this new variant is between 50 and 70 percent more transmissible” than previous strains. Those figures, based on an early estimate by British government scientists in late December, made for terrifying push alerts and headlines. Though this strain of the virus (officially called “B.1.1.7”) quickly became known as “the U.K. variant,” it has already been found in 45 countries, suggesting that the opportunity to contain it with travel restrictions has passed. On January 8, Australia locked down Brisbane, a city of 2.3 million people, after discovering a single case.

Each day, B.1.1.7 is being found in more people in more places, including all around the United States. Experts have raised dire warnings that a 70 percent more transmissible form of the virus would overwhelm already severely stretched medical systems. Daily deaths have already tripled in recent months, and the virus is killing more than 3,000 Americans every day. From a purely mathematical perspective, considering exponential growth, a significantly more transmissible strain could theoretically lead to tens of thousands of daily deaths, with hospital beds lining sidewalks and filling parking lots. To make matters worse, the warnings from Britain were followed by headlines about yet another variant, B.1.351, in South Africa. Then another concerning variant was identified in Brazil. News reports speculated that these strains may resist vaccines. Some experts cautioned that the mutations could render current treatments less effective. Scott Gottlieb, the former director of the FDA, said last week: “The South Africa variant is very concerning right now because it does appear that it may obviate some of our medical countermeasures, particularly the antibody drugs.” On Tuesday, Anthony Fauci echoed that concern, calling the variant “disturbing.”

These new variants demand to be taken seriously. Skyrocketing case counts in the U.K. suggest a potential to do enormous damage, and the identification of B.1.1.7 in so many countries is noteworthy. Still, we don’t yet know whether either variant will become as dominant worldwide as they have in their respective countries. They might spread widely and cause tremendous harm. They might also do neither. The sheer scale and capacity of this virus are challenging many things we thought we knew, but the basic laws governing its evolution are not among them. All viruses are constantly evolving and changing, just as human populations are. When a virus is spreading as widely and rapidly as SARS-CoV-2, spinning through trillions of generations each minute, adaptation is inevitable. The transmissibility of the virus will change. The severity of the disease it causes will change. Its ability to evade our immune system will change. It very well may evolve to circumvent our current vaccines. Thanks to genetic-sequencing technology, we can watch this evolution in real time. We can see the changes in a virus’s genes before we even know what they mean for the spread of disease. Charting the course of this evolution, and assessing its significance, has quickly become a foremost challenge of the pandemic. The peril is not that the virus will suddenly change in an extraordinary way that transforms the pandemic, but that it is changing in small, ordinary ways that are playing out on a vast scale, and whose significance we may not appreciate until it’s too late.

Almost exactly a year ago, in January of 2020, a flight attendant warned the renowned Chinese virologist Zhang Yongzhen: It was time to turn off all portable electronic devices. He was sitting with his phone to his ear. On the other end of the line, his Australian collaborator Eddie Holmes was pleading with him to publish the genetic code of the novel coronavirus. The Chinese government had forbidden this. Yongzhen was torn. The world did not yet know the cause of the rapidly spreading respiratory infection, and he seemed to have uncovered it in a sample of sputum from a severely ill person in Wuhan. Using genomic sequencing to unravel the code of the virus, he had found what appeared to be the blueprint of a new coronavirus. He told Holmes to publish the code. When Holmes did so on Twitter, the international scientific community pounced. Within days, researchers in Thailand were able to verify that the same virus had infected patients there. Scientists at the U.S. National Institutes of Health began to work on a vaccine. The code became the backbone of the Pfizer/BioNTech and Moderna vaccines, which owe their development to the speedy identification and sharing of the genome.

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