SA’s 501.V2 coronavirus variant is now in at least 23 countries – and that isn’t all bad

Countries which have detected 501.V2 cases

• Variant 501.V2 of the novel coronavirus, first detected in the Eastern Cape in August 2020, has spread to at least 23 countries.
• Mutations to the virus’ spike proteins, which make the strain more infectious, could alter the development of vaccines.
• Variants discovered in the UK and Brazil – B.1.1.7 and B.1.1.248, respectively – have also spread to several countries, raising further questions around the effectiveness of blanket travel bans.
• The wide spread means the SA variant is getting attention it may otherwise not have.

A mutation of SARS-CoV-2, the virus which causes Covid-19, is thought to be responsible for driving South Africa’s burgeoning second wave of infections. The variant, known as 501.V2, was first detected in samples from the Nelson Mandela Bay area around August 2020.

It has since spread to at least 23 countries.

Together with novel coronavirus variants discovered in the UK and, more recently, Brazil, the global spread of 501.V2 has raised concerns around vaccine efficacy, transmission rates, and symptomatic impact. While researchers have rushed to isolate and identify these mutations, there is not yet scientific certainty about the variants’ long-term effects.

Viral mutation is common, and there is no evidence to suggest that these genetic mutations result in a deadlier version of the virus. But early studies show that new strains – particularly 501.V2 – are more contagious, which has seen various countries scramble to improve surveillance, and adapt their public health response to new variants.

Changes to the receptor-binding domain’s spike protein, which is responsible for the virus’ ability to bind to human cells, could complicate vaccinations efforts. The vaccines currently in mainstream are centred on virus’ spike protein, and, mutations there may affect efficacy.

This puts further pressure on pharmaceutical companies to develop up to date “booster” or “top-up” vaccines, which may need to be adjusted to combat new coronavirus variants – pressure that may not have been as acute for a variant limited to South Africa.

Dozens of countries have restricted travel to and from South Africa in an attempt to halt the import of 501.V2. But blanket border closures have failed to mitigate the variants’ global spread, and with further mutations expected to arise in 2021, epidemiologists say that isolating countries which have recorded mutations is not sustainable.

Tracing the exact origin of variants is not a simple task, says Salim Abdool Karim, head of South Africa’s ministerial advisory committee on Covid-19. Although the first 501.V2 case was registered in the Eastern Cape, it may have been imported from other provinces, or even another country.

Similarly, the UK variant – also known as lineage B.1.1.7 – has been detected in over 40 countries and has a higher rate of community transmission than the first viruses isolated. Lineage B.1.1.248, first detected in Brazilian travellers who had arrived in Japan on 6 January 2021, is believed to have mutated as far back as July 2020.

Countries which have detected the 501.V2 variant first detected in South Africa

Countries which have detected 501.V2 cases

This map will be regularly updated to reflect new countries which have confirmed 501.V2 cases.

In chronological order, from 23 December 2020 to 18 January 2021:

• United Kingdom
• Switzerland
• Finland
• Japan
• Australia
• Zambia
• France
• South Korea
• Sweden
• Norway
• China
• Austria
• Botswana
• Ireland
• Brazil
• The Netherlands
• Canada
• Israel
• New Zealand
• Germany
• Belgium
• Taiwan
• Denmark

The spread of the three variants – labelled as “Variants of Concern” – is not fully known, and countries which have managed to identify new cases have submitted samples for detailed laboratory analysis.

Current polymerase chain reaction (PCR) and rapid antigen tests do not distinguish between variants.

A US-based molecular diagnostics company, LexaGene, is developing a point-of-care testing system which could identify individual variants, including 501.V2 and B.1.1.7. “It is hard to estimate the impact of a new variant that can re-infect those who have already been infected or vaccinated,” explains LexaGene CEO Jack Regan.

“It is critical that we have the capability to not only detect whether the patient is Covid-19 positive, but also whether they are, in fact, infected with a new variant. We need to be able to more quickly and accurately identify new strains at the point-of-care, as this potentially could have helped better contain SARS-CoV-2 at the start of the outbreak.”

Once developed and trialled, these rapid tests will be submitted to the US Food and Drug Administration for approval.

(Compiled by Luke Daniel)