"A nurse practitioner wrote on a little piece of paper that she got the vaccine for my dad," said his daughter, Andrea Araujo.
"She wrote, 'For my boss and my friend who died weeks before getting the vaccine. #ForDrAraujo.' It was sad but also really nice."
Araujo Preza was 51 when he died on November 30 in the same intensive care unit where he served as critical care medical director at HCA Houston Healthcare in Tomball, Texas.
More than 240,000 health care workers have been infected with coronavirus and nearly 900 have died, according to the US Centers for Disease Control and Prevention.
For their families -- and those of the more than 300,000 Americans who have died of Covid-19 -- the long-awaited vaccine is a source of hope in a year of despair. But it comes too late.
A 'bittersweet' moment
"I hope this is the first step in helping other people not go through what my family has gone through," Andrea Araujo said. "I hope we're headed in the right direction."
Hope is hard work in a country that has surpassed its own hospitalization record for more than a dozen consecutive days.
"As I was walking to go get my vaccine, I actually had just heard that my 27th patient died, so it was very emotional," she said.
'The burden of fear had been lifted'
Lindsay, an ICU nurse at Long Island Jewish Medical Center in Queens, got the shot from Dr. Michelle Chester, the corporate director of employee health services at Northwell Health.
"Everyday since March that I entered work has ... gotten darker and darker," Lindsay said Friday night on the CNN Town Hall "The Color of Covid -- The Vaccines."
"I have seen the effects of it. And I don't want to see you end up in one of our ICU beds or enter our hospitals."
She added, "I have been saying to my colleagues, in my 26 and a half years of nursing, I have never felt so afraid. After the shot ... I applauded. I felt like the burden of fear had been lifted off my shoulders."
"We have to acknowledge that this ... mistrust comes from a historical place," Adams, who is Black, told CNN. "But we also have to explain to people that we put protections in place to make sure this could never happen again.
"When you look at Covid-19, the fact that you are three to five times more likely to end up in a hospital and/or die if you're African American, Hispanic, or Native American, those are wrongs that are going on right now."
No reservations about getting the vaccine
Araujo Preza was born in El Salvador and came to the US in 1994 to continue his medical education. He studied at Staten Island University Hospital in New York and Tulane University in New Orleans. In 2001, he moved to the Houston area, where he worked as a pulmonologist for nearly two decades.
In April, during the height of the pandemic's first wave, he slept in the hospital for nearly a month to be on call, according to his daughter. When he fell ill in October, he downplayed his condition so not to worry his family.
Araujo Preza was admitted to the ICU in early November, and remained there about a week and a half. He had barely been out of the hospital 48 hours before he was readmitted. When his condition worsened he was transferred to Houston Methodist Hospital and later placed on a ventilator. He never returned home.
"For my whole life he always worked really hard and was very dedicated to his patients and his practice," Andrea Araujo said. "And more this year than ever before he exemplified that."
She has no reservations about receiving the vaccine, she said.
"I'm not a health professional but I know that my dad wanted to get the vaccine," Araujo said. "And so that gives me confidence. Whenever I have the opportunity to get it, I will."
"There's a great opportunity in front of us," the 29-year-old engineer said. "We can't change what's already happened and, moving forward, I definitely want health care workers with 29-year-old sons to not have to have the interview we're doing now."
Since her death, Yap-Banago's family always fixes a small plate for her at dinner. They often turn the TV to her favorite station -- The Hallmark Channel, which she would watch as she drifted off to sleep.
"Mom would be excited and relieved for sure, to know that there is a vaccine developed to help us, to help front line workers fight this terrible enemy," Banago said.
SINGAPORE Existing vaccines for Covid-19 will be effective in fighting off infection from new strains of the coronavirus, multiple experts told CNBC on Monday.
The comments came after the U.K. on Saturday said it identified a new mutation of the virus that can spread more quickly than previous variants.
Countries including Italy, Germany, Canada and Israel have barred flights from the U.K. following reports of the new strain.
Vin Gupta, an affiliate assistant professor from the University of Washington's Institute for Health Metrics and Evaluation, said he's confident that the current vaccines will protect against different strains of Covid.
"There is a strong belief here that the vaccine, as it exists today will have effectiveness in warding off infection from this new strain in England, in addition to the old strain that we've been contending with for months now," said Gupta.
That's because at the genetic level, the new strain is likely to be "very similar" to prior strains, he told CNBC's "Squawk Box Asia" on Monday.
The effectiveness of these vaccines in producing antibodies that can really attack and kill Covid-19 is extraordinary
Vin Gupta
Affiliate assistant professor
He added that the vaccines elicit a "really strong response in the body in terms of producing antibodies."
Vaccines produced byPfizer-BioNTechand Moderna have reported efficacy rates of more than 90%. The U.K. was the first country in the world to authorize and roll out the vaccine developed by American pharmaceutical giant Pfizer and its German partner BioNTech for emergency use. The U.S. and Canada are among a handful of countries that have also approved the usage of the vaccine for emergencies.
"The effectiveness of these vaccines in producing antibodies that can really attack and kill Covid-19 is extraordinary," he said. "I don't expect these minor changes at the genetic level to affect the vaccines' performance in the near term."
A member of the public walks past new artwork created by street artist The Rebel Bear in Edinburgh city centre which features a doctor administering a vaccine injection into a coronavirus-shaped balloon.
Jane Barlow | PA Images | Getty Images
However, future versions of the vaccine may need to take new virus strains into account, the same way flu vaccines are updated, Gupta said.
"I do think that this might impact our future facing work, but it's not going to impact the near term," he said. "It will not impact the current vaccines' effectiveness in ending the pandemic."
Dr. Vivek Murthy, who has been tapped by President-electJoe Biden to be the next U.S. Surgeon General, made similar comments on NBC's "Meet the Press" on Sunday.
"There's no reason to believe that the vaccines that have been developed will not be effective against [the new U.K. strain] as well," he said, adding that there's no evidence of the new variant being more deadly.
"The bottom line is if you are at home and you are hearing this news, it does not change what we do in terms of precautions as individuals that can reduce the spread of this virus," said Murthy, who was also previously surgeon general during the Obama administration. "It turns out that masking, keeping physical distance and washing our hands these are still the pillars of preventing Covid transmission."
These sentiments were echoed Monday by Danny Altmann, professor of immunology at Imperial College London.
"I am concerned, because since the beginning of this, we've seen mutations occur all over the world, many thousands of them, but this one has more mutations than any variant we've seen before," Altmann told CNBC's "Squawk Box Europe," adding that the 17 mutations "seem to account for the uncontrollability that we've seen in London and the southeast in recent months."
However, Altmann suggested that owing to the variety of neutralizing antibodies induced by the main vaccine frontrunners, it is unlikely that the new strain will be resistant to inoculation.
Andrew Freedman, a researcher in infectious diseases at Cardiff University, told CNBC's "Street Signs Europe" on Monday that the new strain would most likely be covered by the current vaccines' capabilities.
"It's quite likely, given that the vaccine provides immunity to different regions of the spike protein, not just the one where the mutations are, it is quite likely that the vaccine will work against this thing," he said.
"But of course, there could be further mutations that might in the future render the vaccines less effective."
CNBC's Ryan Browne contributed to this report.
Some groups had suggested the coronavirus vaccines were made using cells from aborted fetuses. The cells are actually engineered and grown in labs from tissue acquired many decades ago, and are not made directly from aborted fetuses.
The Vatican's Congregation for the Doctrine of the Faith said in a note approved by Pope Francis on Monday that receiving the shot was morally permitted.
"It is morally acceptable to receive Covid-19 vaccines that have used cell lines from aborted fetuses in their research and production process," the note said.
The statement was issued and signed by the head of the Congregation in response to several requests for guidelines regarding the use of the vaccine.
There have been some disagreements within the clergy regarding the ethics of taking a Covid-19 vaccine because it had used tissue retrieved from two abortions that took place in the last century.
The abortion connection, which had prompted a number of Bishops to voice their opposition to the vaccine, has now been rejected by the Vatican and by the US Conference of Catholic Bishops. The US Conference of Catholic Bishops had already issued a statement earlier in the month stating that the use of Covid-19 vaccines is morally justified.
"Given the urgency of this crisis, the lack of available alternative vaccines, and the fact that the connection between an abortion that occurred decades ago and receiving a vaccine produced today is remote, inoculation with the new COVID-19 vaccines in these circumstances can be morally justified".
The statement adds that receiving the vaccines do not indicate a cooperation with abortion, and that is not to be considered as an endorsement in any way.
"The licit use of such vaccines does not and should not in any way imply that there is a moral endorsement of the use of cell lines proceeding from aborted foetuses".
The Vatican's statement is aimed at addressing the moral questions surrounding the vaccine and does not aim to judge the safety or effectiveness.
The statement also called on the governments, pharmaceutical companies, and international organisations to pay extra attention to the equitable distribution of the vaccine to the poorer countries.
"There is also a moral imperative for the pharmaceutical industry, governments and international organizations to ensure that vaccines, which are effective and safe from a medical point of view, as well as ethically acceptable, are also accessible to the poorest countries in a manner that is not costly for them," it said.
Gov. Mike DeWine said last week that Ohio plans to administer Moderna vaccines to frontline health care workers, whereas Pfizer vaccines will be given to staff and residents at long-term care facilities.
The Pfizer vaccine, which was the first to receive emergency use authorization by the FDA, arrived in Ohio last week. Nine hospitals across the state received their first shipments last week, including Springfield Regional Medical Center.
The FDA authorized the Moderna vaccine on Friday.
The state is expected to receive another 140,400 Pfizer vaccines this week, as well as 201,000 Moderna vaccines.
Upper Valley Medical Center in Troy received 600 doses of the Moderna coronavirus vaccine Monday morning.
Credit: Premier Health
Credit: Premier Health
Under Ohios vaccination distribution plan, shots are being administered to health care workers and staff at long-term care facilities, such as nursing homes, assisted living centers, veterans homes, psychiatric hospitals and care facilities for those with developmental disorders or mental health disorders.
Both the Morderna and Pfizer vaccines require two doses of the shot to be vaccinated. As of Sunday, 5,930 people in Ohio had received their first shot, according to the state health department.
But it is aiming to lift itself out of the crisis in the coming months with a massive vaccination drive -- covering in its first phase almost as many people as the entire US population.
Indian Prime Minister Narendra Modi's government has identified 300 million people to receive the first doses of the vaccines. The priority group is made up of 30 million health care workers, policemen, soldiers and volunteers, and 270 million vulnerable people -- mostly citizens above the age of 50 and 10 million others with serious comorbidities.
The producers of three leading coronavirus vaccine candidates have applied for emergency use authorization, and all of them require two doses to provide sufficient immunity. That adds up to a total of 600 million shots, and Modi's government wants to complete the whole process by August.
That's an incredibly ambitious undertaking, especially for a developing country with poor rural infrastructure and an inadequate public health system that is already buckling under tremendous pressure from the coronavirus.
But India also has its own advantages. As a global hub for vaccine manufacturing, its mass production lines can churn out coronavirus vaccines -- developed either by Western pharmaceutical companies or domestically -- faster and cheaper than most other countries.
"Every single Indian who needs to be vaccinated will be vaccinated," Indian Health Secretary Rajesh Bhushan said at a news conference on December 8.
Which coronavirus vaccines will be rolled out first?
Of the three Covid-19 vaccine candidates pending approval from Indian regulators, two are being manufactured locally in India.
One of them is Covishield, a vaccine developed by Oxford University and AstraZeneca and produced by the Serum Institute of India, the world's largest vaccine maker.
The other is India's first homegrown coronavirus vaccine, Covaxin, developed jointly by Bharat Biotech and the government-run Indian Council of Medical Research.
Pfizer India has also applied for emergency use authorization for the coronavirus vaccine developed by Pfizer and BioNTech, Dr VK Paul, head of the national expert group on Covid-19 vaccination, confirmed to CNN.
Adar Poonawalla, CEO of Serum Institute of India, said his company is currently producing 50 to 60 million doses of Covishield per month, and production will be scaled up to 100 million doses a month after January or February.
But Poonawalla has made it clear that his company will focus on immunizing India first before sending the vaccines overseas.
According to Serum Institute of India, Covishield could be sold to the Indian government for about $3 for two doses, and later $6 to $8 on the private market. That is likely much cheaper than the Pfizer-BioNTech vaccine, which is sold to the US government for $19.5 for a single does -- although Pfizer India has not announced the price for India.
Covishield has another advantage -- it only needs to be stored at standard refrigerator temperatures of 2 to 8 degrees Celsius (36 to 46 degrees Fahrenheit). Pfizer's vaccine, on the other hand, requires an ultra-cold storage temperature of -75C (-103F) -- infrastructure that India lacks, and must be used within five days once refrigerated at higher temperatures.
What preparations are underway in India?
"We do have the advantage of having run a very large universal immunization program across this country," said professor K. Srinath Reddy, president of the Public Health Foundation of India. "To some extent our health system is fairly well geared up."
But vaccinating 55 million people in a year is still a far cry from the target of 300 million in just eight months.
The country currently has 239,000 vaccinators under the Universal Immunization Program, but fewer than 65% of them will be deployed to administer coronavirus vaccines, to avoid too much disruption to the routine vaccinations, according to Bhushan, the health secretary.
He said the central government is in collaboration with states to arrange additional vaccinators, but did not reveal how many more staff will be added.
"To get adequate work force of people to administer the injections, monitor the side effects, and then ensure that people come back for the second injection as well -- I think that is going to be the challenge that we have to meet," Reddy said.
According to the government's guidelines released Monday, 100 to 200 people will be vaccinated per session per day and monitored for half an hour after receiving the shots to examine any adverse effects, reported CNN affiliate News 18.
A digital platform, the Covid Vaccine Intelligence Network (Co-WIN) system, will be rolled out to track enlisted participants and the delivery of Covid-19 vaccines.
The government is also ramping up its stocks of cold chain storage equipment such as walk-in coolers and freezers, deep freezers and ice-lined refrigerators. At present, the country has more than 80,000 pieces of cold chain equipment at about 29,000 locations, which can store enough Covid-19 vaccines for the first 30 million frontline workers, Bhushan said.
"All necessary resources of vaccination have been delivered to the states," he added.
Manufacturers are also racing against time to increase syringe supplies. Rajiv Nath, managing director of Hindustan Syringes and Medical Devices, said the company was producing 560 million pieces of syringe per annum as of June.
"Currently we are making around 700 million pieces per annum capacity and we plan to increase the production rate to a billion pieces per annum capacity by the second quarter of next year," he said.
Drawing from the electoral machinery
India's decades-long Universal Immunization Program has traditionally focused on children -- and to a lesser extent women. Its coronavirus vaccine drive, however, will focus on adults, and faces challenges in terms of both the sheer number of shots and gathering people to receive them, Reddy said.
And that's where India's electoral machinery for mobilizing the country's huge adult population can come in handy, he said.
"We do have a well-oiled machinery, which conducts this in phases in different parts of the country," Reddy said "That is a very orderly process, which proceeds extremely smoothly, even in the remotest corners of the country. So in terms of adult mobilization, it is a fairly well tested process."
"The same process of identification and lineup can easily be replicated here (for the vaccine drive). Of course, the administration of the vaccine itself will have to be done by people who are trained for that," Reddy said.
And Reddy believes training new vaccinators won't be a difficult task.
"It is only a question of training people to administer intramuscular injections with safety and monitor for side effects," he said. "We can actually recruit people with a science background, preferably science graduates ... who can be trained easily and brought into the process as vaccinators under supervision."
Vaccinating 1.3 billion people?
As the world's second most populous country, India's strategy is to vaccinate "a critical mass of people and break that virus transmission," so that it doesn't have to vaccinate the entire population of 1.3 billion, according to Balram Bhargava, director general of the Indian Council of Medical Research.
Health Secretary Bhushan also said at a news conference last month that "the government has never spoken about vaccinating the entire country."
Reddy, from the Public Health Foundation of India, said after the first phase of 300 million people are vaccinated, experts can better assess how much of a threat the virus remains and then decide on how many more people will need to be inoculated.
"This is an evolving epidemic. And our response will have to be adaptive even in terms of deciding how many and how soon we'll be vaccinated." Reddy said.
"It is possible that conditions may change, and by that time the virus may not be as much of a threat as it is at the moment ... But over a period of time, I believe about 60% to 70% of the population would need to be immunized," he said.
CNN's Rhea Mogul, Swati Gupta and Manveena Suri contributed to this story.
Vice President Mike Pence received a COVID-19 vaccine on live television Friday in an effort to promote the shots safety and encourage the public to get one once its available to them. New polling shows, however, that Pences move did little to boost the publics willingness to get inoculated including among members of his own party.
In a Morning Consult survey conducted Dec. 17-19 among 2,201 U.S. adults, 56 percent said they would get a coronavirus vaccine if one became available: the highest level since Aug. 31 but just an increase of 2 percentage points from the previous week and within the polls 2-point margin of error.
A quarter of adults said they would not get the vaccine, and 19 percent did not know or had no opinion on the matter.
Vaccine willingness among Democrats remained roughly the same, at 64 percent, compared to the previous week, while just over half of independents (51 percent) said the same, a 6-point increase from a week earlier.
Despite Pences inoculation, the willingness among GOP adults to get the vaccine was about the same: 48 percent said they would get a coronavirus shot, compared to 47 percent a week earlier. A third of Republicans in the newest poll said they would not get the vaccine, and 18 percent didnt know or had no opinion.
Pences vaccination came as other high-profile politicians, including former Presidents Barack Obama, George W. Bush and Bill Clinton, have all pledged to receive the coronavirus shot in public to convince skeptics to get inoculated. President-elect Joe Biden received a vaccination Monday afternoon.
Health officials have also considered tapping celebrities to get vaccinated in efforts to promote wide-scale vaccination, though a Dec. 10-15 Morning Consult survey showed adults are most likely to be swayed by their own family members or public health leaders, such as Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases.
An exception for Republicans could be President Donald Trump, who 41 percent said would make them more likely to get the coronavirus vaccine. Trump, who was hospitalized in October after being diagnosed with COVID-19, has not yet committed to receiving a vaccine.
While 44 percent of adults in the most recent Morning Consult survey said they dont plan to get the coronavirus vaccine or didnt know if they would, a large portion of the skeptics could change their mind over time once they see others get the shot, according to a recent study by MassINC Polling Group.
A second vaccine cant come soon enough as the countrys daily death count continues to top 2,400 amid over 210,000 new daily cases, based on weekly averages of data compiled by Johns Hopkins University. The devastating toll is only expected to grow in coming weeks, fueled by holiday travel, family gatherings and lax adherence to basic public health measures.
Italy also suspended air travel, and Belgian officials on Sunday enacted a 24-hour ban on arrivals from the United Kingdom by air or train. Germany is drawing up regulations limiting travelers from Britain as well as from South Africa.
Other countries are also considering bans, among them France, Austria and Ireland, according to local media. Spain has asked the European Union for a coordinated response to banning flights. Gov. Andrew Cuomo of New York asked the Trump administration to consider banning flights from Britain.
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
In England, transport officials said that they would increase the number of police officers monitoring hubs like railway stations to ensure only essential journeys were being taken. The countrys health secretary, Matt Hancock, on Sunday called those who were packing trains clearly irresponsible.
He also said that the restrictions Mr. Johnson imposed could be in place for months.
Like all viruses, the coronavirus is a shape-shifter. Some genetic changes are inconsequential, but some may give it an edge.
Scientists fear the latter possibility, especially: The vaccination of millions of people may force the virus to new adaptations, mutations that help it evade or resist the immune response. Already, there are small changes in the virus that have arisen independently multiple times across the world, suggesting these mutations are helpful to the pathogen.
The mutation affecting antibody susceptibility technically called the 69-70 deletion, meaning there are missing letters in the genetic code has been seen at least three times: in Danish minks, in people in Britain and in an immune-suppressed patient who became much less sensitive to convalescent plasma.
This things transmitting, its acquiring, its adapting all the time, said Dr. Ravindra Gupta, a virologist at the University of Cambridge, who last week detailed the deletions recurrent emergence and spread. But people dont want to hear what we say, which is: This virus will mutate.
People at Saint Pancras station in London, waiting to board the last train to Paris today amid concerns that borders with France will close. Belgium said earlier today that it would ban trains from London for at least 24 hours.
By Kai KupferschmidtDec. 20, 2020 , 5:45 PM
Sciences COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.
On 8 December, during a regular Tuesday meeting about the spread of the pandemic coronavirus in the United Kingdom, scientists and public health experts saw a diagram that made them sit up straight. Kent, in southeastern England, was experiencing a surge in cases, and a phylogenetic tree showing viral sequences from the county looked very strange, says Nick Loman, a microbial genomicist at the University of Birmingham. Not only were half the cases caused by one specific variant of SARS-CoV-2, but that variant was sitting on a branch of the tree that literally stuck out from the rest of the data. Ive not seen a part of the tree that looks like this before, Loman says.
Less than 2 weeks later, that variant is causing mayhem in the United Kingdom and elsewhere in Europe. Yesterday, U.K. Prime Minister Boris Johnson announced stricter lockdown measures, saying the strain, which goes by the name B.1.1.7, appears to be better at spreading between people. The news led many Londoners to leave the city today, before the new rules take effect, causing overcrowded railway stations. The Netherlands, Belgium, and Italy announced they were temporarily halting passenger flights from the United Kingdom. The Eurostar train between Brussels and London will stop running tonight at midnight, for at least 24 hours.
Scientists, meanwhile, are hard at work trying to figure out whether B.1.1.7 is really more adept at human-to-human transmissionnot everyone is convinced yetand if so, why. Theyre also wondering how it evolved so fast. B.1.1.7has acquired 17 mutations all at once, a feat never seen before. Theres now a frantic push to try and characterize some of these mutations in the lab, says Andrew Rambaut, a molecular evolutionary biologist at the University of Edinburgh.
Researchers have watched SARS-CoV-2 evolve in real time more closely than any other virus in history. So far, it has accumulated mutations at a rate of about one to two changes per month. That means many of the genomes sequenced today differ at about 20 points from the earliest genomes sequenced in China in January, but many variants with fewer changes are also circulating. Because we have very dense surveillance of genomes, you can almost see every step, Loman says.
But scientists have never seen the virus acquire more than a dozen mutations seemingly at once. They think it happened during a long infection of a single patient that allowed SARS-CoV-2 to go through an extended period of fast evolution, with multiple variants competing for advantage.
One reason to be concerned, Rambaut says, is that among the 17 mutations areeight in the gene that encodes the spike protein on the viral surface, two of which are particularly worrisome. One, called N501Y, has previously been shown to increase how tightly the protein binds to the angiotensin-converting enzyme 2 receptor, its entry point into human cells. The other, named 69-70del, leads to the loss of two amino acids in the spike protein and has been found in viruses that eluded the immune response in some immunocompromised patients.
A fortunate coincidence helped show that B.1.1.7 (also called VUI-202012/01, for the first variant under investigation in December 2020), appears to be spreading faster than other variants in the United Kingdom. One of the polymerase chain reaction (PCR) tests used widely in the country, called TaqPath, normally detects pieces of three genes. But viruses with 69-70del lead to a negative signal for the gene encoding the spike gene; instead only two genes show up. That means PCR tests, which the United Kingdom conducts by the hundreds of thousands daily and which are far quicker and cheaper than sequencing the entire virus, can help keep track of B.1.1.7.
In a press conference on Saturday, Chief Science Adviser Patrick Vallance said B.1.1.7, which first appeared in a virus isolated on 20 September, accounted for about 26% of cases in mid-November. By the week commencing the ninth of December, these figures were much higher, he said. So, in London, over 60% of all the cases were the new variant. Johnson added that the slew of mutations may have increased the virus transmissibility by 70%.
Theres now a frantic push to try and characterize some of these mutations in the lab.
Christian Drosten, a virologist at Charit University Hospital in Berlin, says that was premature. There are too many unknowns to say something like that, he says. For one thing, the rapid spread of B.1.1.7 might be down to chance. Scientists previously worried that a variant that spread rapidly from Spain to the rest of Europeconfusingly called B.1.177might be more transmissible, but today they think it is not; it just happened to be carried all over Europe by travelers who spent their holidays in Spain. Something similar might be happening with B.1.1.7, says Angela Rasmussen, a virologist at Georgetown University. Drosten notes that the new mutant also carries a deletion in another viral gene, ORF8, that previous studies suggest might reduce the virus ability to spread.
But further reason for concern comes from South Africa, where scientists have sequenced genomes in three provinces where cases are soaring: Eastern Cape, Western Cape, and KwaZulu Natal. They identified a lineage separate from the U.K. variant that also has a N501Y mutation in the spike gene. We found that this lineage seems to be spreading much faster, says Tulio de Oliveira, a virologist at the University of KwaZulu-Natal whose work first alerted U.K. scientists to the importance of N501Y. (A preprint of their results on the strain, which they are calling 501Y.V2, will be released on Monday, de Oliveira says.)
Another worry is B.1.1.7 could cause more severe disease. There is anecdotal evidence that the South African variant may be doing that in young people and those who are otherwise healthy, says John Nkengasong, director of the Africa Centres for Disease Control and Prevention. Its concerning, but we really need more data to be sure. TheAfrican Task Force for Coronaviruswill convene an emergency meeting to discuss the issue on Monday, Nkengasong says.
Still, B.1.177, the strain from Spain, offers a cautionary lesson, says virologistEmma Hodcroftof the University of Basel. U.K. scientists initially thought it had a 50% higher mortality rate, but that turned out to be purely messy, biased data in the early days, she says. I think that is a very strong reminder that we always have to be really careful with early data. In the case of N501Y, more young people may be getting sick because many more are getting infected; Oliveira says some recent postexam celebrations in South Africa have turned into superspreading events. Studies in cell culture and animal experiments will have to show how a virus with several or all of the mutations carried by the new variant compares with previous variants, Drosten says.
Getting definitive answers could take months. But Ravindra Gupta, a virologist at the University of Cambridge, has made a start. The 69-70del mutation appeared together with another mutation named D796H in the virus of a patient who was infected for several months and was given convalescent plasma to treat the disease. (The patient eventually died.) In the lab, Guptas group found that virus carrying the two mutations was less susceptible to convalescent plasma from several donors than the wild-type virus. That suggests it can evade antibodies targeting the wild-type virus, Guptawrote in a preprint published this month. He also engineered a lentivirus to express mutated versions of the spike protein and found that the deletion alone made that virus twice as infectious. He is now conducting similar experiments with viruses that carry both the deletion and the N501Y mutation. The first results should appear just after Christmas, Gupta says.
The ban on flights from the United Kingdom that other countries are imposing is pretty extreme, Hodcroft says. But it does give countries time to think about putting any additional measures in place to deal with passengers from the United Kingdom, she says: I would hope that most countries in Europe are thinking about this.
But scientists say B.1.1.7 may already be much more widespread. Researchers in the Netherlands have found it in a sample from one patient taken in early December, Dutch health minister Hugo de Jonge wrotein a letter to Parliament today. They will try to find out how the patient became infected and whether there are related cases. Other countries may have the variant as well, says epidemiologist William Hanage of the Harvard T.H. Chan School of Public Health; the United Kingdom may have just picked it up first because it has the most sophisticated SARS-CoV-2 genomic monitoring in the world. Many countries have little or no sequencing.
The evolutionary process that led to B.1.1.7 may also occur elsewhere. With vaccines being rolled out, the selective pressure on the virus is going to change, meaning variants that help the virus thrive could be selected for, says Kristian Andersen,an infectious disease researcher at Scripps Research. The important thing in the coming months will be picking up such events, Andersen says.Whatever enabled the B.1.1.7 lineage to emerge is likely going on in other parts of the world, he says. Will we be able to actually detect it and then follow up on it? That, to me is one of the critical things.
In recent days, the world has watched with curiosity and growing alarm as scientists in the U.K. have described a newly identified variant of the coronavirus that appears to be more contagious than, and genetically distinct from, more established variants. Initial studies of the new variant prompted Prime Minister Boris Johnson to tighten restrictions over Christmas, and spurred officials in the Netherlands, Germany and other European countries to ban travel from the U.K.
The new variant is now the focus of intense debate and analysis. Heres some of what scientists have learned so far.
No. Its just one variation among many that have arisen as the coronavirus SARS-CoV-2 has spread around the world. Mutations arise as the virus replicates, and this variant known as B.1.1.7 has acquired its own distinctive set of them.
The variant came to the attention of researchers in December, when it began to turn up more frequently in samples from parts of southern England. It turned out to have been collected from patients as early as September.
When researchers took a close look at its genome, they were struck by the relatively large number of mutations 23, all told that it had acquired. Most mutations that arise in the coronavirus are either harmful to the virus or have no effect one way or another. But a number of the mutations in B.1.1.7 looked as if they could potentially affect how the virus spread.
It appears so. In preliminary work, researchers in the U.K. have found that the virus is spreading quickly in parts of southern England, displacing a crowded field of other variants that have been circulating for months.
However, a virus lineage becoming more common is not proof that it spreads faster than others. It could grow more widespread simply through luck. For instance, a variant might start out in the middle of a crowded city, where transmission is easy, allowing it to make more copies of itself.
Still, the epidemiological evidence gathered so far from England does seem to suggest that this variant is very good at spreading. In places where it has become more common, the overall number of coronavirus cases is spiking. Neil Ferguson, an epidemiologist at Imperial College London, estimates that the variant has an increased transmission rate of 50 to 70 percent compared to other variants in the United Kingdom.
Some scientists have raised the possibility that the increase in transmission is at least partly the result of how it infects children. Normally, children are less likely than teenagers or adults to get infected or pass on the virus. But the new strain may make children as equally susceptible as adults, said Wendy Barclay, government adviser and virologist at Imperial College London.
To confirm that the variant truly is more contagious, researchers are now running laboratory experiments on it, observing up close how it infects cells.
Researchers have already used such experiments to investigate a mutant that arose earlier in the pandemic, called 614G. That variant proved to be more transmissible than its predecessors, studies in cell culture and animals found.
But disciplined containment measures worked just as well against 614G as other variants. The same is likely true for B.1.1.7. According to what we already know, it does not alter the effectiveness of social distancing, face masks, hand washing, hand sanitizers and ventilation, Dr. Muge Cevik, an infectious disease specialist at the University of St. Andrews School of Medicine, said on Twitter.
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
There is no strong evidence that it does, at least not yet. But there is reason to take the possibility seriously. In South Africa, another lineage of the coronavirus has gained one particular mutation that is also found in B.1.1.7. This variant is spreading quickly through coastal areas of South Africa. And in preliminary studies, doctors there have found that people infected with this variant carry a heightened viral load a higher concentration of the virus in their upper respiratory tract. In many viral diseases, this is associated with more severe symptoms.
That is now a question of intense debate. One possibility is that the variant gained its array of new mutations inside a special set of hosts.
In a typical infection, people pick up the coronavirus and become infectious for a few days before showing symptoms. The virus then becomes less abundant in the body as the immune system marshals a defense. Unless patients suffer a serious case of Covid-19, they typically clear the virus completely in a few weeks at most.
But sometimes the virus infects people with weak immune systems. In their bodies, the virus can thrive for months. Case studies on these immunocompromised people have shown that the virus can accumulate a large number of mutations as it replicates in their bodies for a long period of time.
Over time, researchers have found, natural selection can favor mutant viruses that can evade the immune system. Researchers have also suggested that the evolution of the variant might have been additionally driven by medicine given to such patients. Some mutants might be able to withstand drugs such as monoclonal antibodies.
Other scientists have suggested that the virus could have gained new mutations by spreading through an animal population, like minks, before re-entering the human population. Such animal reservoirs have become a focus of intense interest as more animal infections have been detected.
Not yet, as far as anyone knows. But that does not mean it hasnt already reached the United States. British scientists have established a much stronger system to monitor coronaviruses for new mutations. Its conceivable that someone traveling from the United Kingdom has brought it with them. Now that the world knows to look for the variant, it may turn up in more countries.
No. Most experts doubt that it will have any great impact on vaccines, although its not yet possible to rule out any effect.
The U.S. Food and Drug Administration has authorized two vaccines, one from Moderna and the other from Pfizer and BioNTech. Both vaccines create immunity to the coronavirus by teaching our immune systems to make antibodies to a protein that sits on the surface of the virus, called spike. The spike protein latches onto cells and opens a passageway inside. Antibodies produced in response to the vaccines stick to the tip of the spike. The result: The viruses cant get inside.
It is conceivable that a mutation to a coronavirus could change the shape of its spike proteins, making it harder for the antibodies to gain a tight grip on them. And B.1.1.7s mutations include eight in the spike gene. But our immune systems can produce a range of antibodies against a single viral protein, making it less likely that viruses can easily escape their attack. Right now, experts dont think that the variant will be able to evade vaccines. To confirm that, researchers at the Walter Reed Army Institute of Research are analyzing the changes to the structure of its spike protein.
Dr. Moncef Slaoui, the head scientific adviser to Operation Warp Speed, the federal effort to deliver a vaccine to the American public, said that the new variant reported in Britain was unlikely to affect the efficacy of a vaccine.
At some point some day, somewhere a variant of the virus may make the current vaccine ineffective, he said, but the chance of that happening with this vaccine is very low. Nevertheless, he said, we have to remain absolutely vigilant.
But Kristian Andersen, a virologist at Scripps Research Institute, thinks it is too early to dismiss the risk to vaccines. If the U.K. variant evolved to evade the immune system in immunocompromised patients, those adaptations might help it avoid vaccines. The vaccines would not become useless, but they would become less effective. Fortunately, experiments are underway to test that possibility.
We dont know, but well know soon, Dr. Andersen said.
Benjamin Mueller and Katie Thomas contributed reporting to this article
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