Explained: Are New Covid Variants in India Reason for Concern?

FIT asks Dr Rakesh Mishra, Director of Centre for Cellular & Molecular Biology, in CSIR

What do ‘double’ and ‘triple’ mutations mean?

(Photo wikipedia, iStock/ altered by FIT)

Right as the second wave of COVID gripped the country, a novel variant was discovered in India, dubbed the 'double variant'.

This was followed by a slew of other variants including the 'triple mutant' and the 'bengal variant'. And as the cases continue to rise at an alarming rate, each new variant invokes a fresh fear of its consequence.

What do these terms really mean? What are the 'Indian variants'? Are these variants behind the devastation caused by the second wave?

FIT speaks to Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad who heads the 'Genome Organisation and Nuclear Architecture Lab' there.

1. Cutting Through the Jargon: What Is the Difference Between a ‘Variant’ and a ‘Mutation’?

Viruses by nature will constantly go through changes. These altered versions are called variants.

Variants and mutants are essentially the same things, explains Dr Mishra.

Both are the result of certain mutations that take place in the original virus causing a change in its genomic sequence.

"Mutation is more scientific, but 'variant' is more commonly used these days," he says.

“When we say variant we are generally referring to mutants that are able to equally or more efficiently infect people.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

2. When Do These Natural Variants Become ‘Variant of Interest’ or ‘Variant of Concern’?

Speaking to FIT for a different article, Dr Shahid Jameel, too, has talked about how variants and mutations are a natural process that occurs in viruses, and are not a cause for concern in most cases.

"Viruses will often mutate without any consequence. But those mutations that are able to equally or more efficiently infect people, are the ones that we single out as specific variants," says Dr Mishra.

Variants become 'variants of concern' under two circumstances,

• When it spreads faster and starts making up more than 5 percent or 10 percent of the infections.
• If there are mutations that we think may create problems in terms of symptoms or vaccines.

He says, "in the case of variants that are spreading faster but don't have any other different consequence, they are known as 'variants of interest' and will be continued to be monitored for any other changes."

When it comes to the variants of concern, Dr Mishra says,

“Concerns are of two types: the concern of new or worse symptoms and the concern of how well the vaccines can protect against them.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

3. What Do We Know About the ‘Indian Variants’?

"In the case of COVID, what has happened is that some of the variants have become more dominant, and have been seen to be more infectious," says Dr Mishra.

"The first major variants that became famous was the UK variant. It has come to India as well, and seems to be dominant in several parts including Punjab and Delhi."

Since then, other prominent variants have been discovered in India as well.

The 'double mutant', B.1.617

"There is something called the 'double variant' which is formally known as B.1.617," he explains.

"The two most notable mutations in this variant (the reason it's called 'the double mutation') E484Q and L452R have been spotted before in California and Brazil."

“In the case of India, there is a slight difference in the way they have mutated, so we don’t know for sure what the consequence of this will be, but it could be a reason for the virus spreading more efficiently.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

"This double mutant is more prominent in Maharashtra, also in Delhi, Bengal. It's most likely largely concentrated in the northern states, but there is not enough data to say for sure," he adds.

The ‘triple mutant’, B.1.617 + V382L

According to Dr Mishra, "this variant is colloquially called the 'triple mutant' because it is a sub-lineage of the double mutant (with an added strain, V382L), and doesn't have a name of its own yet."

The ‘Bengal variant,’ B.1.618

He also adds that it is "likely to have the same outcome as the double mutant."

It has been so far mostly seen in Maharashtra, but also in some other states including Bihar and Karnataka.

Then there is the Bengal variant.

"This could be related to the Double, triple, or even the UK variant. This is called so because it was identified in Bengal," he says.

“So far its been stable for some months, But it may happen that the double variant may replace it because as it happens the double variant is becoming more in proportion gradually.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

The Variants in South India

Dr Mishra also talks of another less famous variant, the B.1.6.29 which has been around for quite some time.

"This is more prominent in the southern states of Telangana, Karnataka, Andhra Pradesh, and Kerala," he says.

4. Is the ‘Triple Mutant’ More Dangerous Than the ‘Double Mutant?

The terms 'double' and 'triple' variant can sound intimidating, making one sound more threatening than the other, but Dr Mishra assures that this isn't the case.

“People often think that ‘double mutant’ means double the danger, but that is not true at all.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

Double and triple mutations are really misnomers, he explains,

"Each variant really consists of 15-16 variations. You'll hear me call them by these names too because it's just easier to say (than using their alphanumeric names). But they aren't scientifically correct, and they are not indicative of how dangerous they are."

The double variant is called so because the two mutations involved are more prominent, and have been talking about.

5. Are the New Variants Causing New Symptoms?

As far as the data goes, no, says Dr Mishra.

“None of the variants have been shown to cause more severe symptoms or increased mortality so far. The real concern with them is that some of them are more infectious.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

But this time around, doctors speak of higher instances of gastrointestinal issues and issues of the lungs. Can these symptoms be attributed to variants?

According to Dr Mishra, "We haven't found any of the mutants to have any biological consequence in terms of symptoms."

But he also adds, "We still don't understand the genomic signature of the disease to say for sure what may be the reason for it. It could be related, but as of yet, there is no indication that the mutations are causing the difference in the disease.

There's also the fact that a lot of young people are being infected this time around.

Dr Mishra is of the opinion that this could have more to do with behaviour patterns, considering young people went out and socialised more in the time between the two waves.

Not to mention, people under the age of 45 were also more vulnerable to begin with given that they haven't received the vaccine.

"The only concern with the variants as of yet is that they're spreading very fast, he says. "Whether this is completely because of the variant or because of human behaviour is highly debated."

6. Can the New Variants Slip Through RTPCR Tests?

“Many people aren’t aware that the RT-PCR has an accuracy of 80 percent. This has been the case from the very beginning. This means that 20 percent of the cases might be missed, especially if they have a low viral content.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

The results will also depend on how the test is carried out. "If the sampling is not done properly if the kit is not stored or carried properly that can also lead to errors," he adds.

Dr Mishra goes on to assure that they have "tested variants through the RT-PCR tests and you need not worry that they are being missed. "There is no concern of gross false negatives because of variants."

However, he acknowledge that when it comes to the UK variant, in one of the test methods they found that one gene out of the 3 genes was being missed. To counter this problem, they're changing the primer and are monitoring the genome sequence.

7. What About Our Vaccines? Do they Offer Protection from Indian Variants?

“Both the vaccines are likely to protect against these variants. This is because the changes that we’re seeing between the variants are very minute.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

He further explains it by saying, "It isn't like the common cold where such drastic changes take place in the virus that the vaccine has to be changed every year. These changes in this virus are gradual. So it is very likely that they will be protected with the existing vaccines."

“There are ways of testing this and we’ve considered the challenges of the double variants and the triple variants and so far we have found that in the case of those who have taken the vaccine, we are able to protect efficiently.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad 

But the research is still ongoing.

"We are doing more extensive analysis to come up with more quantitative numbers, but so far there is no need to worry," he assures.

Dr Mishra also talks about how they are now focusing on the new variants that aren't as well known and monitoring their responses to the vaccines.

But what if you get infected in spite of being vaccinated?

"We must know that 20 -30 percent of the people may still get infected with COVID irrespective of variants," he says. But they're unlikely to fall seriously sick or need hospitalisation.

"So far we haven't seen any unusual pattern in the cases of breakthrough infections and reinfections to suggest any particular variant may be causing it." But, he says they are keen to continue studying the genome sequence of these cases.

Especially because "there isn't any guarantee that a variant will not come along that is able to transcend the vaccine."

“This is why a large number of cases is a major concern. A new variant could emerge on the platform of these efficiently spreading variants which may end up being more dangerous, or capable of transcending the vaccine.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

"That will be a huge problem," he says. "That is why it is extremely important that we check the spread of these cases and bring them under control."

8. How Worried Should We Be About the New Variants?

“Variants are always going to be there. But only people can spread the variant. It doesn’t spread through mosquitoes or water or any other carrier, so without people’s contribution, it can’t spread.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad

"The way to control the spread of the infection and avoid getting ill has been the same from day one and hasn't changed, no matter what the variant," he adds.

"The more infectious variants may replace the older ones, and variants are contributing to the sharp rise, but people are the key factor."

"The past few months have seen the worst COVID appropriate behaviour by us. We have been constantly saying that the virus is down not out, and yet we have seen all kinds of political, social, and festive gatherings that have no doubt contributed to the huge crisis that we're in."

“No variant has emerged that can travel through a properly fitted mask. So instead of fixating on every new variant, what we need to do is continue masking up, washing our hands, and following COVID appropriate behaviour.”

Dr Rakesh Mishra, Director of the CSIR-Centre for Cellular and Molecular Biology, Hyderabad