The dangerous and dominant Covid-19 Variant: What we need to know?

Dr Bijon Kumar Shil, in the last interview, had predicted correctly "If a second strain of the virus emerges like that in the UK and Africa, that could be a potential threat for herd immunity because of people's exposure to the new strain of the virus and/or the vaccination itself." 

This very situation is evident at present and is a backtrack for Bangladesh as well as the world from reaching pre-pandemic conditions.

What should people know about this new dominant South African variant (B.1.351)? Is it more contagious, and is it more deadly? 

Let's talk about these variants; there are three categories of variants. The first one is Variants of Interest (VOI), which have a specific genetic markup; these variants are associated with high transmission, case fatalities,  reduced treatment efficacy, and potential diagnostic problems. However, these are all under investigation and not confirmed. Under the VOI, a few identified are B.1.526, B.1.525, and P2 from Brazil.

The second group is called the Variant of Concern (VOC); they have strong evidence of increased transmissibility and the ability to cause severe diseases, hospitalisation, and mortality. VOCs also can overcome immunity generated by previous infections or vaccinations. Among the VOC are B.1.1.7, which was identified in Britain in September 2020.  The other variant, P1, was isolated in Brazil; the third one is B1.351, which originated from Africa and is currently prevailing in Bangladesh. VOCs can break through the immune belt and as well as vaccination and are much harder to diagnose. 

The third one is the most critical Variant of High Consequence; luckily, this strain of viruses has not been identified yet. icddr, b detected B.1.1.7 in January 2021. But after March, the dominant strain in Bangladesh became  B1.351. So the question is, what happened to B.1.1.7? The reason may be that the antibodies developed by infection and vaccination wiped out the B.1.1.7 variant. 

As most Bangladeshi might already have antibodies against B.1.1.7, it stopped the virus's further spread. Unfortunately, the African strain B1.351 can break the immune system. One study found that 40 out of 100 people, if exposed to this strain, ultimately failed to protect themselves against this variant and have severe health problems. At the same time, the other 60 people will also develop minor health risks. There is a risk for a large portion of people in Bangladesh to contract the virus.

With the new strain (B.1.351) of the Covid-19 virus, what is your recommendation for people to stay safe?

At this moment, the only recommendation is to prevent the transmission of the virus by using masks. Because the mask is the only means to break the virus's cycle jumping from one person to another, it is still important to maintain other healthy practices like social distancing, washing and sanitising hands, and avoid going out unless it's urgent. If you have to, I think the priority should be to wear masks.

People can also take some Vitamin C (1000mg) per day. People can use locally available sanitiser, while antiseptic like neem and alum in warm water can be used for mouthwash. 

In some parts of the world, especially the UK, there are reports of people having blood clots from AstraZeneca vaccine? Should Bangladeshi people also be worried?

One of the major concerns is blood clots from the AstraZeneca Vaccine, though the numbers are very low. The reason why it is happening is unknown right now and under investigation. If you want to protect most of the population, it's best to go for vaccination as reports show only 80 people out of 35 million have blood clots. So it's a minimal number: even the European Medical Association and the WHO has recommended the continuation of vaccine use.

What would you comment about the management of the spread of Covid-19 in March? What do you think has led to a higher number? Is it something to do with no lockdowns, less social distancing, or any other reason?

People are reluctant to follow the rules and regulations, and they are reckless with their behaviour.  Bangladesh was almost close to eliminating the virus, and for two months, the infection rate was almost 2% after vaccination, before the new variant came. There are also people going to the tourist areas, causing the virus's new strain to be transmitted more.

With the Shortage of ICUS and healthcare for many people, what do you recommend at this time?

The most important thing to do if anyone has symptoms like a headache or rashes is to inform the family members and become isolated. The suspected person and the family members should wear a mask. They should take Covid -19 tests as soon as possible. Trying to limit the spread of the virus is very important. Also, they should clean their homes with antiseptic. They can also increase and alert the immune system by taking Vitamin C. Lastly, if people think they have any symptoms, they should also inform doctors and respective authorities.

Bangladesh has received vaccines from India, but they have stopped exporting vaccines due to the surge in Indian cases. In this case, should we have also imported the Sinovac, Sputnik, or other vaccines? And should we try now to import?

India is showing one of the highest infection rates globally, and in this case, they will try to protect their population. But Bangladesh can import vaccines from other countries. But at the moment, the virus will continue to mutate. We might have to handle it and might have to live with it. So the best course of action in the long term is to develop our vaccines using dominated variants of SARSCoV2. If we develop our vaccines, we are more protected from local strains, and it's more viable for the country.

Should the treatment protocol be different with the new strain from that from before? Based on a recent TBS report, doctors voiced that the old protocol is not working. 

I am sure Bangladeshi doctors are familiar with the new strain. I know doctors working with the patients and are doing their best in diagnosing and treating them. I am sure they can manage it. I cannot suggest any protocols but just recommend social distancing procedures, taking Vitamin C, and wearing masks for people. The viral disease has no specific treatment, and patients are treated based on their symptoms. Bangladeshi doctors are very good at diagnosing and treating when the situation arises.

Do you still think for us to go to a pre-pandemic situation, and if so, what would you say the time frame is for that?

It is very tough now. Last year, in July, I said Bangladesh could have eradicated the virus by January or February 2021. But it was impossible because of the new strain, even if people have antibodies and vaccines. The virus can mutate again and again, and in the future, mutations might come even faster than the last time. At present, It is still tough to go back to the pre-pandemic stage. 

We live in a Global Village, so a single country cannot eradicate the disease alone and be isolated if the whole world's population is at risk. If the world's population were to use masks for 120 days, the virus would be contained because it cannot live outside living beings. Then we can see the infection rates go down. Even if we use vaccines or use treatment, lockdown, or restrictions, it may not affect us in the short term.

Masks may be the only way to eradicate Covid-19 from the world. National and international bodies should spread awareness of wearing masks. In 2003, we contained the SARS-CoV-1 by wearing masks, not by the vaccine. We need to understand the importance of these measures. In a way, masks are the universal Vaccine that can protect whatever variants are circulating and will develop in the future.