A Scientific Update on the COVID-19 501.V2 Variant

Minister of Health Dr Zweli Mkhize on Monday chaired a digital webinar alongside some of the country’s leading scientists who updated medical professionals on the advancement of research into the COVID-19 501.V2 variant discovered last year.

Mkhize said that scientists previously postulated that this variant may be driving the increased transmission observed in the second wave of COVID-19 infections and since then, more work was done to ascertain its virulence and ability to evade defence mechanisms like therapeutics and vaccines.

The minister was hopeful after the previous week showed promising signs of decline in transmission. For example, on Sunday, there was a 23% decrease in new cases nationally compared to the seven days prior.

“This could be attributable to many factors, including enhanced physical distancing facilitated by lockdown regulations. We must thank South Africans for adhering to the regulations, difficult and frustrating as it may be. Every sacrifice made has saved lives and we appreciate the patriotism South Africans are displaying to protect the sanctity of life,” Mkhize said.

However, there is still cause for concern.

The healthcare system continues to experience significant strain, with hospitalisations continuing to trend upwards, showing an 18,3% increase on 16 January compared to seven days prior. As at 16 January, nearly 18,000 (17,878) patients were admitted, with 2472 in ICU, 1117 on ventilators and 5850 requiring oxygen.

“This is a significant additional burden to the system and we must salute our health care workers for their stamina and courage as they continue to battle it out in the forefront. We understand the significant risks that you take every day, yet we have witnessed sheer commitment by the professions in health care and a willingness to engage in pursuit of excellence in health care delivery,” Mkhize said.

Presenting the basic findings on the 501.V2 variant, Professor Salim Abdool Karim said scientists initially noticed 23 mutations in the virus around November last year.

“We saw in November, 23 mutations in the face of a virus that had been quite stable. What we have seen is not just that this virus has mutations, but it has systematically spread. It has been spreading across our entire coastal region,” he said.

“What we saw is how it quickly came to dominate all the sequences we were doing. In our latest data from KwaZulu-Natal, 59 out of the 61 sequences came up with the new variant. It is now the predominant virus spreading in our midst.”

Karim said South Africa’s second wave of infections reached “completely new heights”.

“We are now seeing today more cases and more deaths than we ever on any day saw during the first wave. This rapid rise in cases is also accompanied by hospital admissions. Most unfortunately, we also see the deaths rising,” he said.

Quoting research conducted by scientific bodies, Karim explained that changes in the virus’s amino acids led to changes in the charge and shape of the protein. He showed that the binding of the virus to the human cell had changed significantly and noted that the virus and its spike protein now rotated about twenty degrees and is therefore able to approach more deeply into the binding site. This means that the virus’s affinity and its ability to bind to the human cell is now stronger and that’s what enables it to become a more efficient virus in the way it transmits.

He said changes have also occurred in the receptor-binding domain (RBD) and the N-terminal domain of the virus.

“This virus is spreading about 50% faster. Our second wave is faster than our first, at least in South Africa’s coastal provinces where we know this variant to be dominant. Current data suggests the new variant is not more severe and the published convalescent serum studies suggest that natural antibodies are less effective,” he said.