Covid-19 variant: All that is known so far about the new Delta mutation AY.4.2

In India, cases of patients with the new variant have been detected in Madhya Pradesh and Maharashtra. Representational photo/Atul Kamble

Just as things seem like they are going back to normal, a new descendent of the Delta variant of Covid-19 has been discovered. Found in coronavirus cases in the United Kingdom, the AY.4.2 mutation has been classified as a Variant Under Investigation (VUI) by the UK Health Service Agency (UKHSA). The agency has also given it the name ‘Delta Plus' or VUI-21Oct-01.

In India, cases of patients with the new variant have been detected in Madhya Pradesh and Maharashtra. In a report released by the National Centre of Disease Control (NCDC), seven cases of this variant have been found in Indore and it has been found in 1 percent of samples collected in Maharashtra. There are reports of the variant emerging in other parts of the country too.

While the broader Delta variant was first reportedly found in India, it has also become a dominant variant in the UK. This latest mutation within it, the AY.4.2, was first discovered in July this year and has been spreading since then.

Amid discussions about the possibility of a third wave, Mid-day.com reached out to Dr Pruthu Narendra Dhekane, consultant - infectious diseases, Fortis Hospitals to understand more about the new mutation and if it should be a cause for concern for people in India. Dhekane stresses on the need for vaccination and following Covid-19 protocols at least until the end of next year.

What do we know about the AY.4.2 variant (Delta Plus/VUI-21OCT-01)?

Dhekane explains that in the UK, a lot of sequencing of people testing positive is done as there is a crisis-like situation with a large number of patients. Through this, they have found this new genetic sequencing of the Covid virus named Delta Plus. "Experts are not sure if it's been officially declared as a ‘variant of concern' as of right now but it's a different variant that has come up."

"We are expecting different variants of COVID-19 to come but whether this variant becomes a ‘variant of concern' - which means whether it's a variant with the potential of creating a pandemic situation, is the variant likely to break through people who are already vaccinated and having a good immune response against COVID-19 - is something we need to know," he explains.

As far as India is concerned, Dhekane says there is not much genetic sequencing of every positive case that comes to experts. "We are doing a specific referral lot and the numbers have gone up. However, we do not have any official data of how many patients have come with a new variant, so another variant is very rare till now," he adds.

How do experts determine which variant of Covid a patient has? ‘

Dhekane says the variant is determined by sending the sample to a reference laboratory. "It's the responsibility of the lab to send samples to centres like NIV Pune and specific reference laboratories set up by the government. Unfortunately, not all labs do it and it needs to be done more and more so that we have our data," he concludes.

How is the AY.4.2 variant different from the other Covid variants?

The infectious disease expert says doctors will have to wait and see how it performs to determine how it is different. "There is no definitive evidence or data on whether Covishield or Covaxin is effective or ineffective against protection against this variant. We need more concrete data to be shared," he adds.

A variant in scientific terms, Dhekane explains, is when the genetic structure of the virus changes. "So, whether this change in the genetic structure of the virus is causing something that the virus earlier could not do is what we are interested in knowing. It is proposed that there is a chance that this Delta Plus variant could probably invade the immune response it has generated because of vaccination," he explains.

Dhekane adds that this is a concern because the coronavirus has properties that have made certain vaccines ineffective and it is likely to invade the immune response generated by the vaccination. "Then it is expected to cause another surge in the number of cases because, as all of us know, the lockdown has been opened up pretty much, and even schools are now opening back. So social distancing or masking are not being significantly followed, and everyone has resumed their social life. In the case of a new variant that is likely to be causing trouble, we are likely to see another upsurge in cases if it comes forth. That is how this virus is different and why we need to be watchful in the upcoming days."

Should people be more concerned about this new variant compared to the others?

Dhekane explains, "I think people need to be concerned about COVID-19 and not the variants." He says that everyone needs to be watchful about coronavirus until the period at least until the end of next year. "Even if the variant does not change, we need to follow the social norms until the end of next year. This also means everyone needs to practice universal masking, maintain physical distancing, wash hands regularly, and get vaccinated. Whether a COVID-19 variant changes or not, these principles of prevention will prevent COVID-19 variants from happening or changing. We are getting cases of people who have been fully vaccinated in February-March or April-May and are getting affected right now with COVID-19. These people are essentially being affected by new variants," he adds. He says that it may probably be because they are no longer following social precautions.

COVID-19 continues to exist, says Dhekane, but it's just that when more and more people get vaccinated and affected, we develop a herd immunity kind of response. So, the virus is likely to infect you, but it may not cause symptoms. "No one would like infection happening even in a mild degree of severity. I don't think people should be worried about a new variant coming because if they follow social norms, I don't think it should affect even if the new variant comes."

After the severity of the first and second waves, the fact that people know that there is always a danger that the variant might keep on coming should make them cautious. "Just follow social norms and don't think about the variant, and get vaccinated," he says.

Are the symptoms any different than the other variants?

"As of now, whosoever has got infected with these variants, as per the reports we have, are presenting pretty much the same symptoms," says Dhekane. With the data being minimal, experts are not seeing a large number of patients showing any rare signs as yet. However, he says there is a need to watch out for more data and literature in the upcoming days.

What kind of threat is it for those who have already been infected by Covid-19?

People who have been affected and are surviving should not forget about being vaccinated. He explains, "We have good data that people who suffer from COVID-19, whether mild or severe even if they take even one shot of the vaccine, their immunity levels are pretty much high and sustained overtime for an extended period."

If people who have survived the infection and have taken both shots of the vaccine can be relaxed compared to people who have not suffered from COVID-19.

What kind of risk does it pose for those who are vaccinated and those who are not?

"We still do not have enough data if the Delta Plus variant is affecting people who have been vaccinated to confirm that fact. Experts are not yet sure whether this new variant can cause a breakthrough infection or symptoms in vaccinated people and develop a vaccine immune response. I don't think it makes a difference if this variant is there or any other variant. People who are vaccinated are coming back with COVID-19 re-infection," says Dhekane.

People who are not vaccinated are at even greater risk, he adds.

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