When Portugal was recently removed from the green list of countries that British citizens could travel to, UK Transport Secretary Grant Shapps blamed it on a new variant of the coronavirus. “There is a kind of Nepalese mutation of the Indian variant that has been detected,” he said in a recent interview.
It was the first time that most people had heard of a “Nepal mutation”. In fact, the World Health Organization said it “is not aware of any new variant of SARS-CoV-2 being detected in Nepal .”
And, according to Public Health England (PHE), there is no “variant of interest in Nepal” or “variant of concern”. So what is the variant that Shapps is talking about? Does it even exist?
The ‘Nepal variant’ turns out to be the delta variant – the one first detected in India and which currently accounts for over 90% of cases in the UK – plus a mutation known as K417N. The K417N mutation is found in the spike protein (the mushroom-shaped projection on the surface of the coronavirus that helps it enter human cells).
The first five cases in England were sequenced on April 26, 2021, according to a recent PHE report, and were contacts of travelers to Nepal and Turkey.
At last count, there are 36 cases of the ‘Nepal variant’ in England . Most cases are in young people, with two cases in people 60 and over. Of the 36 cases, 11 were “associated with travel” (six travelers and five cases between travelers’ contacts).
The vaccination status of 27 of the 36 recorded cases of the “Nepalese variant” was known, and records showed that 18 cases were from people who were not vaccinated. Only two cases occurred in people who had received both doses of the vaccine and it had been more than two weeks between the second dose before testing positive. No deaths have been recorded from this variant.
Why the concern?
Despite the small number of cases of the ‘Nepal variant’, what has people concerned is that it is the highly successful combination of the delta variant (which has killed hundreds of thousands of people in India ), plus the K417N mutation, found in the beta variant –detected for the first time in South Africa– and gamma, detected for the first time in Brazil.
Although the beta variant does not appear to be anywhere near as transmissible as the delta variant (note how quickly it replaced the alpha variant in the UK), the beta K417N mutation is believed to help the virus bypass neutralizing antibodies , a vital part of our immune system defenses.
This means that it can make vaccines and antibody drugs less effective, and increase the risk of reinfection, as happened on a large scale in Manaus, Brazil, with the gamma variant.
These are why Public Health England is closely monitoring the situation. However, in the absence of epidemiological and laboratory evidence to show that the “Nepal variant” is more transmissible, virulent or capable of evading vaccines than the delta variant, for example, the “Nepal variant” will remain off the list. of worries, at least for now.
However, no one knows how this will play out in the weeks and months to come. But one thing is for sure: if delta with K417N joins the World Health Organization or PHE list of worrisome variants, it will not be called the “Nepal variant”. It will be designated with a Greek letter. Variant names that stigmatize countries are being phased out, but perhaps Shapps did not receive the memo.
Sally Cutler, Professor, Medical Microbiology, University of East London
This article was originally published on The Conversation. Read the original.
