A new strain of Covid-19 spreading around the world has served to highlight the lingering and evolving threat posed by the virus – nearly seven years after it first emerged.
Doctors have said the new form of the virus, named PJ. 2.1, does not appear to be significantly more harmful than other recent types but is accounting for a greater proportion of cases.
Although Covid-19 is not causing the levels of acute illness or death seen early on in the pandemic, it remains a threat to vulnerable people.
About 780 million infections and seven million deaths linked to Covid-19 have been reported globally to date, although the number of new cases has declined significantly.
A total of 56,471 new infections were recorded in the 28-day period to October 18 – down more than 35,000 from the previous month.
Since being identified in May in North America, PJ. 2.1 has achieved “rapid intercontinental spread”, according to a study by Chinese scientists released in September.
The same research reported that it was more effective than other variants at binding to ACE2, a receptor to which the virus attaches so that it can enter cells.
Another study, released last month, suggested this ability to bind to ACE2 could be accounting for the variant’s rapid spread across the globe.
The World Health Organisation has said that PJ. 2.1, like previous variants, causes symptoms similar to the common cold or influenza.
Wam, the official UAE news agency, has quoted Prof Elena Malinnikova, of the Russian Medical Academy of Continuing Professional Education, as saying that PJ. 2.1 may cause patients to have a more severe throat infection, when compared to other variants. Also, it may result in more prolonged fatigue.
While PJ. 2.1 has many mutations on its spike protein, the structure the virus uses to bind to cells, the variant is not thought to be better at evading the human immune system.
Remaining vigilant
Dr Asher Jamal, an emergency physician at NMC Royal Hospital Sharjah, cautioned against overreacting to the spread of new variants.
“New variants will continue to emerge but so far there’s no convincing evidence that recent variants are causing more severe illness, need a different treatment regimen or pose an imminent threat,” he said. “We still need to keep an eye on them but I don’t think there’s a reason for unnecessary alarm.”
He said that while Covid “is still around”, hospitals were not “seeing the same severity or pressure on healthcare services as during the pandemic”.
“Most cases are now relatively mild, although elderly and immunocompromised patients remain vulnerable to serious complications,” he said. “But overall, the life-threatening pneumonia and long-term complications aren’t something we’re coming across in the emergency department.”
PJ. 2.1 was identified in Ontario, Canada, at the beginning of May this year, and was first detected in the US in New York at the end of June.
It has since spread to numerous other states in the US, where it is thought to be the fastest-growing Covid-19 variant in its numbers.
Highlighting the variant’s global spread, PJ. 2.1 has also been detected in Australia, Singapore and Spain.
Cases on the rise but no need to panic
Echoing this, Prof Paul Hunter, an infectious diseases specialist and professor in medicine at the University of East Anglia in the UK, said PJ. 2.1 appeared to be “on the up” in terms of the proportion of infections for which it was responsible.
“There doesn’t seem to be evidence it causes more severe disease, higher hospitalisation rates or greater mortality than other circulating variants,” he said.
He warned, however, that it was not possible to predict with certainty what would happen with new variants.
Although numbers are down from last year, he said Covid-19 was “still putting people in hospital”.
Prof Eskild Petersen, who previously chaired the emerging infections task force of the European Society of Clinical Microbiology and Infectious Diseases, indicated that with vaccinations most people were well protected against Covid-19.
The new variant, although it has many mutations from other forms of Sars-CoV-2, the virus that causes Covid-19, will “most probably will also be picked up by the rapid test many people have at home”, added Prof Petersen, who is part of the PandemicX Centre at Roskilde University, Denmark.
Although Sars-CoV-2 continues to mutate, he said it was typically more stable than the viruses that cause influenza. “There’s extensive cross-immunity between the different Covid lines,” he said.
As a result, infection with one variant is likely to make a person better able to fight off the virus if they are infected with another variant.
Long-term impact
Dr Ali Alessandro Ayach, a UAE-based partner at the consultancy Arthur D Little who covers the healthcare sector, said that while Covid-19 was not putting strain on hospitals in the way it did early in the pandemic, there was an effect, as some patients have lingering symptoms.
“There’s a longer-term impact as some patients continue to experience health problems after recovering from Covid-19, even with the vaccination, and that’s creating some pressure on healthcare services and affecting their ability to return to normal,” he said.
He said a key long-term aim was to build healthcare services that could “absorb the shock” of future pandemics while retaining the ability to treat patients with other conditions, which meant building the ability to expand capacity when needed.
“How do you manage respiratory infections alongside diabetes, cardiovascular diseases, cancer and growing demand for care?” he said.
