COVID-19: What do we know about the C.1.2 variant?

• Researchers have identified a new SARS-CoV-2 variant, which they refer to as C.1.2.

• C.1.2 contains mutations associated with increased transmissibility and ability to evade antibodies than other variants.

• However, experts say the public should not panic about the C.1.2 variant.

• They add that public health protocols, such as vaccinations, wearing a mask, and social distancing, are effective ways to prevent infection.

The more viruses spread, the more likely they are to mutate and form different variants. Variants that become more transmissible, resistant to current treatment options and vaccines, or cause more severe disease, are called Variants of Concern (VOC).

The World Health Organization (WHO) currently recognizes four SARS-CoV-2 VOCs:

• Alpha B.1.1.7, first detected in September 2020 in the United Kingdom

• Beta B.1.351, first detected in May 2020 in South Africa

• Gamma P.1, first detected in November 2020 in Brazil

• Delta B.1.617.2, first detected in October 2020 in India

Viruses need a host to replicate and mutate. The only way to stop new and more dangerous variants of SARS-CoV-2 from emerging is to prevent transmission and infection.

SARS-CoV-2 replicates quicker in unvaccinated people and, therefore, the virus has more opportunity to mutate. As these individuals have not already developed an immune response to the virus, it can survive and multiply for longer periods of time in their bodies.

The more opportunity SARS-CoV-2 has to cause infection in unvaccinated individuals, the higher the chance for new VOCs to emerge.

In recent research, scientists from the National Institute for Communicable Diseases (NICD) in Johannesburg, South Africa, alongside other institutions in the country, identified and discussed a new potential Variant of Interest called C.1.2.

Since its initial discovery in May 2021, scientists have detected the C.1.2 variant in seven other countries, including New Zealand, the U.K., and China. While it has some characteristics that may cause concern, experts are still gathering data.

A recent study investigating the variant appears on the preprint server, medRxiv.

Mutations

Using genetic analysis, the study authors note that C.1.2 contains many mutations also present in the Alpha, Beta, Delta, and Gamma variants of SARS-CoV-2. The researchers state these mutations make it easier for the virus to enter target cells, resist current treatments and vaccines, and pass from one person to another.

“​​Scientists are concerned about the variant, because of how quickly it has mutated: it is between 44 and 59 mutations away from the original virus detected in Wuhan, [China] making it more mutated than any other WHO-identified VOC or Variant of Interest,” said Dr. Vinod Balasubramaniam, senior lecturer at Monash University of Malaysia, who was not involved in the study.

“It also contains many mutations that have been associated with increased transmissibility and a heightened ability to evade antibodies in other variants,” the scientists said, “though they occur in different mixes, and their impacts on the virus are not yet fully known,” he added.

As the variant has had just a few months to circulate, knowledge on how it works is limited. However, the researchers reported that cases of the variant have increased in recent months at a similar rate to the Beta and currently dominant Delta variants as they began to spread in South Africa.

In May, C.1.2 accounted for 0.2% of genomes sequenced, in June, 1.6%, and in July, 2.0%.

The researchers also note there is usually a delay of 2–4 weeks between sampling and data being publicly available. This, alongside limitations in their sampling capacity, may mean the variant is more common than current data suggests.

Where did C.1.2 come from? 

“Viruses mutate in part as a result of an immune attack,” Dr. Cathrine Scheepers, first author of the study and senior medical scientist at the NICD in South Africa, told Medical News Today, “When someone [acquires an infection] with a virus, our antibodies bind onto this virus to kill it and prevent it from getting into our cells.

“During infection, the virus will mutate randomly. If these random mutations confer a benefit, such as the ability to evade these immune attacks by preventing antibody binding, that mutation will increase in number, as viruses with that mutation have a competitive advantage,” she continued.

“The longer somebody [has an infection] with a particular virus, the more chance it has to accumulate a lot of mutations. Since this lineage (C.1.2) is so highly mutated, we hypothesize it is a result of a prolonged infection allowing the virus to accumulate many mutations before being transmitted to others,” she added.

Should we be concerned?

“Right now, there is no need for the public or health authorities to be concerned about the C.1.2 variant,” Dr. Scheepers told MNT. “Although we are monitoring it very closely, we are still only detecting it at very low levels in South Africa (less than 3% of viruses in the country) and globally (less than 1% in other regions).”

Dr. Richard Stanton, a reader in the Division of Infection and Immunity at Cardiff University in the U.K., who was not involved in the study, told MNT, “At the moment, it’s worth keeping an eye on, but not one to be too worried about.”

He continued, “The number of cases remains fairly low, and we don’t have any evidence that the particular mutations it carries make it any more dangerous than Delta.”

Professor Adrian Esterman, Chair of Biostatistics and Epidemiology at the University of South Australia, who was also not involved in the study, commented: “It is too early to determine whether or not it is likely to create major problems or indeed even take over from the Delta variant.”

“Similar concerns were expressed about the Iota variant first detected in New York, and that was swiftly overtaken by the Delta variant.”

“At the moment, C.1.2 is not even a Variant of Interest, let alone a VOC. So, I think that we should remain calm, let the excellent South African virologists do their work, and watch carefully what happens over the next few weeks.”

Could C.1.2 overtake other variants? 

“We’ll have to wait and see,” said Dr. Stanton. “Some very early data suggest that C.1.2 is being beaten by Delta, but it’s too early to say for sure.”

Dr. Scheepers added: “It is still too early to tell what this variant will do. At the moment, it doesn’t seem to be overtaking Delta, which is currently predominating in South Africa. Delta also remains the predominant variant globally.”

“We continue to monitor this virus for evidence of marked increases as well as performing testing in laboratories around South Africa, specifically asking whether C.1.2 would be able to out-compete Delta. We hope to have the results of those tests soon,” she continued.

Will vaccines protect against the C.1.2 variant?

“Since C.1.2 shares a similar mutation profile as Beta and Delta, we are fairly confident that vaccines will still be protective against hospitalization and death against the C.1.2 variant as they have been against the Beta and Delta variants,” said Dr. Scheepers.

Dr. Paul Griffin, Associate Professor of Medicine at the University of Queensland, says: “It has not yet been established whether this variant does indeed have any of the properties that will make it a VOC — investigations into this are ongoing.”

“The discussion around this new variant should reinforce why it is so important to continue to do what we can to reduce the global burden of this virus, most notably striving for high vaccine coverage worldwide,” he explained.

He also said that we must “remain vigilant with respect to basic infection control strategies, including the use of hand hygiene, social distancing, masks, and having high rates of testing and isolating of positive cases wherever practical.”

How can we defend against C.1.2?

“The same as the other variants — vaccines!” said Dr. Stanton. “Combined with behavioral measures such as social distancing, ventilation, and mask-wearing when indoors and in proximity to each other.”

Dr. Scheepers added: “The same interventions as those being used for all other variants will likely protect against this one, too.”

“For example, we highly recommend that people get vaccinated to protect against severe disease. Nonpharmaceutical interventions, such as the wearing of masks, sanitizing and washing your hands, keeping a safe distance, and avoiding crowds, are effective against all variants.”

Written by Annie Lennon on September 10, 2021 — Fact checked by Ferdinand Lali, Ph.D.

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