By Daniel R. Lucey MD, MPH, FIDSA
Today the World Health Organization posted its weekly epidemiological update, with a special focus on SARS-CoV-2 variants, that contains a world map (below) showing the 37 nations verified to have the 501Y.V2 variant already dominant in South Africa and some neighboring nations. “Local transmission has been reported in at least 12 countries across four WHO regions” (p. 7).
In addition, maps showing the 17 nations verified to have the P.1 variant already dominant in Manaus, Brazil and the 88 nations verified to have the “Variant of Concern (VOC) 202012/01” dominant in the UK are also provided.
All three of these variant viruses, more contagious than non-variants, have been reported in the United States. Recently, the 501Y.V2 variant has been reported in Washington, D.C. and nearby Montgomery County, Maryland (site of the main National Institutes of Health campus), as well as Baltimore and two locations in South Carolina.
The U.S. is joined by nine other nations where all three of these variants have been verified, according to my reading of line listings in Annex 2 (pages 23-26 of the 26-page WHO document): UK, France, Germany, Netherlands, Spain, UAE, Reunion, Japan and Republic of Korea.
These global data on the spread of these variants is particularly notable given that today the WHO also announced that the AstraZeneca vaccine (using a chimpanzee adenovirus vector) will start to be made available through their COVAX facility to multiple nations in the coming weeks and months, after receiving the WHO’s “Emergency Use Listing ” on Monday (yesterday).
Concern regarding this vaccine’s very low efficacy against 501Y.V2 infection causing mild-moderate disease (manuscript posted Feb. 12 on a preprint server by Madhi S. and many colleagues) Safety and efficacy of the ChAdOx1 nCoV-19 (AZD1222) Covid-19 vaccine against the B.1.351 variant in South Africa | medRxiv has led South Africa to use a different vaccine (by J&J) in the initial vaccination campaign of health care workers this month. No data are yet available on whether the AstraZeneca vaccine protects against severe disease or death due to the variant now dominant in South Africa.
Daniel Lucey, M.D. MPH, FIDSA, FACP, is a Clinical Professor of Medicine at Dartmouth Geisel School of Medicine, Infectious Disease adjunct Professor at Georgetown Medical Center, senior scholar at Georgetown Law, Anthropology Research Associate at the Smithsonian Museum of Natural History and a member of the Infectious Diseases Society of America Global Health Committee. He served as a volunteer to outbreaks overseas including hands-on Ebola patient care in Sierra Leone and Liberia (Doctors without Borders) 2014, MERS 2013, SARS 2003, as well as HIV, H5N1, Zika, yellow Fever, and pneumonic plague 2017 (with WHO/USAID/CDC). Since Jan. 6, 2020 he has contributed over 75 posts to Science Speaks on COVID-19 and traveled to China in February 2020. He initially proposed, then fundraised and helped design the content for 2018-2022 Smithsonian Exhibition on Epidemics due to zoonotic viruses. From 1982-1988 he trained at University of California San Francisco and Harvard and was an attending physician at the NIH (NIAID) in the 1990s while in the US Public Health Service.