By Daniel R. Lucey MD, MPH, FIDSA
As the highly transmissible “Delta Variant” has spread to over 85 nations, on June 22 India also declared “Delta Plus” a Variant of Concern. The “plus” refers to the addition of a spike protein mutation, K417N, in the Delta Variant. This K417N mutation has been seen in other variants, most notably the Beta variant (B.1.351).
The concern is that this K417N mutation could confer resistance to at least one monoclonal antibody. This concern is still under investigation and has not been confirmed for the Delta Plus variant.
Of note, I did not find similarly detailed information on the Delta Plus variant on either this week’s WHO epidemiological update, or the US CDC webpages. Neither WHO nor US CDC have followed India’s lead this week in declaring Delta Plus a Variant of Concern.
I anticipate much more information on this Delta Plus variant over the next week. The question naturally arises as to what’s next. Will additional key mutations occur in the Delta or Delta Plus variants, especially ones that confer marked immune evasion?
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 more than 100 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 U.S. Public Health Service.