Exclusive: Delta plus variant may bypass immunity provided by both vaccines or an earlier infection: Doctor

New Delhi: The latest Delta plus variant of COVID-19 has been detected in 12 states in India with more than 51 cases detected from over 45,000 samples sequenced so far in the country. This variant was first seen in Europe in March this year. It was, however, brought into the public domain only in June. Eleven countries have reported this variant so far.

Delta plus is suspected to bypass immunity provided by both vaccines or an earlier infection by experts.

Research is going on across the world to better understand this new variant. In India, the Indian Council of Medical Research (ICMR) and the National Institute of Virology (NIV) have decided to carry out a study to check if the newly found Delta Plus variant (B.1.617.2.1/(AY.1), can be neutralized by the vaccines present.

To know more, we got in touch with Dr Chandrashekhar T., Chief Intensivist, Fortis Hiranandani Hospital, Vashi, to explain to us everything about Delta plus variant of COVID-19.

What is the Delta Plus variant?

Delta Plus is a sub-lineage of the Delta variant first detected in India, which has acquired the spike protein mutation called K417N. The mutation K417N has been of interest as it is present in the Beta variant (B.1.351 lineage), which was reported to have immune evasion property. Some scientists worry that the mutation could make it more transmissible. However, right now, there is no proof that this variant could be any more transmissible than others. Virologists are finding out if this new variant may be able to evade pre-existing immunity better than either Delta or Beta.

Why is it classified as a 'variant of concern'?

The Union Health Ministry has warned States that the Delta plus variant, which is currently a Variant of Interest (VoI), and under investigation, may become a Variant of Concern (VoC). The variant has increased transmissibility, stronger binding to receptors of lung cells, and potential reduction in monoclonal antibody response. Moreover, experts say that the Delta variant itself is more resistant to medication, treatment, and vaccination. Therefore, people who have been vaccinated can still be affected by this variant and can get severely ill. Neutralizing antibodies against this variant post-vaccination seem to be nearly five times lower in people who have already been vaccinated, than the other variants. Therefore, it is a variant of concern 

What are the worrisome properties of Delta plus COVID-19 variant?

Properties of concern for this variant are:

• Increase in transmissibility or detrimental change in COVID-19 epidemiology
• Increase in virulence or change in clinical disease presentation
• Decrease ineffectiveness of public health and social measures or available diagnostics, vaccines, therapeutics

How is it different from the Delta variant? Is the Delta plus variant more contagious and infectious?

It has been found that the Delta plus variant has a greater affinity to lung tissues as compared to other strains of Coronavirus but clarified that it does not mean the Delta Plus variant will cause more severe disease or is more transmissible. This more contagious version of the virus has been spreading rapidly throughout different parts of the world. There’s also the concern that this variant may be more adept at attacking lung cells causing more severe disease.

Is monoclonal antibody treatment not effective on Delta Plus?

Based on what is known so far by scientists in India, Delta Plus is considered highly infectious. What is more worrying is, scientists warning us that Delta Plus may show resistance against monoclonal antibodies cocktail treatments. There are concerns that this new variant may be able to bypass immunity provided by both vaccine and earlier infection.

Does Delta Plus evade immunity from vaccines as it carries symptoms from Beta variant as well?  Also are COVID-19 vaccines not effective against this variant?

Scientists are of the opinion that the Delta Plus variant also exhibits some immune escape, although estimates vary as to the extent of it. Currently, the Indian Council of Medical Research (ICMR) and the National Institute of Virology (NIV) have decided to carry out a study to check if the newly found Delta Plus variant (B.1.617.2.1/(AY.1), can be neutralized by the vaccines present in India.

Can it possibly be responsible for COVID-19 third wave?

It is said that the Delta Plus variant may trigger the third wave. But I would say with appropriate response measures and maintaining safety protocols, we may be able to avert major catastrophes.

What precautions should people follow?

• Always maintain a physical distance and stay home as much as possible, unless going for medical treatment or urgent supplies
• Wear masks when you are outside, and make sure the face mask is covering your nose
• Continually wash hands with soap, or use an alcohol-based sanitizer, making sure the whole surface of the hands is covered
• Avoid attending public functions, avoid social gatherings, and avoid group play
• Discuss, demonstrate, and reiterate the importance of COVID-19 appropriate behavior with your children to keep them safe
• ​For the healthcare providers and local authorities, the way forward is to keep a close watch on its potential presence in the country and ensure an appropriate public health response