Runners, To Your Marks…

We’ve all heard it. The first of three signals in a foot race, “Runners, to your marks. Get set…” and then either a gun is fired or the word, “Go,” is said. From then on, it is up to the runners to determine what happens.

In the efforts to limit spread and survive the Covid-19 pandemic, it is much the same. It is up to the participants, us, to determine if we win or if the virus does. That’s why the admonitions to wear a mask, limit unnecessary contact and travel, and become vaccinated are even more critical now.

Viruses mutate.

It’s a fact. Viruses change and adapt and overcome like teeny tiny Marines. In order to prevent them from adapting to eliminate our medical advances, we have to adjust our behavior or the vaccine or medications we have could become useless. If we don’t and they do mutate reducing our therapeutic effectiveness, then we have to come up with new scientific advances every time all over again. We’ve witnessed how difficult that can be over the last year. It is not easy or quick. It becomes a vicious cycle. That’s the race. The virus versus us. In the case of Covid, the race is to limit spread and vaccinate to get enough “herd immunity” among the global population that the virus cannot move from one person to another and have a chance to mutate.

Every time a virus passes from one person to another, it enters the newly infected person’s cells where it disassembles, takes over the cell’s genetic machinery and creates multiple new versions of itself. How successful that process is and how broadly infected the person’s cells are relates to a term called “viral load.” Basically that describes how much virus the person has and how much they shed. The higher the viral load, the more virus that is shared from one infected person to another. As with any disassembly and reassembly, little imperfections, changes, and hybridizations can and do occur. This can be carried along by the newly reconstructed viruses as a mutation. Therefore, to limit the potential for mutation, a society, group, population, club or collective of people must limit spread. Every time a new person becomes infected and passes it on, the potential for viral change and mutation is there.

Variant versus Strain

There is a lot of conversation about viral strains and variants. In the simplest terms, when a virus experiences enough mutations it can become a new variant, meaning it may have some difference in how contagious it is, even though it still retains the same way it presents to a human host's body. The term for that presentation of the those genetic or “genotype” changes is called the “phenotype” of the virus. When the phenotype changes so that the interaction with the host’s (human’s) cells change, it is referred to as a new strain. This can be quite bad. An analogy is a pressure gauge. As pressure builds, the gauge may show a warning range as “yellow.” If it goes far enough into the “red” it indicates imminent danger. A variant may be like a yellow reading. “Red” would equate to a new strain.

The Risk

A mutated virus could affect how well a vaccine protects us, how contagious the virus is, and how deadly it may become. Of concern, recent findings suggest that new variants such as B.1.1.7. (also known as the UK variant), B.1.351 (also known as the South African variant), and P.1 (the variant from Brazil) have up to 75% increases contagiousness. This makes personal behavior and cooperation with strategies to limit spread by mask-wearing and social-distancing as well as hygiene measures increasingly important. Vaccination strategies will take time. In order to win the race to herd immunity’s protecting us and ensuring a return to “normalcy,” we need to catch up and stay ahead of the viral potential for mutation. The only way to do that is to limit the number of people infected. That can’t be done by a government administration. It can’t be done by a law. It can’t be done by doctors or a healthcare system. It can be done by a population, by the people of a society.

Where are we in the race?

This is the million-dollar question. Or rather the 1.9 trillion-dollar question. Historically pandemics and plagues end in one of two fashions, by actions of the impacted population to limit spread and thus stop the pathogen’s ability to continue on, or by the pathogen (virus) self-limiting. Populations can limit spread by techniques such as distancing and barrier protection or by technology such as a vaccine. Self-limitation of the virus can occur by a mutation that renders the virus ineffective, or no longer contagious, or by killing so many people that too few are left to become infected. This last scenario is, of course, the most horrific. In the US and the world, we have already seen considerable mortality, and that was due to a much less infectious variant of a novel virus. If one considers the potential for more mutations and the potential for increased lethality as well, then the imperative for us to act more intelligently as a group is obvious.

This pandemic is slightly over a year old. In that time, we have seen a lot of good and bad behavior, heard a lot of rhetoric and witnessed an acceleration of changes in the virus. It has adapted to become more infectious. Presently, we have a tenuous advantage in the scientific development of an effective vaccine. Unfortunately, if we don’t adapt our behavior significantly, we can obliterate that advantage by increasing opportunities for viral mutation and change. If a new strain of greater infectivity, resistance and lethality occurs, then a horrible genie will certainly be out of the bottle. In fact, I worry that said genie may be peeking over the rim already.

What’s worse, in relation to the opening analogy of a footrace, the genie may already be lacing up its track shoes.

How this ends depends on us.