It’s not just delta: The list of COVID variants is getting longer

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The list of coronavirus variants is getting longer, and some of them are making Israeli experts worried. This is a natural biological and evolutionary process that is hardly unexpected, and that demonstrates how complex and fragile a process it is to try to control a global pandemic.

This week it was the AY3, a sub-strain of the delta variant, which has been found in several recent cases in Israel. Last month it was the “delta-plus” variant. It isn’t clear whether these new strains will have a serious effect, if any, on our daily lives, but the threat worries scientists, researchers and analysts around the world, as well as public health officials and the World Health Organization.

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The WHO, in cooperation with organizations and experts all over the world, monitors, classifies and maps out the new variants and sorts them into different groups. Under the group of “worrisome variants,” there are currently four, labeled with Greek letters – alpha (the British variant), beta (the South African variant), gamma (the Brazilian variant) and delta (from India). Each of them has sub-strains that have evolved very quickly, among them AY3, which was mentioned in a hearing this week of the Knesset Constitution, Law and Justice Committee as being potentially harmful.

Another WHO list comprises variants that are “of interest,” known by the Greek letters eta, iota, kappa and lambda. There have been cases of these variants being detected in Israel, but they are not a cause of concern right now. Each of them, however, is developing growing numbers of sub-types whose significance is not yet clear.

“We are identifying new versions of the delta variant that feature new mutations familiar from previous variants,” said Dr. Tomer Hertz, of the department of microbiology, immunology and genetics at Ben-Gurion University of the Negev. “What allows the delta [variant] to spread in this way is a combination of attenuation of the vaccine over time and traits that allow the variant to evade some of the antibodies.”

A woman receives a coronavirus booster shot in Jerusalem, last week.Emil Salman

Hertz is a member of the U.S. National Institutes of Health international working group that maps and ranks variants. Each month, the group issues an updated list of variants that bear monitoring. The group is now working on the list for September.

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Delta: “What’s interesting is that even when the delta variant reached Israel, there was no immediate outbreak – only sporadic cases,” said Hertz. “It’s not just a matter of the virus’ characteristics, it’s a matter of a critical mass of virus spreaders, helped by super-spreaders.”

Delta-Plus: This version of the delta virus was identified in 12 cases in Israel last month, after it had been found in several European countries and the United States, Canada and Japan. It is still less common than the delta version.

AY3: Dr. Asher Shalmon, the head of the Health Ministry’s international relations division, told the Knesset Law Committee this week that this variant had been spotted in 10 cases in Israel that originated in the U.S. “It looks very, very virulent in terms of its infection rate, and it looks as if it is developing relative resistance to the vaccine,” he said. “If this variant comes to Israel it could be a game changer and push us into the lockdown we are so trying to avoid it.” However, a source in the Health Ministry said it was still too early to say that this variant was pushing out delta or that it has the potential to spread widely.

Lambda: This variant is widespread in South America. First identified a year ago, its incidence had been relatively rare. However, in recent months, it has spread to 29 countries, becoming dominant in Argentina and Chile. It seems to flourish in countries where delta isn’t present.

The South African and Brazilian variants: According to Hertz, both the beta and gamma variants “look very worrisome in terms of their mechanisms and ability to evade the vaccine, but interestingly, the delta variant is dominant over both of them. When you do tests in petri dishes in the lab, it’s the Brazilian variant that’s more worrisome in terms of evading the vaccines, but in practice what’s spreading most quickly is the delta. Almost nowhere has there been an outbreak of the beta variant when the delta is dominant,” he said.

According to Dr. Adi Stern of Tel Aviv University, who has been studying the genetic sequence of the coronavirus, “When the delta [variant] emerged, there was a real fear that it was highly capable of circumventing immunity. We saw the mutations in its genome and, at first, also the data about the many immunized people [who were being infected]. But I think that the data that’s accumulated since then is more encouraging; it seems that the story is more a weakening of the vaccine and less [delta’s] inherent ability to circumvent the vaccine.”

Stern said the attenuation of the vaccine could explain what’s been happening in Britain, because it began vaccinating after Israel. This hints that the vaccine is indeed more effective when it’s “fresh” and that delta’s ability to seemingly circumvent the vaccine isn’t necessarily what it seems. “We are seeing evasive efforts by delta, and there are areas in the protein’s genome that change, which is connected to its evasive ability. But it isn’t true evasiveness. When the vaccine is fresh and strong it should do the job,” she said.

Prof. Cyrille Cohen, a Bar-Ilan University immunologist, said he believes that vaccines are the key and that this latest outbreak is connected to the attenuation of the vaccine. “We see the effectiveness rates increase when the vaccine is fresher,” he says. “The data clearly shows a rise in efficacy, from 16 percent among those vaccinated in January, compared with nearly 90 percent among those vaccinated in April.

“We don’t have a lot of options. We have a virus that has to be stopped, and we have vaccines that, if they’re fresh, can stop all the variants,” he said. “I think we have to aspire to a solution in which, like with the flu, the vaccine is updated annually based on the dominant variants.”