Prof. Neelika Malavige

• The Indian variant has not yet been added to the WHO’s list of variants to watch out for. Because the data is insufficient and not because it is not dangerous
• There is some evidence that the Indian variant might also evade immunity, but the data is limited. We will find out soon
• The WHO recommendation of masks too came later. This is the nature of science. With the emerging evidence, things change
• Airborne transmission ONLY occurs in certain settings like closed, overcrowded, poorly ventilated settings
• The virus causing COVID, doesn’t mutate as much (as influenza), but if it does, then we can do the same as we are doing for influenza

Globally new cases of Covid are falling, after an all-time peak through March to April this year, according to the World Health Organisation (WHO). 
The levelling-off has mostly been attributed to vaccination programmes around the world. However, the Director of the global health agency warned that if the Coronavirus is allowed to spread in parts of the world where vaccine rollout has been stalled, dangerous strains of the virus will continue to evolve and wreak havoc across the world. 
This seems especially true in the South Asian context, where a nation’s healthcare system has been brought down to its knees in nearby India, alarming many of its neighbours. 
With the Government of Sri Lanka scrambling to introduce restrictive measures to curb the spread of more ferocious strains of Covid-19, public concern over new variants and vaccine efficacy too have increased. We asked Professor Neelika Malavige, Head of the Department of Immunology and Molecular Medicine at the University of Sri Jayawardenapura some pertinent questions, about the new variants of Covid-19 and what it means for Sri Lanka. 

With the Government of Sri Lanka scrambling to introduce restrictive measures to curb the spread of more ferocious strains of Covid-19, public concern over new variants and vaccine efficacy too increases

"One important thing I wish to mention is that no vaccine protects you the day after you get it. Some vaccines provide some protection about 21 days after getting the first dose. But some vaccines only give protection from 14 days after the 2nd dose. So don’t expect immediate protection soon after getting a vaccine"

   Q    Which variant is likely to be more dangerous in the Sri Lankan context? The UK variant or the

Indian one? Are there any other lethal mutations authorities are keeping track of?

Currently, there are over 100 SARS-CoV-2 variants causing COVID-19. Only a few are more dangerous than others because of increased transmissibility, increased disease severity or causing infection to those who have got the vaccine or who have had a natural infection.
The WHO has named three variants as dangerous (Referred to as Variants of Concern). B.1.1.7 (UK variant), B.1.351 (South African variant) and P.1 (Brazilian variant). 
The Indian variant (B.1.617.2) has not yet been added because the data is insufficient and not because it is not dangerous. The problem with the B.1.351 and P.1 is that they can re-infect those who have already had COVID-19 once, and also those who have had the vaccine. There is some evidence that the Indian variant might also evade immunity, but the data is limited. We will find out soon. The UK variant is very transmissible and may cause more severe disease, but vaccines work against it. 

"It is absolutely important to avoid these settings and wear a mask at all times.However, airborne transmission is highly unlikely and does not play a role outdoors in places such as parks, beaches etc"

   Q    The initial stance of WHO was that COVID-19 wasn’t airborne. As a result of the changes in new guidelines issued, public trust in the agency has taken a hit. What was the cause of this change in your opinion? Would governments have been better equipped to minimize the spread if this information that was available earlier?

The WHO and other authorities change with the emerging evidence. The evidence is first published and then the experts review and change their guidance. As you know the WHO recommendation of masks also came later. This is the nature of science. With the emerging evidence, things change. 
But just a few words about this ‘airborne’ transmission. This airborne transmission ONLY occurs in certain settings like closed, overcrowded, poorly ventilated settings. 
This can be a restaurant, an office, an air-conditioned public vehicle or in a setting like a wedding. Therefore, it is absolutely important to avoid these settings and wear a mask at all times. However, airborne transmission is highly unlikely and does not play a role outdoors in places such as parks, beaches etc.

   Q    Will new variants need new vaccines? 

Right now most vaccines protect against these dangerous variants. The protection is less against the South African, Brazilian and also possibly against the Indian variant (data is not conclusive). Although the protection is less, almost all vaccines do prevent severe disease with these variants. So right now we are alright. This is the same such as with infections such as the Spanish Flu. We know it killed around 50 million people in 1918 and 1919. We know that influenza mutates a lot and many individuals in cold climates get their yearly flu shots. The virus causing COVID doesn’t mutate as much, but if it does, then we can do the same as we are doing against influenza. 
One important thing I wish to mention is that no vaccine protects you the day after you get it. Some vaccines provide some protection about 21 days after getting the first dose. But some vaccines only give protection from 14 days after the 2nd dose. So don’t expect immediate protection soon after getting a vaccine.