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New variants of COVID-19 may prolong the duration of the virus

11 August 2021 | Story André Damons | Photo Anja Aucamp

Prof Burt read more — Prof Felicity Burt from the University of the Free State (UFS) and the National Health Laboratory Services (NHLS) holds an NRF-DST South African Research Chair in Vector-borne and Zoonotic Pathogens Research. She is also an expert on arbovirology in the UFS Division of Virology.

New variants of severe acute respiratory coronavirus 2 (SARS-CoV-2) have the potential to influence the size and duration of waves of infection and may prolong the duration of COVID-19’s stay with us. Despite the development of vaccines and the technology available to adapt vaccines in the future to address the emergence of new variants, it is extremely unlikely that COVID-19 will ever be eradicated.

The emergence of new variants has illustrated the importance of continually monitoring circulating variants for changes in viral proteins associated with cell binding (in other words, influencing entry of the virus into a cell) and immune responses (which would influence vaccine efficacy and reinfections).

Prof Felicity Burt from the University of the Free State (UFS) and the National Health Laboratory Services (NHLS), who holds an NRF-DST South African Research Chair in Vector-borne and Zoonotic Pathogens Research, says the current vaccines are effective against severe disease, but do not prevent transmission. Hence, complete eradication of the virus is unlikely, as the virus will continue to circulate at low levels in the population even if high levels of vaccine coverage are achieved. Prof Burt is also an expert on arbovirology in the UFS Division of Virology.

“To date, the only pathogen that has been eradicated globally is the smallpox virus. This was achievable because of a highly efficacious vaccine and because smallpox caused a disease that was readily recognisable, enabling rapid isolation of afflicted patients. In contrast, a virus such as SARS-CoV-2 that can cause asymptomatic infections in which the person is unknowingly infected and able to shed and transmit the virus, is probably impossible to eradicate,” explains Prof Burt.

Development of affordable treatment options remains important

The current vaccines are, however, able to reduce the severity of the disease until a vaccine is available that prevents complete transmission of SARS-CoV-2; therefore, the development of affordable treatment options remains important. Novel therapeutics, such as an antiviral drug that interrupts replication of the virus, or monoclonal antibodies that neutralise the virus, would go a long way to contribute to the treatment of infections.

“Currently, monoclonal antibody therapy is available in higher-income countries. Monoclonal antibodies mimic our natural antibody response, targeting specific regions of the virus, neutralising the virus, and stopping it from entering cells. Monoclonal antibodies have been used to treat other viral infections such as Ebola; however, they have significant limitations due to cost, availability, and high specificity, meaning that mutations in emerging variants could influence their efficacy. They are unlikely to be an affordable option in lower-income countries.”

Mutations become problematic

According to Prof Burt, viruses have a propensity to acquire mutations, or changes, in their genetic make-up during replication, and as expected, this virus has changed during the pandemic and will inevitably continue to mutate.

“These mutations become problematic if they influence the way the virus is transmitted between people, or if the disease profile changes and the virus causes a more severe disease, or if the changes result in a virus that is not recognised by the body's immune response. In other words, the virus is capable of hiding from, or can escape, the immune response that a person has developed as a result of a previous natural infection or from vaccination.

“If the virus has changed such that an existing immune response does not recognise it, then a person can become reinfected. Hence, changes in the ability to escape immunity are considered to confer an advantage to the virus. Although there are changes in all regions of the viral genes, we are concerned with changes that occur in the gene that codes for the spike protein. This protein is responsible for binding and entry of the virus into cells, hence changes in the spike protein that allow the virus to more readily enter cells are considered to be an advantage to the virus.”

Variants of interest vs variants of concern

Prof Burt says there is now some evidence suggesting that antibodies produced in response to the Beta variant – the dominant variant during the second wave in South Africa – are less efficient at neutralising the Delta variant of the virus. In addition, there is evidence suggesting that the Delta virus can replicate to higher levels in the body, resulting in a higher viral load. Although the kinetics of each variant are still not completely understood, the combinations of higher viral load, and the potential for reinfections to occur will likely contribute towards a larger wave of infection.

“The World Health Organisation (WHO) and international partners characterise emerging variants as variants of concern (VOC) or variants of interest (VOI). Although there are multiple new variants globally, only a small proportion of these meet the definition. The Lambda variant, initially recognised in South America, is deemed a VOI. This is a level below VOC, indicating that it has mutations that are known or have the potential to affect the characteristics of the virus and that the prevalence is increasing in multiple countries over time. Currently, Lambda is not a concern in SA. In contrast, a VOC has the same characteristics as a VOI, but in addition, has one or more of the following: increased transmissibility or is associated with change in disease severity or clinical presentation, or the public health and social measures are less effective against the variant,” says Prof Burt.

Vaccines will likely need to be adapted to accommodate future variants

It is impossible to predict which variants may emerge next, explains Prof Burt. “Fortunately, although the current vaccines may not prevent mild disease, they have all been shown to reduce the incidence of severe disease and fatalities. The technology for adapting vaccines is available – but of course – if a vaccine has to be adapted, it will take some time for that to be available. As this virus is now well established globally and will continue to evolve over the years, it is likely that, in the future, vaccines will be required to be adapted to accommodate circulating variants.”

“Although there is some reduction in vaccine efficacy against the currently circulating variants, there are fortunately high levels of protection against severe disease and hospitalisation in people who have received the single-dose Johnson & Johnson vaccine or both doses of the Pfizer vaccine. In other words, they are fully vaccinated,” says Prof Burt.

Despite reduced effectiveness and potential for vaccine breakthrough, it is still important for people to be vaccinated, as it reduces viral load and duration of virus shedding. Less viral replication means that the virus has less chance to mutate, with less chance of new variants emerging.

News Archive

In January 1, 2003, the Qwa-Qwa campus of the University of the North (Unin) was incorporated into the University of the Free State (UFS).

2003-02-07

FREDERICK FOURIE

IN January 1, 2003, the Qwa-Qwa campus of the University of the North (Unin) was incorporated into the University of the Free State (UFS).

While this is merely the beginning of a long and complex process, it does represent a major milestone in overcoming the apartheid legacy in education, realising the anti-apartheid goal of a single non-racial university serving the Free State.

The incorporation is also part of the minister's broader restructuring of the higher education landscape in South Africa - a process which aims to reshape the ideologically driven legacy of the past.

In contrast to the past educational and social engineering that took place, the current process of incorporating the Qwa-Qwa campus of Unin into the UFS is informed by three fundamentally progressive policy objectives, clearly outlined in the education white paper 3: (A framework for the transformation of higher education):

To meet the demands of social justice to address the social and structural inequalities that characterise higher education.

To address the challenges of globalisation, in particular the role of knowledge and information processing in driving social and economic development.

To ensure that limited resources are effectively and efficiently utilised, given the competing and equally pressing priorities in other social sectors.

Besides informing the way the UFS is managing the current incorporation, these policy objectives have also informed the transformation of the UFS as an institution over the past five years.

In 2001, former president Nelson Mandela lauded the success of the UFS in managing this transformation, by describing the campus as a model of multiculturalism and multilingualism. This was at his acceptance of an honorary doctorate from the UFS.

Indeed our vision for the Qwa-Qwa campus as a branch of the UFS is exactly the same as it is for the main UFS campus - a model of transformation, academic excellence, community engagement and financial sustainability, building on the histories and strengths of both the Qwa-Qwa campus and the UFS (Bloemfontein campus).

Realising this vision will be a giant leap forward in establishing a unified higher education landscape in the Free State.

In more concrete terms, the UFS is working towards this vision by focusing on the following areas of intervention: access and equity; academic renewal; investment in facilities; and sound financial management.

These interventions are being made not to preserve any vestiges of privilege or superiority, but precisely to increase access for students from poor backgrounds and to promote equity and representivity among all staff.

The current growth phase of the UFS has seen student enrolment almost double over the past five years, in particular black students, who now constitute approximately 55 percent of the student population of nearly 18 000 (including off-campus and online students).

But it has not just been a numbers game. Our approach has been to ensure access with success.

Our admissions policy, coupled with the academic support and "career preparation" programmes we offer, have resulted in significant successes for students who otherwise would not have been allowed to study at a university.

This will be continued at Qwa-Qwa as well.

Our academic offerings too have undergone dramatic change. We have become the first university in the country to offer a degree programme based on the recognition of prior learning (RPL).

This is not just a matter of academic renewal but of access as well, especially for working adults in our country who were previously denied a university education.

As for the sound financial management of the UFS (including the Qwa-Qwa campus), this is being done not for the sake of saving a few rands and cents, but for the greater value to our society that comes from having sustainable institutions.

It is sustainable universities that can make long-term investments to fund employment equity, provide information technology for students, upgrade laboratories, construct new buildings, develop research capacity, and provide a safe environment for students and staff, as is happening now at the UFS.

As a result of such management, a practical benefit for prospective students at the Qwa-Qwa campus of the UFS will be lower academic fees in some cases compared with the Unin fees.

As is the case with all these processes, there are concerns from staff and students at Qwa-Qwa and the broader community of the region that the Qwa-Qwa campus serves.

To get the campus viable and to ensure its continuation in the short term, tough choices had to be made by the minister of education regarding which programmes to offer and fund.

But we have been encouraged by the community's understanding that these concerns can be addresed over time as the campus becomes financially viable.

Meetings between the top mangement of the UFS and community representatives, staff and students at Qwa-Qwa have laid the basis for building a climate of trust in such a complex process.

We should not be captives of the past divisions but build this new unified higher education landscape that can meet our country's developmental needs.

It should be a higher education landscape that is based on broadening access, promoting equity and social justice, developing academic excellence, and the effective and efficient management of scarce resources. This should be our common common objective.

Professor Frederick Fourie the rector and vice-chancellor of the University of the Free State (UFS)

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