P.1 Various, Dominant Strain in Brazil, reported in New York

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it was only a matter of time before the P.1 version, first discovered in Brazil, made its way around the U.S. and landed in New York. More than a dozen states have now reported cases of the P.1 variant, having first been identified in patients in Minnesota in early January.

The P.1 difference was reported by Mount Sinai Hospital in New York City and confirmed by the Wadsworth Laboratories Department of Health. The patient who tested positive for the P.1 version lives in Brooklyn in their 90s with no travel history, according to a press release posted yesterday. P.1 has been identified as an “anxiety variant,” showing evidence of increased transmission, and potential for more severe disease and less efficacy of other vaccines or treatments.

P.1 is thought to be highly contagious, and has even led to some recurrence cases in people who had already passed Covid-19. To date, at least 48 cases of the variant have been reported in more than 16 states, and it is now present in at least 25 other countries.

While experts have been predicting that imminent changes will affect the main U.S. source, the country has been embroiled in an ongoing race to get the vaccine at risk. so many people before that happens – in the middle of several states opening mask orders, a capacity restaurant, and a smattering of maskless spring breakers in Miami Beach setting up scenarios that could lead to super spreader events as I told for Forbes yesterday.

To date, Florida has reported 21 cases of the P.1 variant, the highest number recorded to date in the U.S., according to CDC data. At the same time, the B.1.1.7 variance was reported, representing up to 30% of Covid-19 diseases in the U.S. according to Dr. Fauci, in all 50 U.S. states and co. -at least 94 countries. At least 180 cases of the South African variant, B.1.351, represent a growing threat, along with so-called domestic versions, B.1529 (New York) and B.1429 and B 1.427, both from California, which has been growing.

“The presence of the P.1 converter in New York is not surprising given that several states have already reported and series are restricted in the US (so there are more unknown cases),” he said. Amesh Adalja, MD, and infectious disease physician, and Senior Scholar at the Johns Hopkins Center for Health Security. “While the P.1 variant may seem to be a bit of a problem with the standard vaccines, the vaccines are nonetheless effective in terms of what matters – serious illness, hospitalization and death.

“With this more contagious difference [P.1], the solution is to accelerate vaccination, ”he said.

Eric Topol, MD, Founder and Director of the Scripps Research Institute of San Diego, and Professor of Molecular Medicine noted in a Tweet yesterday that while the P.1 variant is certainly contagious, it is not. is approaching transmission or lethality of the variable B .1.1.7, which now represents at least 30% of cases in the U.S., according to Dr. Fauci. He also tweeted that the P.1 variant “has responded well to the J and J vaccine and all the data support a full response to the mRNA vaccines.”

In addition, an introduction posted on March 3 on the MedRxiv server (not peer-reviewed) suggested that P1 may be more mobile, from 1.4-2.2 times, and “ 25-61% more likely to avoid immune suppression with previous infection (not vaccines) with non-P.1 lines, ”according to the authors. Researchers of this study used genomic and mortality data to reach their conclusions.

Dr. Eric Feigl-Ding raised the issue of controversial data out of Brazil, regarding increased transmission of the P.1 variable, (2-2.5 times).

In a recent interview, answering a question about the response to changes to the Johnson and Johnson single-shot vaccine in Brazil and South Africa, Monica Ghandi, MD, MPH, Professor of Medicine and Head of Related Departments (Operations) Clinical / Education) of the department of HIV, Infectious Diseases, and Global Medicine at UCSF / San Francisco General Hospital explained “we cannot say with certainty that the difference in these areas is due to more changes, but in his opinion. ” In Brazil, 69% of the circulating virus was a P.1 / P.2 variant at the time of the trial, and in South Africa, 95% of the virus was was circulating the B.1351 version. The most important drawback, however, is that while the Johnson and Johnson vaccine was less protective against mild and moderate disease in these regions, it was great protection against serious disease, hospitalization and death.

“While I am concerned about the increase in Brazil in cases with this variability due to slow vaccination rates, I still think the routine vaccines will be effective against the P.1 version,” offered Ghandi.

“The Johnson and Johnson vaccine was equally effective in preventing serious infections in Latin America, the USA and South Africa, despite the fact that 95% of the virus circulating in Africa was The variant B.1.351 and 69.4% of the virus in Brazil should be of the P.1 / P.2 mutant line, ”she explained. In fact, “the following description of the variables shows that P2 is the same as B.1.1.28.P2, and states that P.2 is one of the three mutations seen in P1 (aka B.1.1.28.P1). Therefore, the effectiveness of the Johnson and Johnson vaccine – at least against serious disease – for the circulatory variables in Brazil at the time is encouraging. ”

“Regarding the efficacy of the two mRNA vaccines (Moderna and Pfizer) against the P.1 variant, we can judge the efficacy of the vaccines against different variants by examining not only the neutralization of antibody responses, with remember that immunity has two arms: antibody responses and T cells. ”Ghandi explained. “T cells (CD4 and CD8 T cells) are the main immune defenses against viruses, and complex CD4 / CD8 responses after natural Covid-19 infection can be seen across multiple epitopes (parts) of the virus.”

“Similarly, strong and extensive T-cell responses are generated against several components of the spike protein after the mRNA vaccination and these T-cell responses are conserved against P.1, B. 1.351, B.1.1.7 and CAL. 20C variables, ‘she said.

“Despite the P.1 variant being discovered in New York City yesterday, I am not concerned about avoiding immunity from those who are already vaccinated,” Ghandi stressed. “However, vaccination is as soon as we can to prevent the spread of viruses, alterations or otherwise. ”