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SARS-CoV-2 is mutating. Here’s what your hospital needs to know

Viruses mutate, and SARS-CoV-2 is no exception. According to the US Centers for Disease Control and Prevention (CDC), multiple variants of the virus that causes COVID-19 have been documented and are currently circulating around the globe.

Some of the variants are causing more concern among health officials than others.

One particular variant, first detected in the United Kingdom in September 2020, has spread through much of London and southeast England and has since shown up in many other countries, including the United States and Canada.

Known as B.1.1.7, this particular variant seems to spread more quickly and easily than other variants, although there’s no evidence that it causes more severe illness or an increased risk of mortality. The CDC says the same is true of another variant (B.1.351) that first emerged in South Africa and shares some of the same mutations as B.1.1.7.

NEWStat asked J. Scott Weese, DVM, DVSc, DACVIM, whether veterinary hospitals should be concerned about these variants. A contributing reviewer of the 2018 AAHA Infection Control, Prevention, and Biosecurity Guidelines, Weese is the author of a series of in-depth guides on COVID-19 safety protocols for hospitals on behalf of the Ontario Veterinary Medical Association (available for download on his Worms & Germs blog’s COVID-19 Veterinary Resources page).

Weese told NEWStat that while there might be many variants, most mutations are random and appear to have no effect. “We’re worried about variants that might differ in their infectivity, virulence, or in our ability to [prevent infection via vaccination].”

Mostly, he says, that relates to spike protein variants, because the spike protein is what the virus uses to attach to angiotensin-converting enzyme 2 (ACE2) receptors—a better fit between the spike protein and the ACE2 improves the chance of infection. “The B.1.1.7 variant appears to be more infectious [than other variants], based on its spike mutation. However, it will not likely impact vaccine efficacy and doesn’t impact virulence.” Weese says there’s concern that the variant found in South Africa might be more likely to impact vaccine efficacy, “but that’s still unclear.”

Weese says companion animals are likely susceptible to the SARS-CoV-2 variants because they’re susceptible to SARS-CoV-2, but it’s hard to say to what extent—mutations could make strains more or less likely to infect different species. But given that the variants will likely have a similar infection potential as the original, Weese says their potential impact will depend on what’s happening to people around them, i.e., more infected people around pets will mean more pets at risk of exposure.

The good news? Weese says that despite reports that some of the variants spread more easily, hospitals don’t necessarily need to take additional—or more stringent—safety precautions because the mode of transmission is the same for SARS-CoV-2 and its variants, therefore, so are the safety precautions.

So how concerned should hospitals and veterinary staff be about these new strains?

As concerned as anyone else, says Weese. “They’re not more virulent [than SARS-CoV-2] but higher infection rates can lead to more disease—and therefore more people with serious illness or death—and greater potential for overwhelming [human] hospital capacity.” By extension, more pet owners may be ill or hospitalized, which translates to a higher risk of human-to-animal transmission and the likelihood of pets being cared for by family members or friends.

Weese recently updated his guidelines but says they don’t differ a lot from the previous edition. “I added more information regarding ventilation and CO2 monitoring,” he says. “That was the biggest change.”

And despite the variants, he said, overall, the protocols haven’t changed.

But Weese wrote the guidelines for Ontario hospitals. Given that rates of COVID infection are lower in Canada than in the US, what additional thoughts or recommendations does he have for US practices?

“Fight pandemic fatigue,” Weese says. And, of course, “get vaccinated as soon as you can.”

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