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AU: Delta variant causing COVID-19 now mutating across Augusta

Augusta Chronicle

Dr. Ravindra Kolhe, director of the Georgia Esoteric and Molecular Laboratory at Medical College of Georgia at Augusta University, with a bar chart showing the number of different sequences of the virus that causes COVID-19. The group circled on the left is all of the new strains of the Delta variant, most of which cropped up in the last month.

In a month, the number of offshoots from the Delta variant that causes COVID-19 have sprung up rapidly among the largely unvaccinated population in Augusta. It's creating concerns that a different disease than the original infection will arise and could lead to adaptations that evade vaccines and treatments, the director of sequencing laboratory at Augusta University said. The Mu variant, still relatively rare in the U.S. but coursing across South America, is also now present in Augusta.

The Georgia Esoteric and Molecular Laboratory at Medical College of Georgia completed, on Sunday night, sequencing 360 samples of the virus from local patients. Their findings reveal some expected and concerning results.

The biggest majority – 146 – are the Delta variant that dominates across Georgia and across the U.S., accounting for 95.8% of the sequences in Georgia and 98.9% nationally, according to GEM data and tracking data from the Centers for Disease Control and Prevention. But the Delta-like sequences, those Delta strains that now have additional mutations, have increased from 3 significant mutations at the end of July to 13 at the end of August, said Dr. Ravindra Kolhe, the lab's director. A lot of that has to do with the area's low vaccination rate, which allows the virus to spread easily, he said.

"These are the Delta strains that carry additional mutations, and this has been all across the communities that have very low vaccination rates," Kolhe said.

Through the sequencing, he can easily track the virus mutating as it spreads.

"We know in communities where there is no vaccination or less vaccination the virus tend to evolve and mutate more rapidly rather than in the communities where the vaccination rates are high," Kolhe said.

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In addition, it allows for new mutations such as the Mu to show up. There were two Mu sequences in the latest batch, a tiny percentage of those identified in Augusta and in keeping with the national trend, where it accounts for .1% of all COVID-19 viruses, CDC data show. But it is what the variant is doing in other countries that heightens the concern.

The World Health Organization labeled Mu a "Variant of Interest," meaning it has characteristics that could make it an emerging threat, but a step below a Variant of Concern for strains like Delta, Variants of Concern have shown to cause greater problems; Delta is known to be much more infectious than the original version and therefore capable of causing more disease.

"But if you look at what happened with Delta long ago and then what is happening with Mu in South America, there is a concern that, it might not dominate, but it will definitely become a significant portion of infections," Kolhe said.

The Mu variant has also raised concerns because of its potential resistance to vaccine-derived antibodies. A paper in the preprint journal bioRxiv from Japan noted resistance to vaccine antibodies in the lab, although that work has not been peer-reviewed.

During a recent White House briefing, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to President Biden, noted that while that is a concern, it should not be reason to panic. While the Mu variant appears to diminish some protection, it is still "well within the range" of the vaccines being effective against it, he said.

What is concerning is the continued mutation of Delta and the Delta-like strains and their impact on patients, Kolhe said.

"We are coming to the point where not only the sequence is fundamentally far from the original virus but the (transmissibility) or epidemiology of the virus is very different," he said. It is also hitting segments of the population, such as children, that had been relatively unaffected before, Kolhe said.

"The Delta and Delta-like, there is a huge influx of children who are getting infected," he said. It could also start affecting therapies. Even with monoclonal antibodies, which are still under Emergency Use Authorization by the Food and Drug Administration as a relatively new treatment, some providers have already shifted away from an early version because it did not work well against the Delta variant.

"So if you look at the entire picture, this is nothing like COVID-19 with the original (virus) strain," Kolhe said. "The virus has fundamentally changed, the symptoms are changing. And the treatment is definitely changing based on the changed strain or the changed virus."