Nicaragua became the last Central American country on November 17 to report the circulation of SAR-CoV-2 variants, which cause more aggressive pictures of covid-19, after the Ministry of Health (Minsa) was silent for more than six months about its presence, even during the outbreak of covid-19 between August and September. The Minsa, in addition, still does not report what is the incidence of these variants and which of these strains is the one that predominates in the country.
According to the information that the Minsa gave to the Pan American Health Organization (PAHO), in Nicaragua there are four variants of concern: alpha, beta, gamma and delta. The delta variant, according to medical opinions, could detonate the largest wave of infections, hospitalizations and deaths that occurred in the country between August and September, due to the characteristics of the symptoms and the rapid transmissibility that was reported.
The COVID-19 Citizen Observatory, which independently monitors the impact of the pandemic in Nicaragua, said in a statement that by making this information public late, the Minsa made it clear that “The national authorities once again allowed citizens to face this health crisis without adequate information to know the risk to which they were exposed and to take measures to protect health and life ”.
Since last May, the Minsa had the molecular screening material to search for the SAR-CoV-2 variants; However, it spent months without reporting progress and It was not until the beginning of October, when the wave of infections and deaths began to decline, that he informed PAHO that they were preparing a report on the circulation of variants. This was delivered until mid-November.
“It is very important to know which variant there is because we must take more prevention measures to prevent these variants from being introduced ”, warned Dr. Leonel Argüello last June, when the delta variant began to circulate in Central America.
In September, the secretary general of the Minsa, Carlos Saénz, affirmed that in Nicaragua the circulation of the delta variant has not yet been confirmed. However, he did not rule out its presence in the country. He did not speak about the circulation of three other variants.
According to the genomic sequence monitoring carried out by PAHO, In most Central American countries, a greater presence of delta was identified between July and August 2021, dates on which an increase in infections began to be reported.
Variants make the virus more aggressive
SARS-CoV-2 mutations and variants were expected by the scientific community. These arise during the transmission of the virus from one individual to another. They are like a copying process that sometimes shows flaws that alter its characteristics.
“The virus is always making copies of it and the more copies there are, the more chances there is that an error will arise. These copies that go wrong can cause the virus to be less or more aggressive, more or less contagious. Unfortunately, the variants that we are seeing make the virus more contagious ”, explains Dr. Leonel Argüello and adds that “If the original virus infected three or four people, it can pass it to four to eight people.”
The World Health Organization (WHO) classified the variants with three types: some are variants under supervision (VUM), variants of interest (VOI) and variants of concern (VOC), these are the most dangerous. VOCs have been shown to have higher transmissibility, increase the severity of covid-19 disease, they have less effectiveness of treatments or vaccines and failures in the detection of diagnosis.
Being more contagious, they predominate more than the original virus and that triggers increases in infections, of people who develop the disease in a serious way due to the level of exposure, of deceased and also of patients who suffer from sequelae after overcoming covid-19.
VOCs and their characteristics
Initially the variants were known by the place where they were first identified, however, this caused stigma and discrimination to these nations. Because, The WHO established since the end of May that the VOCs since then be named with the letters of the Greek alphabet.
As of November 2021, four VOCs have been identified. However, the WHO reported in its latest epidemiological report that delta is already the most prevalent worldwide. “Delta has outperformed other variants in most countries. Of the 799,645 sequences uploaded to GISAID with samples collected in the last 60 days, 99.7% were Delta, 0.1% were gamma, alpha, beta ”, cites the WHO.
The first variant of concern classified by WHO was alpha. This was identified in the United Kingdom. And it was shown to be highly transmissible and produces the same symptoms of the original virus. However, a study conducted by researchers in the United States and the United Kingdom concluded that alpha disables the first line of immune defense in our body, so the variant has more time to multiply.
The second variant was originally identified in South Africa. It has been shown to be 50% more transmissible and evades Lilly’s dual monoclonal antibody treatment, but not others. As detailed in a medical article published in CCN, blood tests and real-life use suggest that It can infect people who have recovered from COVID-19 and also people who have been vaccinated against the disease.
For its part, gamma is a variant that spreads quickly, since it can partially escape both natural and vaccine-induced immunity. It produces common symptoms of the disease. Initially reported in Brazil. It has been shown to bypass the effects of Lilly’s monoclonal antibody treatment, but not one manufactured by Regeneron. Blood tests show that it could escape both natural and vaccine-induced immune responses.
The variant delta was initially reported in India. Its main characteristic is that it is transmitted more quickly than the others, it can partially escape the immunity both natural and caused by the vaccine. The reported symptoms of people infected with this variant are headache, sore throat and runny nose. A document from the CDC indicates that the delta variant is as transmissible as chickenpox: each infected person infects up to eight or nine, on average. The original variant of coronavirus, the CDC noted, was as contagious as the common cold, with each infected person infecting two others.
