In the traditional daily balance of the coronavirus pandemic, the Minister of Health, Enrique Paris, detailed the efforts of the Institute of Public Health (ISP) to advance in the sequencing of the virus to know the reasons why the numbers of infections have been fired over the past two weeks.
According to the minister, the ISP is currently investigating all suspected variants and so far two have been detected: “The Brazilian and the British.” However, starting next week and as a result of the collaboration of various university laboratories in coordination with the Ministry of Sciences, searches will increase from 176 to 500 per week. The goal, said Paris, is “to search for any new or strange strains that may also explain the increase in cases.”
Could the Brazilian variant be responsible for the rise in infections? What is the difference with the cases of the Sars-CoV-2 strain? What are the projections of the disease? They are part of the questions left by the second wave of the health emergency. For now, the basic thing is to understand that the Brazilian and British variants are not strains. To be considered strains, viruses would have to undergo a drastic change or mutation in their gene chain, which has not happened until now.
At least the numbers of the main air port in the country confirm that the massive influx of Brazilian and Chilean tourists returning to the country did not decrease in the months of January and February 2021. According to PDI figures, 5,606 Brazilians have entered Chile during January and February of this year.
Meanwhile, the concessionaire of the Arturo Merino Benítez Airport, Nuevo Pudahuel, confirmed to Third that during the first two months of the year “1.9 daily flights have arrived, with an average occupancy between 55% and 59% of the aircraft.” The main origins of the passengers are Sao Paulo, Rio de Janeiro and Florianopolis.
The Brazilian variant is considered one of the most dangerous due to its ability to spread. In addition, it has key mutations that have already been studied in other variants independently in the protein called Spike, which is what allows the virus to bind to the cells it infects.
According to the report on Circulation of Sars-CoV-2 Variants in Chile, dated March 26, carried out by the Department of Epidemiology, 45 cases of the Brazilian variant, known as P.1, have been found. Of these, 34 correspond to travelers; eight are community cases and three are secondary cases. In this group, 71% had symptoms and four cases required hospitalization.
The same study by the Ministry of Health pointed out that there is evidence that suggests that some of the mutations in the Brazilian variant may affect its transmissibility and antigenic profile, which, in turn, could influence the responsiveness of antibodies generated through previous natural infection or by vaccination to recognize and neutralize the virus, but further studies are still needed.
Manuel Nájera, surgeon and professor at the Center for Epidemiology and Health Policies of the Universidad del Desarrollo (UDD), explains that what we are certain of is that the transmission of the Brazilian variant is not only from travelers: cases have already been detected among people in the community.
“We do not know what the impact of the Brazilian variant is, because there is no report on the surveillance of the variants in community outbreaks, nor do we know what proportion of the cases are the product of the variant. We are a little blind in that sense, but with all that we know, it cannot be ruled out that there have been a large number of cases of this variant in the last two weeks, because the increases have been very strong and intense ”, indicates the specialist in epidemiology.
Faced with the rise in the number of infections detected, the government ruled that as of March 25, travelers entering Chile from Brazil during the last 14 days must be transferred to a transit hotel, where they will stay at least 72 hours, even if your PCR test is negative. You can only go to your home or place of destination to do mandatory quarantine for 10 days, after this time and with a negative PCR result. “It is important to highlight that all costs associated with the entry of the traveler must be paid by the traveler when requesting the international health passport before traveling to Chile,” stated the report from the Department of Epidemiology of the Minsal.
Nicolás Muena, PhD in Biotechnology and researcher at the Science & Life Foundation, He comments that “the measures taken today are correct, but they arrive late. I am referring to the mandatory quarantine of any person who enters the country, regardless of the country from which they come. This measure should have been taken since the first variants were detected in other countries. You always act reactively and not preventively ”.
Under this logic, the expert warned that “the Brazilian variant has two mutations that are important: N501Y, which makes the virus bind with more affinity to the lock in the cell, can infect better and makes it more transmissible, and E484K, which makes it possible to evade the immune response of some antibodies ”.
According to the scientific community, vacation leave and leaving our borders open when the first wave had not yet finished are the reasons that influenced the arrival of the Brazilian variant in Chile.
“The holidays allowed the mobility of about five million people between different regions. But I think that the most determining factor was not the vacation permit within the country, but rather keeping the borders open, despite having detected the Brazilian variant already in February of this year ”, explained Muena.
Along these lines, Ignacio Silva, infectologist at the University of Santiago, He argued that “more than the vacation permit per se, what influenced the entry of the Brazilian variant was the policy of opening borders that Chile has had during most of the pandemic”, since if not the risk of circulation of that variant in our country would be much less.
In addition, the researchers believe that it cannot be ruled out that a variant of interest and concern may occur in Chile. Especially because “today we are vaccinating many people, but at the same time we have a very high number of active cases; This can cause the virus to have a selective pressure when infecting people who have antibodies, but who have few: this pressure can cause the virus to change towards mutations that allow it to evade that immune response, still poor, in people who they have received a dose of the vaccine, ”Muena said.
Mario Calvo Arellano, infectologist at the Austral University, elaborates on this issue: “What Chile is doing in that sense is super good, because the vaccination process is fast. It helps them to be immunized faster and lower the number of viral circulation faster. What is the problem? That we are not making a very effective restriction. The more mobility, the more cases ”.
Both Silva and Muena agree that the Brazilian variant, known as the P1, is dangerous due to its high level of contagion. Meanwhile, Calvo Arellano said that “there are very serious cases or places where there has been a spread that seems extraordinarily fast compared to other geographical places. Now, it is certain that we have variants, what we do not know is if we have what is called variants of interest or concern ”.
In his opinion, today the Chilean variant is very likely to be detected by the authorities. The reason? One of the key points is the geography of our country that would allow the development of a new variant.
But – in his opinion – “the big question is whether a variant will arrive that is resistant to those vaccinated. Everything is on a theoretical level. I tell my patients never to ask me if something can happen. The answer is always yes. Of course, at the moment, if the question is, is there a probability that there is a Chilean variant? It exists, because a variant existed in many parts of the world ”, he stressed.
Nájera added that, likewise, there are other variants of concern that also seem to be more transmissible, such as the one found in the United Kingdom. However, the studies that have been carried out are inconclusive regarding lethality.
Another variant of concern is the one found in New York, which is more efficient at making a person sick and could be more lethal.
“So far it is not possible to say that there is a Chilean variant. There is no described variant of interest and less of concern. Nor in research that has occurred in Chile. It’s just an assumption, ”Najera said.
In his opinion, the virus continues to mutate very fast, because it replicates genetic material continuously. But so far there is no variant in Chile that is of concern.
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