Dear Editor,
This letter is written with regards to an article published in the Kaieteur News dated June 28, 2020 and entitled, `Coronavirus: It has mutated and is now even more infectious.’
I find this article misleading and confusing and wish to make the following points/comments on what is problematic:
1. Generally, viral mutations are normal. This is why public health organizations have global surveillance programmes to monitor for this among other things. For example, a function of the World Health Organization’s (WHO) Global Influenza Program (GIP) is to collect global virology and epidemiology data which includes monitoring of mutations in circulating strains of the Seasonal Influenza Virus; carefully surveying for any virulent strains. This sets the global standard on what strains are to be selected for the following year’s vaccine. This is vital as influenza strains are known to mutate rapidly throughout the year; with WHO’s recommendation, flu vaccines are manufactured twice per year, for both Northern and Southern hemispheres. Of course, such surveillance programmes exist globally for COVID-19.
2. The article paints a picture that the D614G mutation on the Spike (S) Protein, present on the surface of the Coronavirus virus particle, is responsible for an increase in the number of infections across the world in human populations. It is true that the frequency of this mutation detected in new coronavirus genomes isolated globally has increased in number and is the reason why it is under extensive laboratory investigations; whether this translates to an increase in disease transmission in the real world requires more data and epidemiological studies.
3. To data, this increase in infectivity was observed for experiments done in cell culture, in vitro (in a petri dish). Again, nothing has been proven (as yet) in humans.
It is important to note that cell culture experiments do not necessarily translate to real world success as exemplified by the hydroxychloroquine/choloroquine saga. This is a lengthy story but in short, early experiments with hydroxychloroquine showed that it was effective at fighting the coronavirus in a petri dish. Emergency Use Authorization (EUA) for chloroquine and hydroxychloroquine was granted by the US Food and Drug Administration (FDA) in March 2020 with a few promising in vivo studies. It was a heavily touted drug with extensive media coverage and became a household name when President Trump advocated for chloroquine’s use in combination with azithromycin during the April 4 Coronavirus Task Force Briefing. “What do you have to lose?” he said. On June 15, 2020 the US Food and Drug Administration (FDA) revoked its EUA saying, “Based on its ongoing analysis of the EUA and emerging scientific data, the FDA determined that chloroquine and hydroxychloroquine are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA… and posed potential safety risks.”
On June 17, 2020 the WHO announced that for its solidarity clinical trial hydroxychloroquine testing will stop. They reported that this was a result of the lack of evidence to show that the mortality of hospitalized COVID-19 patients was reduced when compared with standard-of-care.
I’m not saying that the D614G Coronavirus S Protein mutation should be ignored (it’s not, it is being rigorously investigated by experts) but let’s wait for further in vivo studies before making formal conclusions on its associated infectiousness in humans. To quote Jeremy Luban, a virologist at the University of Massachusetts Medical School, “The bottom line is, we haven’t seen anything definitive yet.”
4. Even if it’s eventually proven to be more infectious in humans, it doesn’t mean it increases mortality rate. The work done so far with cell culture does not show an increase in mortality rates. Scientists at the prestigious Scripps Research Institute in the US, one of the labs who reported the boost in infectivity in vitro, said, “It is still unknown whether this small mutation affects the severity of symptoms of infected people, or increases mortality. While ICU data from New York and elsewhere reports a preponderance of the new D614G variant, much more data, ideally under controlled studies, are needed.”
5. To date, to the best of my knowledge, all science published on this mutation, on which media reports are base, is unvetted. That is, the research is not published in peer-reviewed journals and therefore has not undergone expert scrutiny; although expert scrutiny of this topic is rampant on social media. Articles have been uploaded to open-access preprint servers without going through the normal peer-review process or while the work has been submitted for peer-review. Hence the existence of the very useful COVID-19 retraction watch where many COVID-19 research article have been retracted as results of questionable science. It should be noted that COVID-19 research articles from two of the world’s most prestigious medical journals, The New England Journal of Medicine and The Lancet, have been retracted. So, even expertly scrutinized work can be retracted.
6. The credibility of scientific content, at the minimum, is supported by reference to reputable publications and in this case might include global public health organizations. No fact, claims or statistic in this article was supported by any reference.
As a scientist I am an advocate for the whole truth or, if research efforts are ongoing, the story as it is with published evidence in support of what is said. Partial/incomplete stories to suit a perspective or in the interest of being the first to publish a catchy headline is not science communication of high standing. Further, public dissemination of unvetted and ongoing science may invite danger and invoke fear. So, while I agree with the author of the KN article on the continual adherence to guidelines set out by public health organizations worldwide in order to control the spread of COVID-19, I strongly urge caution in circulating information on unproven and unvetted science.
Yours faithfully,
Jacquelyn Jhingree, PhD
(Scientist in Vaccine and Drug
Research)
