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Covid-19: Mutant variant 'Pirola' causing alarm as NZ experts propose smart way to track virus

Author
Jamie Morton,
Publish Date
Mon, 21 Aug 2023, 1:41pm

Covid-19: Mutant variant 'Pirola' causing alarm as NZ experts propose smart way to track virus

Author
Jamie Morton,
Publish Date
Mon, 21 Aug 2023, 1:41pm

Experts are proposing a smarter way to gauge Covid-19鈥瞫 spread in New Zealand, as a heavily mutated new subvariant puts global health authorities on high alert.

Just days after聽, scientists have been closely tracking the new Omicron type BA.2.86, nicknamed Pirola, whose 36 mutations set it well apart from its closest relative.

So far detected in just a handful of countries, Pirola has been designated a 鈥渧ariant under monitoring鈥 by the World Health Organisation, amid growing concern it represents a large enough evolutionary leap to drive new waves.

鈥淭here are two really important questions with this variant,鈥 Covid-19 modeller Professor Michael Plank told the聽Herald.

聽鈥淥ne is the growth rate: if it doesn鈥檛 or can鈥檛 compete with variants that are currently in circulation, then it鈥檚 not going to have much of an impact.鈥

For around a year now, the coronavirus circulating in New Zealand has been made up of a 鈥渟oup鈥 of Omicron subvariants.

More recently, a succession of 鈥渞ecombinant鈥 lineages classified as XBB, each packing some immune-evasion advantage,聽.

But none have managed to trigger any major new surges in a population that鈥檚 now highly exposed to 鈥 and vaccinated against 鈥 the virus.

聽鈥淭he second one is, if it does have the legs to take off, then what does the severity look like?鈥 Plank said.

鈥淭hat鈥檚 a harder question to answer 鈥 or will at least take longer to do 鈥 because estimating severity is difficult without a reliable estimate of the number of infections.

鈥淏ecause, while you might see a rise in hospital numbers, you don鈥檛 really know whether that鈥檚 an increase in the number of infections, or there鈥檚 actually a genuine increase in severity.鈥

罢丑别听聽also concluded that, based on the few confirmed cases, it was too early to make a call on Pirola鈥檚 severity.

The agency did, however, suggest there was now 鈥渆stablished international transmission鈥, along with potential for rapid growth, at a time another Omicron off-shoot, EG.5 or 鈥淓ris鈥,聽聽in the US.

On Pirola鈥檚 striking number of mutations, again, the UK agency said it was too soon to predict what this meant for impact 鈥 but added there was 鈥渟ufficient information to expect significant antigenic change鈥.

Like his international counterparts, Plank expected we were only now seeing the tip of Pirola鈥檚 iceberg.

鈥淚t鈥檚 certainly a reminder that we need surveillance 鈥 including genomic surveillance - to keep an eye out for new variants that could really have an impact.鈥

It comes after New Zealand鈥檚 reported cases dropped off by about 40 per cent over the week since the Government announced an end to the seven-day isolation requirement for infected people.

Even before the rollback, Plank estimated the ratio of cases picked up or reported versus total overall infections 鈥 something called the case ascertainment rate of CAR 鈥 sat somewhere between one in three and one in four.

While the fraction of reported infections had been clearly falling over time, Plank said the numbers could still be useful for surveillance.

鈥淚f we see those reported case numbers growing rapidly, that鈥檚 potentially an early warning signal that could translate into significant demand on healthcare systems.鈥

贬补惫颈苍驳听聽for a permanent infection prevalence survey, health authorities continue to rely on a mix of聽聽and community and hospital-level case reporting and sampling.

In a new Government-funded study,, Plank and others propose a new statistical model that combines those different indicators to give an overall picture of infection rates in the population.

That included giving the CAR at any point in time, along with the effective reproduction number, or Reff, which represented the average number of people a given infected person was likely to pass the virus onto.

Covid-19 modeller Professor Michael Plank.

Covid-19 modeller Professor Michael Plank.

With Covid-19 rates, but growing slowly again, modellers estimate the current Reff stands at just above one.

Fellow study author and University of Canterbury researcher Dr Leighton Watson said the model could be applied nationally or regionally, and used by any country where most people were connected to the wastewater system.

鈥淲hile the results are not the only piece to the puzzle, the model could be used as an additional source of information to inform public health policy decisions and hospital capacity planning.鈥

Watson said this approach took into account the fact that restrictions and testing guidelines had eased dramatically since Omicron first washed over the country 18 months ago.

鈥淎t first, people would test every time they got a sore throat,鈥 he said.

鈥淎necdotally, now it seems like many people are assuming they are just under the weather because, for example, their kids bring every single bug possible home from school.鈥

Wastewater surveillance has been crucial in gauging Covid-19's prevalence in New Zealand.

Wastewater surveillance has been crucial in gauging Covid-19's prevalence in New Zealand.

Fewer cases could mean fewer infections or fewer people reporting - and the difference was crucial to understand.

In their study, the researchers used their new model to demonstrate that, while reported case numbers made 2022鈥瞫 first wave appear twice as large as the winter wave a few months later, the true numbers of infections in both surges were actually similar.

Plank said the study highlighted the value of keeping聽聽running, in an environment where fewer people were testing.

鈥淓veryone who lives somewhere that鈥檚 linked up to the town wastewater system is going to shed the virus into the wastewater if they have Covid,鈥 Watson added.

鈥淚f they are plumbed into the wastewater system and we are sampling it, we can pick that up independent of whether people are testing or not.鈥

Over the longer term, there remained many troubling unknowns about Covid-19 and its potential to drive fresh waves, kill or hospitalise more people, or widen the聽.

鈥淯nlike something like the flu, we don鈥檛 really have a clear sense of how Covid is going to behave,鈥 Plank said.

鈥淔or instance, are we going to get one wave in winter, or will we continue to see three or four waves at different times of the year?

鈥淪o, we really just need to have that picture of the health burden that it鈥檚 creating, so we can respond accordingly.鈥

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