Effect of Viral Mutations on the Spread and Severity of COVID-19



Deepak Bhatt, MD, MPH: Speaking of genetics, you're talking about humans. What about the virus? As you are well aware, there have been descriptions now of mutation of the virus. The current belief, if I understand it correctly, is that this mutated version spreads more rapidly but isn't necessarily more lethal per se, other than if more people are infected. There's potentially more risk of complications and death, but the viral strain per se isn't more lethal than the prior one. What do you make of all that, and what does that bode for the future?

C. Michael Gibson, MS, MD: Well, Deepak, early on, you and I were both reassured to hear some experts say that this virus isn't mutating. A month or so later, there began to be reports of an enormous number of mutations, and I got very concerned. It turns out that many of those mutations are not on the surface of the virus but in the core. Those core mutations in the center of the virus don't do a lot in terms of the pathogenicity of the virus; it's those surface proteins that mediate a lot of the infectivity and the ability to infect and rev up your viral load. That's what was seen here. This is a surface protein mutation. You get a much higher viral load, which makes it more infectious. The good news, as you pointed out Deepak, is that you don't get more severe disease with it, as far as we know. It came over from Europe, and it has spread throughout a lot of the world, not just the United States, but a lot of the world.

Deepak Bhatt, MD, MPH: You mentioned something interesting the last time you and I talked about this, which was maybe a couple of months ago. I forget the exact time, but a lot has changed in terms of new knowledge, and some knowledge has changed. It's been an interesting social experiment seeing science play out on the public stage. It may be the case that people who aren't scientists or physicians don't understand how hypotheses are formed, tested, refuted, and refined. When they hear things like you just mentioned, that this virus is definitely not mutating, to it looks like it's mutating, it, in part, makes them lose faith in what any of us are saying. It leads some people to think we don't know what we're talking about as a collective scientific and medical community. Therefore, it's just all a bunch of noise and garbage, and they tune a lot of it out, including some of the important public health messages.

C. Michael Gibson, MS, MD: Wow, Deepak. There’s a lot to unpack there. Yes, the problem with this is that it's such a rapidly moving target. As we just heard, it's a changing target. I did a lot of research for another program on what people want in terms of truth and trust. Trust is predicated on consistent messages that have a basis in fact, and when the message is always changing from, “It's not spread from human to human, you can travel, you don't need to wear a mask, it can only travel 6 feet, it's not airborne,” when every one of those communications is now undone by data, it erodes people's trust.

On the other hand, people should feel that there is trust in the majority of people who are trying to find out the right answers to all of this. If anything, at the end of the day, scientists were largely ignored in the past. What's good for science now is that scientists are the rock stars in 2020. Hopefully, we'll get more young people of all races and genders and denominations to be interested in science because you can see, you think you have the answer, but it's almost like a mystery wrapped within an enigma that's a riddle topped with secret sauce. It keeps changing, and it's a lot of fun to be a scientist.

Deepak Bhatt, MD, MPH: For what it's worth, I've always considered you a rock star, Mike, even before COVID-19 [coronavirus disease 2019].

C. Michael Gibson, MS, MD: I've got my guitar in the other room.

Deepak Bhatt, MD, MPH: Maybe we can bring that out later in the program.

Transcript Edited for Clarity

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