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D614G mutation: No reason to sound alarm, say experts

KUALA LUMPUR: While the discovery of the "super spreader" variation of the Covid-19 coronavirus in Malaysia is a cause for concern, experts believe that there is no reason to sound the alarm just yet.

They believe that the authorities' ability to manage the situation, coupled with overall public compliance with the standard operating procedures (SOP) in place, will help steer Malaysia to calmer waters.

The Health Ministry yesterday confirmed that it has detected a D614G-type mutation of Covid-19 in the culture tests of samples taken from three cases linked to the Sivagangga cluster and one from the Ulu Tiram Cluster.

The D614G variant has earned a distinct reputation for reportedly being 10 times more likely to infect other individuals and easier to spread by "super spreader" individuals, compared with the previous D614 variant.

Professor Datuk Dr Awang Bulgiba Awang Mahmud, an epidemiologist with Universiti Malaya, said it had yet to be proven that the presence of the D614G mutant variant would affect the severity of Covid-19 in Malaysia.

He believed it should not have much effect on public health measures for now.

"This is because the same public health measures in place are effective for the previous D614 and the current G614 variants," he said.

The original Covid-19 strain in China is dubbed D614, while the mutated version found in the United Kingdom, Italy and North America by May is dubbed G614.

The G614 variant, said Dr Awang Bulgiba, had become the dominant variant in some countries.

"It has been reported that the G614 variant now accounts for 70 per cent of studied Covid-19 viruses."

He allayed concerns about the higher death rates in other countries and said it might not be due to the new variant being more severe.

"It could also be due to these countries' health facilities being overwhelmed by the large number of patients, leading to a lower quality of care," he said.

However, he said that there could be hiccups with vaccine developments.

"We do not yet know whether the candidate vaccines, which are undergoing trials, will protect against the new variant.

"If they protect against the new variant, then there will be no impact on vaccine development.

"If they make the virus more difficult for antibodies (resulting from vaccination) to recognise, then there may be issues," he said.

He said there was no need to resort to a wholesale statewide lockdown and ban on interstate travel on affected states such as Perlis, Kedah, and Penang.

He said the authorities' prompt action in locking down some parts of these states under the Targeted Enhanced Movement Control Order was adequate and less disruptive than locking down entire states.

He said the authorities — namely district health offices, Health Ministry, National Security Council and state governments — had acted swiftly to prevent the further spread of cases in these states.

"They traced contacts and isolated positive cases quickly," he said.

He said the rise in cases in the northern states was not entirely unexpected, given that there had been imported cases over the last few months.

Fellow epidemiologist Dr Sanjay Rampal, while noting that the D614G variant has been associated with higher infectivity, said its preventive measures remained the same.

"The basic pillars of prevention and control of Covid-19 remain the same, such as border control, movement restriction, hand and respiratory hygiene, physical distancing and use of Personal Protection Equipment.

"(And) we have plenty of healthcare capacity to combat the virus."

On whether lockdowns were needed to manage the spread of Covid-19 in the northern states, Dr Sanjay said it would be difficult to do.

"I understand the anxiety of the public as they hear of a few more cases every other day coming from these clusters.

"However, the decision (to lock down) should consider the healthcare capacity for screening, contact tracing, testing and treating the cases.

"A too-low threshold may result in high economic cost for little additional health benefits, whereas too high a threshold may result in the number of cases overwhelming the state's healthcare capacity, leading to higher morbidity and mortality."

He said the Health Ministry had been implementing prevention and control activities against these clusters.

"More cases may be reported in the coming days as a result of these clusters secondary to intensive screening and active case detection.

"However, it is important to acknowledge that the Health Ministry has the capacity to prevent further blooming of these clusters."

Health director-general Datuk Dr Noor Hisham Abdullah, in announcing the discovery of the D614G-type mutation of Covid-19 in Malaysia yesterday, had also noted that studies would likely reveal that any existing vaccine was ineffective against the mutation.

He said while public health controls in the field had been effective, the people should remain vigilant and careful.

He said tests by the Institute of Medical Research, which discovered the presence of the mutated version, were preliminary and that follow-up tests were being conducted on other cases.

He said the Covid-19 situation in the country was under control and that the Health Ministry, along with other agencies, was making efforts to curb the spread of the coronavirus.

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