SARS-CoV-2 Delta variant, also known as lineage B.1.617.2, and commonly referred to as the Indian variant[a] is a variant of lineage B.1.617 of SARS-CoV-2, the virus that causes COVID-19.[2] It was first detected in India in late 2020.[3][4] The WHO named it the Delta variant on 31 May 2021.[5]
It has mutations in the gene encoding the SARS-CoV-2 spike protein[6] causing the substitutions T478K, P681R and L452R,[7] which are known to affect transmissibility of the virus as well as whether it can be neutralised by antibodies for the original "wild type" COVID-19 virus.[8] Public Health England (PHE) in May 2020 observed secondary attack rates to be 51-67% higher than the alpha variant.[9]
On 7 May 2021, Public Health England changed their classification of lineage B.1.617.2 from a variant under investigation (VUI) to a variant of concern (VOC) based on an assessment of transmissibility being at least equivalent to B.1.1.7 (Alpha variant), first identified in the UK (Kent).[10] Subsequently on 11 May 2021, the World Health Organization (WHO) also classified this lineage VOC, and said that it showed evidence of higher transmissibility and reduced neutralisation. The variant is thought to be partly responsible for India's second wave of the pandemic beginning in February 2021.[11][12][13]
Contents
Classification[edit]
The Delta variant has mutations in the gene encoding the SARS-CoV-2 spike protein[6] causing the substitutions E484Q and L452R.[8] It is identified as the 21A clade under the Nextstrain phylogenetic classification system.[14]
At the end of May 2021, the WHO assigned the label Delta to lineage B.1.617.2 after introducing a new policy of using Greek letters for variants of concern and variants of interest.[5]
Mutations[edit]
Defining mutations in the
SARS-CoV-2 Delta variant
show
The B.1.617.2 genome has 13 mutations (15 or 17 according to some sources,[which?] depending on whether more common mutations are included) which produce alterations in the amino-acid sequences of the proteins it encodes.[4] Four of them, all of which are in the virus's spike protein code, are of concern:
D614G. The substitution at position 614, an aspartic acid-to-glycine substitution, is shared with other highly transmissible variants like Alpha, Beta and Gamma.[16]
T478K.[16][17] The exchange at position 478 is a threonine-to-lysine substitution.[18]
L452R. The substitution at position 452, a leucine-to-arginine substitution, confers stronger affinity of the spike protein for the ACE2 receptor and decreased recognition capability of the immune system.[8][19] These mutations, when taken individually, are not unique to the variant; rather, their simultaneous occurrence is.[8][20]
P681R. The substitution at position 681, a proline-to-arginine substitution, which, according to William A. Haseltine, may boost cell-level infectivity of the variant "by facilitating cleavage of the S precursor protein to the active S1/S2 configuration".[21]
The E484Q mutation is not present in the B.1.617.2 genome.[21][22]
There are three sublineages of B.1.617 categorised so far.
B.1.617.1 (VUI-21APR-01) was designated a Variant Under Investigation in April 2021 by Public Health England. Later in April 2021, two other variants B.1.617.2 (VUI-21APR-02) and B.1.617.3 (VUI-21APR-03) were designated as Variants Under Investigation. While B.1.617.3 shares the L452R and E484Q mutations found in B.1.617.1, B.1.617.2 lacks the E484Q mutation. B.1.617.2 has the T478K mutation, not found in B.1.617.1 and B.1.617.3.[23][24] Simultaneously, the ECDC released a brief maintaining all three sublineages of B.1.617 as VoI, estimating that a "greater understanding of the risks related to these B.1.617 lineages is needed before any modification of current measures can be considered".[25]
Symptoms[edit]
See also: Symptoms of COVID-19
The most common symptoms may have changed from the most common symptoms previously associated with standard COVID-19. "Headaches, a sore throat and a runny nose are the most common symptoms". (The Guardian) Infected people may mistake the symptoms for a bad cold and not realize they need to isolate. "So, the number one symptom is headache … followed by sore throat, runny nose and fever.” "It might just feel like a bad cold or some funny 'off' feeling - but do stay at home and do get a test." (King’s College London professor, Tim Spector)[26][better source needed][27] "In the United Kingdom, where the Delta variant makes up 91 percent of new cases, one study found that the most reported symptoms were headache, sore throat, and runny nose." (US publication Healthline)[28]
Treatment[edit]
See also: Treatment and management of COVID-19
The treatment for those infected by the SARS-CoV-2 Delta variant is as per others infected by COVID-19.
Vaccine efficacy[edit]
This section needs to be updated. The reason given is: This section is contains more RECENTNEWS about the B1.617 variant in general rather than the Delta Variant. This section needs to be concentrating on MEDRS information on WHO supported vaccine efficacy and effectiveness against the Delta variant in particular. The Pfizer-BioNTech vaccine was shown to be 79-88% effective against the Delta variant in U.K studies.. Please update this article to reflect recent events or newly available information. (June 2021)
ICMR found that convalescent sera of the COVID-19 cases and recipients of Bharat Biotech's BBV152 (Covaxin) were able to neutralise VUI B.1.617 although with a lower efficacy.[29]
Anurag Agrawal, the director of the Institute of Genomics and Integrative Biology (IGIB), said the study on the effectiveness of the available vaccines on lineage B.1.617 suggests that post-vaccination, the infections are milder. He tweeted:
Initial positive neutralization studies of B.1.617, with both post-Covaxin or Covishield sera, are correlatable with the milder disease during post-vaccination breakthrough infections. This is positive while we get quantitative data for a better understanding of infection protection.[30]
Anthony Fauci, the Chief Medical Advisor to the President of US, has also expressed his confidence regarding the preliminary results. In an interview on 28 April, he said:
This is something where we're still gaining data daily. But the most recent data was looking at convalescent Sera of COVID-19 cases and people who received the vaccine used in India, the Covaxin. It was found to neutralise the 617 variants.[31]
Another study by the Centre for Cellular and Molecular Biology (CCMB) in Hyderabad found Covishield (Oxford–AstraZeneca) vaccinated sera offers protection against lineage B.1.617. Rakesh Mishra, the Director of CCMB, said in a tweet on 28 April:
Very preliminary but encouraging result: #Covishield protects against #B1617. Early results using in vitro neutralisation assay show that both convalescent (prior infection) sera and Covishield vaccinated sera offer protection against the B.1.617 variant, aka #DoubleMutant.[32]
The WHO has said current vaccines will continue to be effective against the variant. In an update in May, they said there may be some evidence of "reduced neutralization".[33] A study conducted by the Public Health England, has found that both Pfizer-BioNTech and AstraZeneca-Oxford vaccines provide a 33% protection against symptomatic disease caused by the variant after the first dose. Two weeks after the second dose the Pfizer-BioNTech vaccine was found to be 88% effective at stopping symptomatic disease from the Delta variant while the AstraZeneca-Oxford vaccine was 60% effective against the variant.[34][35]
In another laboratory study, a group of scientists led by Olivier Schwartz, at the Pasteur Institute reported a slightly diminished efficacy by Pfizer vaccine and low levels of antibodies induction by AstraZeneca vaccine against the Delta variant.[36][37] A group of researchers from the Francis Crick Institute, published in The Lancet shows that humans fully vaccinated with the Pfizer-BioNTech vaccine are likely to have more than five times lower levels of neutralizing antibodies against the Delta variant.[38][39]
In June 2021, Public Health England announced it had conducted a study which found that after two shots, the Pfizer-BioNTech vaccine and the AstraZeneca vaccine are respectively 96% and 92% effective at preventing hospitalisation from the Delta variant.[40]
Epidemiology[edit]
This section needs to be updated. Please update this article to reflect recent events or newly available information. (June 2021)
Emerging research suggests the variant may be more transmissible than previously evolved ones.[41] Whether the effectiveness of currently-deployed vaccines is affected remains under investigation.[42][43][44]
Surveillance data from the Indian government's Integrated Disease Surveillance Programme (IDSP) shows that around 32% of patients, both hospitalised and outside hospitals, were aged below 30 in the second wave compared to 31% during the first wave, among people aged 30–40 the infection rate stayed at 21%. Hospitalisation in the 20-39 bracket increased to 25.5% from 23.7% while the 0-19 range increased to 5.8% from 4.2%. The data also showed a higher proportion of asymptomatic patients were admitted during the second wave, with more complaints of breathlessness.[45]
Statistics[edit]
By 13 May 2021, more than 4,500 sequences of the variant had been detected in about 60 countries.[3][46] Reported numbers of sequences in countries with detections are:
Cases by country (As of 30 May 2021)
Country/AreaConfirmed Delta variant cases:
(PANGOLIN)[47] as of 16 JuneConfirmed cases
(GISAID)[3] as of 30 MayConfirmed cases
(PANGOLIN)[48] as of 1 JuneCases (other sources)First detection
India 4,208 3,364 3,571 5 October 2020
United Kingdom 26,694 8,956 9,273 22 February 2021
United States 2,247 1,539 1,542 23 February 2021
Singapore 244 156 156 26 February 2021
Australia 154 145 144 16 March 2021
Canada 94 163 - 1,539[49] 15 March 2021
Germany 710 420 420 1 March 2021
Fiji - - - 42[50] 28 April 2021
Israel 35 38 35 41[51][52][53] 16 April 2021
Denmark 90 105 105 8 March 2021
Japan 147 174 165 28 March 2021
Bahrain - 19 19 5 April 2021
Poland 69 34 34 16[54] 26 April 2021
Ireland 141 155 155 26 February 2021
Switzerland 83 61 64 29 March 2021
Belgium 220 98 120 25 March 2021
France 104 88 85 21 February 2021
New Zealand - 15 15 9 March 2021
China - 7 7 24 April 2021
Nepal - 7 - 9[55] 28 April 2021
Angola - 8 8 14 January 2021
Hong Kong - 10 8 22 April 2021
Portugal 62 38 52 5 April 2021
Sweden 37 17 17 26 March 2021
Luxembourg 51 7 6 15 April 2021
The Netherlands 75 51 50 6 April 2021
Italy 164 80 81 2 April 2021
South Korea - 6 7 26 March 2021
Spain 182 65 65 22 April 2021
Turkey - 1 - 5[56] 28 April 2021
Finland - 1 - 60[57][58][59] 18 March 2021
Jordan - 5 4 21 April 2021
Russia 163 4 4 16[60] 21 April 2021
Bangladesh 43 20 20 9[61][62] 28 April 2021
Czech Republic - 7 2 24 April 2021
Greece - 2 2 23 March 2021 Guadeloupe - 2 2 10 March 2021
Indonesia 48 32 32 3 April 2021
Argentina - 1 - 2[63] 24 April 2021
Morocco - 1 - 2[64] 3 May 2021
Thailand 92 1 - 2[65] 24 April 2021
Sint Maarten - 4 - 19 March 2021
Algeria - - - 6[66] April 2021
Aruba - 3 3 16 April 2021
Austria - 5 - 17 April 2021
Botswana - 1 - 2[67] 28 April 2021
Cambodia - 1 - 5 April 2021
Curacao - 1 - 23 April 2021
Cyprus - - - 4[68] 19 May 2021
DR Congo - 6 - 5[69] 3 May 2021
Haiti - - - (number unreported)[70] 
Iran - 6 6 3[71] 11 May 2021
Kenya - - - 5[69][72] May 2021
Kyrgyzstan - - - (number unreported)[70] 
Malaysia - 4 - 10 April 2021
Mexico 32 26 27 5 April 2021
Nigeria - - - 1[69] May 2021
Norway 68 20 20 1[73] 15 April 2021
Panama - - - 1[74] April 2021
Romania - 19 19 26 April 2021 Reunion - 1 - 4 May 2021
Slovenia - 2 - 20 April 2021
South Africa - 14 15 4[75] 30 April 2021
Sri Lanka - 1 - 1[76] 30 April 2021
Uganda - 5 4 1[77] 26 March 2021
Philippines - - - 13[78][79][80] 11 May 2021
Uzbekistan - - - (number unreported)[70] 
Vietnam 54 - - 12[81][82] 18 April 2021
Brazil - 2 2 10 [83] [84] 20 May 2021[85] [86] [87]
Qatar - 8 - 19 April 2021
Guam - 1 - 26 April 2021
Ghana - 5 - 20 April 2021
Pakistan - 1 - 16 May 2021
Lithuania - - - 1[88] 17 June 2021World (73 countries) Total: 36,828
(solely B.1.617.2) Total: 16,049 Total: 16,366
incl. B.1.617.1, B.1.617.2, and B.1.617.3 1,729 Total as of 30 May 2021.
The latest available data from the end of May indicates prevalence in the U.S., the Netherlands and Germany was in the 1 % to 10% range. Surveillance data from the U.S. and the Netherlands indicates the Delta variant is growing by about a factor of 2 every weeks with respect to the Alpha variant, so it is expected to become dominant in around July or August in these countries.[89][90][91][92]
History[edit]
In countries other than India, the first cases of the variant were detected in late February 2021, including the United Kingdom on 22 February, the United States on 23 February and Singapore on 26 February.[48][4][3]
British scientists at Public Health England redesignated the B.1.617.2 variant on 7 May 2021 as "variant of concern" (VOC-21APR-02),[93] after they flagged evidence in May 2021 that it spreads more quickly than the original version of the virus. Another reason was that they identified 48 clusters of B.1.617.2, some of which revealed a degree of community transmission.[94][95] With cases from the Delta variant having risen quickly, British scientists considered the Delta variant having overtaken the Alpha variant as the dominant variant of SARS-CoV-2 in the UK in early June 2021.[96] Researchers at Public Health England later found that over 90% of new cases in the UK in the early part of June 2021 were the Delta variant; they also cited evidence that the Delta variant was associated with an approximately 60% increased risk of household transmission compared to the Alpha variant.[97]
Canada's first confirmed case of the variant was identified in Quebec on 21 April 2021, and later the same day 39 cases of the variant were identified in British Columbia.[98] Alberta reported a single case of the variant on 22 April 2021.[99] Nova Scotia reported two Delta variant cases in June 2021.[100]
Fiji also confirmed its first case of the variant on 19 April 2021 in Lautoka, and has since then climbed up to 42 cases and counting.[101] The variant has been identified as a super-spreader and has led to the lockdowns of five cities (Lautoka, Nadi, Suva, Lami and Nausori), an area which accounts for almost two-thirds of the country's population.
On 29 April 2021, health officials from Finland's the Ministry of Social Affairs and Health (STM) and the Finnish Institute for Health and Welfare (THL) reported that the variant had been detected in three samples dating back to March 2021.[57]
The Philippines confirmed its first two cases of the variant on 11 May 2021, despite the imposed travel ban of the country from the nations in the Indian subcontinent (except for Bhutan and Maldives). Both patients have no travel history from India for the past 14 days, but instead from Oman and UAE.[102]
North Macedonia confirmed its first case of the variant on 7 June 2021 after a person who was recovering from the virus in Iraq was transported to North Macedonia. In a laboratory test, the variant was detected in the person.[citation needed]
The detection of B.1.617 was hampered in some countries by a lack of specialised kits for the variant and laboratories that can perform the genetic test.[103][104] For example, as of 18 May, Pakistan had not reported any cases, but authorities noted that 15% of COVID-19 samples in the country were of an "unknown variant"; they could not say if it was B.1.617 because they were unable to test for it. Other countries had reported travellers arriving from Pakistan that were infected with B.1.617.[103]
Society and culture[edit]
International reactions[edit]
After the rise in cases from the second wave, at least 20 countries imposed travel bans and restrictions on passengers from India in April and May. UK prime minister Boris Johnson cancelled his visit to India twice, while Japanese Prime Minister Yoshihide Suga postponed his April trip.[105][106][107]
In May 2021, residents of two tower blocks in Velbert, Germany were quarantined after a woman in the building tested positive for the variant.[108]
In May, Delhi Chief Minister Arvind Kejriwal said that a new coronavirus variant from Singapore was extremely dangerous for children and could result in a third wave in India. Singapore's Ministry of Health said there was no Singapore variant nor any evidence of a coronavirus variant extremely dangerous for children,[109][110] and that the increase in COVID-19 cases came from the Delta variant.[110]
On 14 June, the British prime minister Boris Johnson announced that the proposed end of all restrictions on "Freedom Day" (21 June) in the United Kingdom was delayed for up to 4 weeks and vaccination roll-out was accelerated following concerns over the Delta variant, which accounted for the vast majority (90%) of new infections. UK scientists have said that the Delta variant is between 40% and 80% more transmissible than the previously-dominant Alpha variant, which was first identified in the UK (Kent).[111]
See also[edit]
Medicine portal
Viruses portalSARS-CoV-2 Alpha variant
SARS-CoV-2 Beta variant
SARS-CoV-2 Gamma variant
SARS-CoV-2 Theta variant
SARS-CoV-2 Iota variant
SARS-CoV-2 Lambda variant
SARS-CoV-2 Kappa variant
Notes[edit]
^ Other names include:
– G/452R.V3[1]
– Indian variant
References[edit]
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External links[edit]
Public Health England: Variants of concern or under investigation, B.1.617
