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    One Virus or Two? Can covid-19 mutate into something even more dangerous?

    23 April 2020
    Viruses undergo mutations rapidly. RNA viruses like the flu undergo two mutations per month. We call it "flu" all the time but every season it is slightly different, sometimes milder, sometimes deadlier. This covid-19 coronavirus is also mutating as it is spreading (see this excellent graph maintained by scientists). It is just the way life works: mutation, reproduction, selection. Since mid-March, a statistical anomality has refused to go away: the percentage of infected people who died in mainland China, Taiwan, South Korea and Japan has remained low, whereas in Italy, Spain, France, Britain, Holland, Sweden and the east coast of the USA that percentage is much higher. Initially, this statistical oddity was explained simply as a difference in testing numbers: South Korea had tested a lot more people than Italy and it was assumed that Italy had not tested many infected people; but months later the statistical oddity remains, even after the Europeans have tested tens of millions of people. Next, a simple explanation was that Italy has many more people in their 90s than most countries (the median age in Italy is 47.3 compared with 38.3 in the USA); but Japan too has a lot of very old people, and in any case one after the other all western European countries ended up posting numbers similar to Italy's. Even more puzzling is the fact that Germany has consistently remained in the "east Asian" camp instead of the "European" camp, and ditto for California versus New York. As of April 28: the death rate per million people is 500 in Spain, 450 in Italy, 350 in France and 320 in Britain, compared with 76 in Germany, and compared with 4.7 in South Korea and 3 in Japan.

    We still don't have a rational explanation for the statistical divide: east Asia, Germany, Greece and California versus most of Europe and the east coast of the USA. It's hard to find commonalities in these two groups. You rarely see Holland grouped with Italy, and rarely Greece in the same group with Germany.

    As more and more testing is being done, the data show that the average German is less likely to get infected and die than the average Italian or Brit. One explanation is that Germans have some kind of natural defense. Karl Friston of University College London called it "immunological dark matter" because we cannot see it but the data show that it is out there. However, it should be something in common with South Korea, and we just can't find anything that those two populations they have in common, and NOT have in common with Britain and Italy.

    This explanation works well to explain the low death rates in the region near Yunnan: see this article.

    But there is a second explanation. My humble opinion, based on absolutely no scientific evidence:
    * The original virus originated somewhere (let's assume Wuhan) in October 2019 and killed very few people
    * Then in December 2019 it mutated in Wuhan into something deadly and Chinese scientists realized it, Wuhan was locked down etc, but the death rate remained relatively low (at least compared with SARS and MERS). That's the virus that spread to Korea, Japan, California and Germany: these are the places where the contamination started with people coming directly from China, carrying directly the Chinese virus. They all have a low death rate (Japan: 300 deaths out of 12000 cases in a country of 126 million people).
    * When the virus spread from Germany into Italy, it mutated into a deadlier virus, with a death rate of almost 10%. That's the far deadlier virus that went to Spain, France, Britain and New York.

    (See this excellent graph for how the strains evolve).

    That's my rational explanation for why the death rates are so different. We see a big divide between the countries where the death rate is max 3% and the places where the death rate is way higher. The places that got the virus early (directly from China) tend to have the low death rate; all the places that got it after Italy seem to have the high death rate.

    After all, we now know that the "ebola virus" is actually four different ones, for which four different vaccines are required. We know that the "Spanish flu" was actually three waves of flu: first in the USA, then spread by US troops to Europe, then mutated into the virus that killed tens of millions.

    If i am right, the statistics about the USA are misleading, because they combine the deaths from two different viruses: on the West Coast, where the virus came directly from China, the death rate is low (California: 1400 deaths out of 38000 cases in a state of 40 million people), while on the East Coast, where the virus came from Italy, it is very high (New York: 20000 deaths out of 262000 cases in a state of 20 million people). The data are of April 23.

    If i am right, that's bad news because
    a) there's a chance that the virus is mutating again as it spreads
    b) it will be difficult to develop a vaccine for a rapidly shifting target

    I came up with this theory almost a month ago. Since then i have been looking for at least one scientific paper that supports it. So far: zero! I submitted it as a question to a Stanford panel but they didn't use it, maybe because they thought it was a stupid question. So take it for what it is: a wild guess.

    P.S.

    A more attentive reader than me has spotted this paper under review of April 14 about a study conducted by Li Lanjuan's team at Zhejiang University, according to which the coronavirus is mutating much faster than we knew and mutations affect its deadliness ( a summary here). Thank you, Luke.

    I also discovered a study by Linfa Wang's team at Duke-NUS Medical School in Singapore suggesting that the Singapore lineage may make it less dangerous (paper).

    Two weeks later, a study by Bette Korber's team at Los Alamos National Laboratory argued that a new more contagious strain appeared in February in Europe and migrated to the East Coast of the USA and became dominant worldwide since mid-March. Thank you, Mike, for pointing me to this paper. (Of course this is just a tentative conclusion, as this article points out but by July 2020 Korber published another study proving that the new mutation G614 had almost completely replaced the first European mutation D614 and it was more infectious).

    P.S.

    Two weeks later, the New York Times published this article that shows the mutations.

    TM, ®, Copyright © 2020 Piero Scaruffi All rights reserved.
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