A highly mutated Covid variant – BA.2.86 – has been identified in a handful of countries including South Africa, Denmark, Israel, the UK and the US.

The World Health Organization (WHO) designated BA.2.86 as a “variant under monitoring” on 17 August. 

The WHO designates variants at three levels. If one is detected which may pose future risks, it is designated as a variant under monitoring. If a variant appears to pose an increased risk of either transmission or severe disease, it is designated as a variant of interest. Those that are widely circulating and have shown the ability to either spread more easily or cause severe disease, are designated as variants of concern and assigned a Greek alphabet name such as Omicron.

To date there have only been nine cases detected in Denmark, Israel, the UK, the US and South Africa. “However, as these cases are unrelated, found in multiple countries, and one had a recent travel history from Japan to the USA, it is likely that this variant under monitoring is already circulating more widely,” said Department of Health director-general Dr Sandile Buthelezi.

The situation in South Africa

The genomes from the two South African cases were uploaded to the Global Initiative on Sharing All Influenza Data by the National Institute For Communicable Diseases (NICD) on 22 August. “Both are from routine surveillance from private laboratories, one from Gauteng and the other from Mpumalanga. With the detection of the two genomes from South African cases, we will be increasing genomics surveillance and conducting detailed phylogenetic analysis,” said Buthelezi.

It is unknown whether BA.2.86 is associated with either easier transmission or more severe disease. This is why it has not been assigned a new name or declared a variant of interest or a variant of concern. “However, given the large number of mutations in this variant, caution is warranted,” he said.

Most of the virus currently circulating in South Africa was the Omicron variant. There were still a small number of Covid-19 cases being reported and some of them were severe. “There is no evidence at this point of an increase in either the number of cases or their severity.”

Read more in Daily Maverick: ‘Spike in infections’: WHO declares new Covid variant – but no evidence yet of increase in severity

South Africa, along with other countries, was intensifying efforts to further detect and characterise BA.2.86, and monitor the number and severity of Covid-19 cases. Other variants under monitoring and variants of interest continued to be monitored. “Public health measures can be implemented to assist with this effort and to protect the public while more information is gathered.”

South African scientists form part of the WHO Technical Advisory Group on SARS-CoV-2 Virus Evolution and continue to monitor the genotyping of the currently circulating viruses in South Africa.

What you should do

The public is encouraged to take the following actions to protect themselves, their families and the community:

• Anyone who has symptoms associated with Covid-19, such as fever, cough, sore throat, loss of taste or body ache, should test for the virus. Diagnostic tests can be done by health professionals and self-tests are available in pharmacies. Tracking the cause of these flu-like symptoms is important for the general community and further monitoring of the virus;
• Those who test positive for Covid-19 should, as before, self-isolate and seek immediate medical attention if their symptoms become worse;
• In addition, anyone who tests positive using a rapid antigen test (self-test) should request laboratory confirmation (PCR test), which would allow for the isolated virus to be sequenced to know which variant is circulating;
• Anyone at high risk of serious C0vid-19 such as people over the age of 60, those with compromised immune systems or underlying conditions including lung disease, should consider wearing a mask in crowded public spaces;
• All those eligible for a Covid-19 vaccine should be fully vaccinated. Booster doses are available to everyone six months after the prior dose. This is particularly important for people at increased risk of severe Covid-19 (see above);
• Vaccine doses are available at many public sector health facilities, both Pfizer and J&J. Find My Jab or the Health Department’s coronavirus website can be used to find the closest and most convenient vaccination site;
• At this time children under 12 with a high-risk immunocompromised condition are being vaccinated as a priority population at sentinel referral paediatric sites in the public sector; and
• The public is urged to note further scientific information from official public health sources and be cautious about information circulated by individuals and organisations with no scientific authority. The latest information on Covid-19 is available on the NICD website.

The Department of Health is engaging with the WHO, local scientists and clinicians, with input from the Ministerial Advisory Committee on Covid-19, said Buthelezi. DM