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Published on: Apr 25, 2021
2 minute read
By: Dr Rajan Choudhary

COVID 19 Mutations: An Update

COVID 19 Mutations: an update

India is currently experiencing a very high rate of infections across the country, resulting in record hospitalisations, ICU admissions and now a severe shortage of oxygen. How did this happen? As with all things, it is likely multifactorial, and blame cannot be associated with one single issue. Socioeconomic issues preventing effective lockdown, stretched healthcare resources, poor communication and maintenance of social distancing and mask use. And of course, viral variants, something we will be discussing below.

GENETIC MUTATIONS

Mutations are integrated deeply into the backbone of genetics. When DNA replicates, its two strands split apart and are used as blueprints to create two new strands, each containing half the original DNA. Mutation’s sneak into the replication phase, and can change the proteins the DNA encodes. If these mutations are compatible with life, they survive and may be passed down the generations. If the mutations provide an evolutionary benefit that improves the survival of the organism and allows it to outcompete other organisms, its descendants will survive, and the mutation will flourish.

Complex organisms such as plants and animals have inherent DNA repair mechanisms that reduce the rate of mutations. This is because most mutations are incompatible with life, as they destroy critical proteins required for the most basic functions of cell function and life. Cancer is evidence of what happens when these repair mechanisms fail. Viruses do not have such protection; when the high mutation rate is combined with the high replication rate, viral variants are inevitable.

COVID MUTATIONS

Scientists have been tracking mutations of the SARS-CoV-2 virus closely. Countries across the world are basing the re-opening and recovery of their societies on reducing infection rates and preventing re-infections through vaccination programmes. If the virus mutates, it can result in increased infectivity, mortality, and potentially the ability to escape from natural immunity offered by antibodies.

Indian genome scientists first detected the “double variant” of the novel coronavirus in October 2020, and in the UK in Feb 2021. It has been on the rise, and B.1.617 accounts for almost 70% of genomes submitted by India to the global database GISAID. It has a total of 13 mutations, which in turn lead to the change in multiple amino acids. B.1.617 has multiple mutations and describing it as a “double mutant” virus is therefore inaccurate.

L452R

B1617 s more contagious because of a mutation in the spike protein known as L452R.This mutation has been studied as it has also been found in variants identified in California (including apes in San Diego Zoo). It is thought this improves the binding to the ACE2 receptors in the lung and may also have some ability to escape from neutralising antibodies.

E484Q

The second mutation is E484Q, which also affects the spike protein to make it less susceptible to pre-existing antibodies, though there is limited evidence for this. Looking at convalescent plasma donated by people it appears to have weaker neutralisation of B.1.617 in some people, though this isn’t a consistent finding.

Mutations at position 484 have also been found in other global variants, though these E484K mutations lead to different functions. One study looking at the UK B.1.1.7 variant looked at how this E484K mutation affected viral interactions in vaccinated patients. Patients who have been vaccinated produce antibodies with a wide range of actions targeting multiple sections of the spike protein. When these patient serums were exposed to the B.1.1.7 mutation, it was found to have decreased neutralisation. This raised the risk of reduced vaccine efficacy and threatened the vaccine programme. Currently, public health officials are confident our vaccine programmes cover the emerging variants.

CONCERNS

Whilst B.1.617 is concerning, it currently accounts for about 20% of cases in Maharashtra, and likely a low percentage of total infections in the country. There is not yet enough evidence to classify it as a “variant of concern”, and further research is required. Though it has increased potential for spreading, currently the UK variant B.1.1.7 may be on the rise, and more concerning. It has over 50% increased transmissibility and 60% lethality and contributed to the UK’s most recent wave of infections. Genomic studies have shown it is now the dominant form of the virus in the Indian state of Punjab.

What is most concerning, however, is the risk of more variants emerging. As the infection spreads unimpeded through the population, viral replication remains at an all-time high, which in turn increases the risk of mutations. Current mutations are covered by vaccines, future mutations may not be. This is why we need to lower infection rates as soon as possible.

Social distancing, use of masks, vaccinations, lockdowns, and quarantine when expressing symptoms. We have to follow public health advice, to prevent our infection rates from spiralling further out of control

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Health Risks of Low Water Intake: How Dehydration Slowly Damages the Body

Water is fundamental to human survival, yet low water intake is one of the most common and overlooked health issues. Many people go through the day drinking far less water than their body requires, especially in hot climates like India. Understanding the health risks of low water intake is essential because dehydration affects nearly every system in the body, often without obvious early symptoms.

Why Water Is Essential for the Body

Water makes up nearly 60 percent of the human body.

It is required for:

maintaining blood volume
regulating body temperature
transporting nutrients
removing waste products
lubricating joints and tissues

Even mild dehydration disrupts these processes.

What Happens When Water Intake Is Low

Low water intake leads to dehydration, a state where fluid loss exceeds intake.

This causes:

reduced blood circulation
thicker blood consistency
impaired cellular function

WHO classifies dehydration as a major but preventable health risk.

Dehydration and Kidney Health

The kidneys rely on adequate water to filter waste.

Low water intake can lead to:

concentrated urine
kidney stone formation
urinary tract infections
long-term kidney damage

ICMR studies link chronic dehydration with rising kidney disease cases in India.

Impact on Digestive Health

Water is essential for digestion.

Low intake causes:

constipation
bloating
acidity
poor nutrient absorption

Digestive enzymes and gut movement depend on proper hydration.

Effect on Brain Function and Mental Performance

The brain is highly sensitive to hydration levels.

Even mild dehydration can cause:

headaches
dizziness
poor concentration
irritability

Studies show cognitive performance drops when fluid intake is inadequate.

Fatigue and Low Energy Levels

Low water intake reduces oxygen and nutrient delivery to cells.

This leads to:

constant tiredness
reduced stamina
poor physical performance

Many people mistake dehydration-related fatigue for stress or lack of sleep.

Cardiovascular Effects of Dehydration

Dehydration reduces blood volume.

This can result in:

low blood pressure
dizziness on standing
increased heart rate

Severe dehydration strains the heart and circulation.

Muscle and Joint Problems

Water helps lubricate joints and muscles.

Low intake can cause:

muscle cramps
joint stiffness
increased injury risk

Hydration is essential for physical recovery and mobility.

Dehydration and Skin Health

Skin reflects hydration status.

Low water intake contributes to:

dryness
reduced elasticity
dull appearance

While water alone does not cure skin problems, chronic dehydration worsens them.

Increased Risk of Infections

Dehydration affects immune defence.

Adequate fluids help:

flush bacteria from urinary tract
maintain mucosal barriers
support immune cell function

Low intake increases infection susceptibility.

Impact on Blood Sugar and Metabolism

Dehydration affects metabolic processes.

It may:

worsen insulin resistance
increase sugar cravings
affect appetite regulation

NFHS-5 data highlights dehydration as a contributing factor in metabolic imbalance.

Heat-Related Health Risks

In hot climates, low water intake increases risk of:

heat exhaustion
heat stroke
electrolyte imbalance

WHO heat-health guidelines emphasise hydration as a primary preventive measure.

Why Many People Do Not Drink Enough Water

Common reasons include:

busy work schedules
lack of thirst awareness
preference for caffeinated drinks
limited access during work hours

Thirst often appears after dehydration has begun.

Signs That Water Intake Is Too Low

Common warning signs include:

dark yellow urine
dry mouth
headaches
reduced urination
fatigue

Ignoring these signs increases health risk.

How Much Water Does the Body Need?

Water needs vary based on:

climate
physical activity
body size
health conditions

Most adults require approximately 2–3 litres daily, more in hot or active conditions.

Simple Ways to Improve Hydration

Effective strategies include:

carrying a water bottle
drinking water at regular intervals
increasing intake during heat or illness
limiting sugary and caffeinated beverages

Consistency is more important than quantity at once.

Role of Preventive Healthcare

Regular health checkups can detect:

dehydration-related kidney issues
electrolyte imbalance
metabolic stress

Preventive care reduces long-term complications.

Long-Term Consequences of Chronic Dehydration

Persistent low water intake increases risk of:

kidney disease
chronic constipation
urinary disorders
cardiovascular strain

These effects develop gradually and are often overlooked.

Conclusion

The health risks of low water intake extend far beyond temporary thirst. Dehydration affects kidney function, digestion, brain performance, heart health and overall energy levels. In hot climates and busy lifestyles, inadequate hydration has become a silent contributor to chronic health problems. Making water intake a daily priority is one of the simplest and most effective preventive health measures. Small, consistent hydration habits protect the body and support long-term wellbeing.

References

World Health Organization (WHO) – Hydration and Health Guidelines
Indian Council of Medical Research (ICMR) – Kidney and Dehydration Studies
National Family Health Survey (NFHS-5) – Nutrition and Hydration Indicators
Lancet – Dehydration and Organ Function Research
NITI Aayog – Climate, Heat Stress and Public Health Reports
Statista – Water Consumption and Health Trends

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