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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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Sleep Debt and Its Impact on the Body: Hidden Risks of Chronic Sleep Loss

Sleep is not a luxury; it is a biological necessity. Yet in today’s fast-paced world, many people consistently sacrifice sleep due to work demands, screen time and stress. Over time, insufficient sleep accumulates into what is known as sleep debt. Understanding sleep debt and its impact on the body is essential because chronic sleep loss silently affects nearly every organ system.

According to the World Health Organization and global sleep research, chronic sleep deprivation is associated with increased risk of cardiovascular disease, metabolic disorders and mental health conditions.

What Is Sleep Debt?

Sleep debt refers to the cumulative effect of not getting enough sleep.

For example:

if you need 8 hours but sleep 6 hours daily
you accumulate 2 hours of sleep debt per night

Over a week, that equals 14 hours of lost sleep.

This deficit places strain on the body.

Why Sleep Is Critical for Health

Sleep supports:

brain function
immune response
hormonal regulation
tissue repair
memory consolidation

Without adequate sleep, these processes become impaired.

Immediate Effects of Sleep Debt

Short-term consequences include:

daytime fatigue
poor concentration
mood swings
irritability
reduced reaction time

Even one night of poor sleep affects cognitive performance.

Sleep Debt and Hormonal Imbalance

Sleep regulates several key hormones.

Chronic sleep loss disrupts:

cortisol
insulin
leptin and ghrelin (hunger hormones)

This imbalance affects appetite, stress and metabolism.

Impact on Metabolic Health

Sleep debt increases:

insulin resistance
blood sugar fluctuations
abdominal fat accumulation

ICMR and NFHS-5 data show rising metabolic disorders in India, partly linked to lifestyle patterns including poor sleep.

Increased Risk of Obesity

When sleep is insufficient:

appetite hormones increase
cravings for high-calorie foods rise
impulse control weakens

Sleep deprivation promotes weight gain.

Sleep Debt and Immunity

The immune system relies heavily on sleep.

Chronic sleep loss:

reduces infection-fighting cells
increases inflammation
slows recovery from illness

Lancet research confirms that sleep deprivation weakens immune response.

Cardiovascular Consequences

Sleep debt increases risk of:

hypertension
heart disease
stroke

Poor sleep affects blood pressure regulation and vascular health.

Mental Health Impact

Sleep and mental health are deeply connected.

Sleep debt contributes to:

anxiety
depression
emotional instability

Chronic insomnia is both a cause and consequence of mental health disorders.

Cognitive Decline and Brain Health

Lack of sleep impairs:

memory
attention
decision-making

Over time, chronic sleep deprivation may increase risk of neurodegenerative disorders.

Sleep Debt and Inflammation

Chronic sleep loss elevates inflammatory markers.

Persistent inflammation contributes to:

metabolic syndrome
cardiovascular disease
autoimmune conditions

Preventing sleep debt reduces systemic inflammation.

Can Sleep Debt Be Recovered?

Short-term sleep debt can be partially recovered through:

consistent longer sleep
improved sleep hygiene

However, chronic sleep deprivation requires long-term behavioural changes.

Weekend “catch-up sleep” offers temporary relief but does not fully reverse long-standing sleep debt.

Warning Signs of Sleep Debt

Common indicators include:

reliance on caffeine
difficulty waking up
daytime drowsiness
poor focus
frequent illness

Persistent symptoms require lifestyle correction.

Practical Strategies to Reduce Sleep Debt

Maintain a Consistent Sleep Schedule

Go to bed and wake up at the same time daily.

Limit Screen Exposure Before Bed

Blue light suppresses melatonin production.

Create a Sleep-Friendly Environment

Dark, quiet and cool environments improve sleep quality.

Manage Stress

Relaxation techniques reduce cortisol levels and support sleep.

Avoid Heavy Meals and Caffeine at Night

These disrupt sleep cycles.

Role of Preventive Health Checkups

Screening helps detect:

hypertension
metabolic imbalance
stress-related conditions

Sleep quality assessment should be part of preventive care.

Long-Term Benefits of Adequate Sleep

Restorative sleep supports:

stable mood
strong immunity
healthy weight
improved productivity
reduced disease risk

Sleep is foundational to wellness.

Conclusion

Understanding sleep debt and its impact on the body highlights the critical role sleep plays in maintaining physical and mental health. Chronic sleep loss disrupts hormones, weakens immunity, increases metabolic risk and affects heart health. While occasional sleep loss may be manageable, consistent deprivation carries serious long-term consequences. Prioritising adequate, high-quality sleep is one of the most powerful steps toward protecting overall health and preventing chronic disease.

References

World Health Organization (WHO) – Sleep and Non-Communicable Diseases
Indian Council of Medical Research (ICMR) – Lifestyle Disorders and Sleep Patterns
National Family Health Survey (NFHS-5) – Adult Health Indicators
Lancet – Sleep Deprivation and Chronic Disease Research
NITI Aayog – Preventive Healthcare and Lifestyle Risk Factors

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