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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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Insomnia in Teens and How to Manage It

Sleep is essential for growing teens, yet many struggle to get enough of it. From school stress to social media scrolling, teenagers today face multiple challenges that affect their sleep. One of the most common sleep disorders among adolescents is insomnia—the inability to fall asleep, stay asleep, or wake up feeling rested.

In this blog, we’ll break down the causes, effects, and simple strategies to handle insomnia in teens and how to manage it naturally.

What is Insomnia?

Insomnia is a sleep disorder that makes it hard to fall asleep, stay asleep, or get quality rest. Teens with insomnia often feel tired during the day, even if they’ve spent enough time in bed.

There are two main types:

Short-term insomnia: Lasts for a few days or weeks, often triggered by stress or changes in routine.
Chronic insomnia: Occurs at least three times a week for over three months.

Why Is Insomnia Common in Teens?

Teenagers go through many physical, emotional, and social changes. All these factors can disturb their sleep:

1. Hormonal Shifts

During puberty, the sleep hormone melatonin is released later at night. This shifts the body clock, making teens naturally want to sleep and wake up later.

2. Screen Time

Excessive use of phones, tablets, or laptops before bedtime exposes the brain to blue light, which delays melatonin release and interferes with sleep.

3. Academic Stress

Homework, exams, and performance pressure can cause anxiety and overthinking at night, preventing restful sleep.

4. Caffeine Intake

Energy drinks, tea, coffee, and cola consumed in the evening can make it difficult to fall asleep due to their stimulating effects.

5. Mental Health Issues

Anxiety, depression, and emotional distress are often linked with poor sleep in teens.

Signs of Insomnia in Teenagers

Difficulty falling asleep at night
Waking up multiple times during the night
Feeling tired or sleepy during the day
Irritability or mood swings
Trouble focusing in school
Frequent headaches or stomach issues
Increased use of stimulants (coffee, energy drinks)

How Insomnia Affects Teens

Sleep deprivation can harm a teen's physical and mental health. Here are a few ways it affects their well-being:

Poor concentration in school
Weakened immunity
Increased risk of depression and anxiety
Weight gain due to hormonal imbalance
Risky behaviors due to impaired judgment

Teens who consistently sleep less than 7–8 hours are more likely to face emotional and academic challenges.

Natural Ways to Manage Insomnia in Teens

Thankfully, insomnia doesn’t always need medication. Many teens can improve their sleep with simple lifestyle changes.

1. Set a Regular Sleep Schedule

Encourage going to bed and waking up at the same time every day—even on weekends. This helps reset the body’s internal clock.

2. Limit Screen Time Before Bed

Avoid phones, TVs, and tablets at least 1 hour before bedtime. Use “night mode” or blue light filters if screen use is necessary.

3. Practice Relaxation Techniques

Deep breathing, meditation, gentle yoga, or reading a book before bed can calm the mind and prepare the body for sleep.

4. Watch Food and Drink

Avoid heavy meals, sugar, or caffeine in the evening. A light snack like warm milk, bananas, or almonds can promote better sleep.

5. Get Daily Exercise

Physical activity during the day can improve sleep quality—but avoid intense workouts right before bedtime.

6. Create a Sleep-Friendly Environment

Keep the bedroom cool, dark, and quiet. Use blackout curtains, soft bedding, and remove distractions like phones or bright lights.

When to See a Doctor

If your teen’s insomnia lasts longer than 3 weeks or affects their daily life, school, or mood, it’s important to consult a doctor or sleep specialist. Underlying conditions like anxiety, ADHD, or depression might need professional care.

Lab Tests That May Help

If your teen complains of constant fatigue or disrupted sleep, you might consider lab tests to rule out medical reasons such as:

Thyroid Function Test (for hormonal imbalance)
Vitamin D & B12 Tests (deficiency can affect sleep)
Stress Hormone Panel (Cortisol)
Iron Levels (especially in girls)

These tests are available through diagnostic providers like Thyrocare on platforms like SecondMedic.

Helping Teens Build Healthy Sleep Habits

As a parent, here’s how you can support better sleep:

Encourage open conversations about school pressure or emotional issues.
Set boundaries for screen use, especially at night.
Make the home environment calm and supportive before bedtime.
Lead by example—follow healthy sleep habits yourself.

Quick Tips for Teens

Sleep 8–10 hours every night
Don’t study in bed
Use a sleep diary or app to track sleep patterns
Avoid naps longer than 30 minutes in the day
Try journaling to clear the mind before sleep

Conclusion

Teenage insomnia is more common than many people realize. Fortunately, with the right support, structure, and healthy routines, it can be managed without medication.

If your teen shows signs of poor sleep, don’t ignore it. Better sleep leads to better mood, focus, and health.

So, if you’re wondering how to support better sleep for your child, remember to understand insomnia in teens and how to manage it the natural way—with empathy, good habits, and expert care when needed.

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