Health care professionals perform testing at ProHEALTH Urgent Care of...

Health care professionals perform testing at ProHEALTH Urgent Care of Jericho at its drive thru rapid testing for COVID-19 on Dec. 3 in Jericho. Credit: Howard Schnapp

Mutations and variants are evolutionary trial and error, fundamental to viruses. The oldest known ones date back an estimated 310 million years ago, when the ancient symbiotic bracoviruses infected wasps.

"Dogs bark, ducks quack, viruses mutate," said Dr. Jay Varma, New York City Mayor Bill de Blasio’s senior adviser for the coronavirus pandemic. "That's what viruses do."

"The more infections that occur in humans, the more likely it is the virus will mutate," Varma said, outlining why it's important to minimize how many people are infected.

The most common ancestor of coronaviruses — there are seven coronaviruses that can infect people — existed about 10,000 years ago, according to a 2013 article published in the Journal of Virology.

Some viruses pretty much go away, but others continue to spread indefinitely.

In the case of the coronavirus, Varma said, it’s possible COVID-19 could become a disease akin to influenza and the seasonal flu, for which an annual shot is updated based on mutations, that society must contend with indefinitely.

Why do viruses mutate?

After invading the body, viruses begin to make copies of themselves.

"It's just like copying a manuscript. Sometimes there's typos. The virus just makes random mistakes when it gets copied," Bettie Steinberg, a virologist at Northwell Health's Feinstein Institutes for Medical Research, told National Public Radio in an interview aired earlier this month.

Those variants often don’t matter, and may be weaker. But sometimes variants can bolster a virus.

What are some of the notable variants?

Even the most dominant form of the coronavirus is a variant, according to the World Health Organization.

The initial virus was identified in Wuhan, China, but by June the D614G mutation — identified in late January or early February 2020 — became the dominant variant circulating.

Another mutation, B.1.1.7 — commonly known as the United Kingdom variant — was first detected in September and is now prevalent in London and southeast England, according to the U.S. Centers for Disease Control and Prevention. That variant, which spreads quickly and more easily than others, also has been detected in the United States, Canada and numerous other countries around the world.

Additional variants include one connected to South Africa, called B1.351, and another connected to Brazil, called P.1, the CDC said. On Monday, according to The Washington Post, Minnesota reported the first known U.S. case of the Brazil variant, which is highly contagious. The South Africa variant, which has yet to be detected in the U.S., was first found in October and shares some mutations with the one from the United Kingdom.

How dangerous are variants?

For weeks, there have been reports of an absence of evidence that the U.K. variant causes more severe illness or increases an individual’s death risk. But on Friday, British officials warned, that the variant may be more lethal than previous ones. The Wall Street Journal reported that the fatality risk was boosted by 30% to 40 %.

Even if the U.K. variant proves only as deadly as the more common D614G mutation, the more people infected with a potentially fatal virus, the greater the number of total deaths; the more people in hospitals, the more likely that hospitals will be overwhelmed, according to Dr. David Hirschwerk, an infectious disease specialist with Northwell Health. Overwhelmed hospitals must then limit who is treated.

Speaking Thursday at a news conference, Dr. Anthony Fauci, the nation's top infectious-disease doctor and President Joe Biden's chief medical adviser, said that even if treatments and vaccines for the new variants proved less effective, the vaccines create a "cushion effect," in which the new strains would only somewhat diminish their efficacy.

He called the situation with variants "concerning," but said it's "nonetheless not something that we don’t think we can handle."

On Monday, Moderna, which makes one of the two approved vaccines in the United States, said it's working on a booster shot to protect against the South African variant, but the current vaccines provide some protection, CNBC reported.

Could this mean a third shot — a booster — for those who have already gotten the current ones?

There could theoretically be a third booster shot, or only those vaccinated in the future would get the updated formula, but the answers are uncertain, Hirschwerk said.

So is it better to wait?

No, "unequivocally," Hirschwerk said.

"It is highly likely that these vaccines will retain a significant degree of effectiveness against the current strain or the new strains of virus that appear," he said. Even after being vaccinated with an original formula, he said, an infected person is less likely to suffer a severe case.

Have any variants been detected on Long Island?

The U.K. variant was detected earlier this month in a handful of Nassau and Suffolk county cases. It's also been detected throughout New York City and the state. So far, there are at least four cases in Suffolk and two in Nassau, according to figures released this month by Gov. Andrew M. Cuomo's office.

Does the coronavirus vaccine protect you from variants?

On its webpage about new variants, the CDC reported: "Scientists are working to learn … whether currently authorized vaccines will protect people against them."

But the CDC, referencing the spikes — coronas — the virus uses to attach itself to human cells, said: "The virus would likely need to accumulate multiple mutations in the spike protein to evade immunity induced by vaccines or by natural infection."

A study posted Jan. 19 in bioRxiv — research that still needs to be finalized and that has not been peer-reviewed — found that the vaccine made by Pfizer, the company behind the other vaccine approved in the U.S., was just as effective in protecting against the U.K. variant as the dominant one. And in late December, Moderna said its shot should also be effective against the U.K. variant.

Referring to the South Africa variant, another preliminary study released earlier this month found that a research finding "may foreshadow reduced efficacy of current spike-based vaccines," the type being used in the U.S. and much of the world.

According to NPR, mutations including the Brazil variant could decrease the efficacy of the vaccines.

Do we need to take additional measures to protect ourselves from the variants?

The same precautions remain as earlier in the pandemic: Observe social distance, wear masks and wash hands frequently. People should avoid large gatherings and isolate if they’re feeling sick, received a positive COVID-19 test, recently traveled to a coronavirus hot spot, or believe they’ve been exposed to the virus.

As the stronger variants continue to infect the population, Varma said, you should consider wearing two masks, perhaps one surgical and another fabric."

"If you have the opportunity to wear more than one mask, it is more likely that it's going to be helpful then it's going to be harmful. And in fact, myself, you know, I now am more starting to wear a surgical mask covered by a fabric mask."

The CDC has not said when all the COVID-19 precautions can stop.

"Not enough information is currently available to say if or when CDC will stop recommending that people wear masks and avoid close contact with others to help prevent the spread of the virus that causes COVID-19," the CDC website says.