Assume the more infectious coronavirus variant is in your community

Mark Kaufman

You may have missed it.

The same day a mob of weapon-bearing Trump-zealots hijacked the Capitol Building, fatally injured a police officer, carved “Murder the media” on a door, and marched freely through the halls with a Confederate flag, the coronavirus killed nearly 4,000 Americans. It was the deadliest COVID-19 day in the U.S., but only for a short time. Regrettably, the following day COVID-19 deaths eclipsed 4,000. That equals almost 24 Oklahoma City bombings.

Yet the latest coronavirus outbreaks in the U.S. come with another unsettling reality. A new, more contagious variant — some 40 to 70 percent more infectious than previous strains and responsible for skyrocketing cases in the UK — is spreading in the U.S., though the CDC estimates its prevalence in reported cases is still low. The variant has been confirmed in Texas, New York, Florida, California, Colorado, and beyond. The impacts could grow serious, as previous coronavirus strains were already excellent at spreading. Infectious disease experts emphasize it’s wise to assume the new strain (dubbed the B.1.1.7 lineage) has been spreading for at least weeks in the U.S., and will continue spreading.

“It’s a safe assumption that this virus can be found in communities all around the country,” said Brian Labus, a public health expert at the University of Nevada, Las Vegas. 

The true extent of spread in the U.S. is uncertain because the nation currently lacks the resources to undertake rigorous genomic sequencing of the coronavirus. This means regularly analyzing the virus in infected patients to identify both common and newly mutated strains. (In contrast, the UK, where researchers first discovered this more infectious variant, has an advanced coronavirus surveillance system.) 

The more transmissible variant is becoming dominant in parts of the UK, and will likely grow dominant in regions around the U.S., too. It has an edge over less infectious strains. 

“That’s how virus dynamics work,” said Mark Cameron, an immunologist at Case Western Reserve University who previously helped contain the outbreak of another deadly coronavirus, SARS, in 2003. “The variant has a competitive advantage. The virus will dominate. The virus will spread faster.”

“That’s a bitter pill to swallow,” he added. 

Exponential increases in the pandemic with variant virus strains in UK, Ireland. I’ve never seen an epidemic curve like this, and the curve is with lockdown. If the variant becomes common the US, it’s close to a worst-case scenario, with a baseline of full hospitals.

— Dr. Tom Frieden (@DrTomFrieden) January 8, 2021

If you want to see what happens when B.1.1.7 becomes the dominant strain, you can look at Ireland, now the highest new cases per capita globally pic.twitter.com/IjyVwMDGyL

— Eric Topol (@EricTopol) January 11, 2021

There is “good news,” however. The coronavirus vaccines, which proved safe and effective through a meticulous vetting process in the U.S., are expected to work on the mutated strain, Labus said. (Viruses naturally and often mutate, so virologists and drugmakers plan for some degree of change when creating vaccines.) What’s more, the new variant hasn’t shown to be more virulent, meaning more harmful to the body, emphasized Labus. There’s no evidence it will increase the rate of hospitalization and death in those infected. “It’s the same disease,” he said. 

“The virus will dominate. The virus will spread faster.”

But, if the more infectious variant tends to infect more people than previous strains, this means more hospitalized individuals overall than otherwise would have occurred. Grimly, more sick inevitably means more deaths, said Cameron. The mounting sick will continue to strain already-overburdened hospitals, some of which are already in crisis.

What can we do?

Fortunately, we aren’t powerless. The arrival of the new variant means fighting pandemic fatigue and boosting vigilance about what you likely already know:

“There’s even more reason to follow common-sense precautions,” said Dr. Amesh Adalja, an M.D. and senior scholar at the Johns Hopkins University Center for Health Security.  

“Now it’s even more critical that you practice the good old things that Fauci has been talking about for the last year,” agreed Dr. Peter Gulick, a D.O. and professor of medicine at Michigan State University.

Yet as the new variant spreads and vaccinations lag, some of our public behaviors may need to change, emphasized Cameron. For example, we’ve learned how to reduce (but not nearly eliminate) the risk of spreading COVID-19 in many workplaces, at doctors’ offices, and during outdoor dining. But those measures might not cut it anymore. “All of a sudden risk increases,” said Cameron. Perhaps we’ll need to start enhancing our masks (double-masking), or reduce the number of people allowed in certain workplaces.

This new, mutated strain is more infectious because it has changed the notorious spikes that protrude from the coronavirus. It makes the spike significantly better at binding to human cells and, like a key, entering. “It attaches quicker, and gets into cells quicker, and infects quicker,” said Gulick. 

With variant starting to take off, easy to see us hit 500,000 deaths before February ends

Catastrophic

But not baked in. Not inevitable.

We can substantially slow deaths in February

How? By getting high risk people vaccinated in January

6/8

— Ashish K. Jha, MD, MPH (@ashishkjha) January 8, 2021

What’s more, disease experts emphasized getting vaccinated with the deeply vetted, FDA-approved vaccines when your state allocates them to you. Vaccines are an extraordinary public health achievement: They’re the reason you don’t know anyone in the U.S. suffering the terrible ills of smallpox or polio. For this latest pandemic, we must vaccinate around 80 percent of the populace to achieve widespread herd immunity. This makes it difficult for the virus to move through the population. 

We can’t, however, contend with this new variant alone. We’ll need the help of the incoming Biden administration if we want to track the spread of this variant (along with inevitable, forthcoming mutations).

“We need to restore our connection to global efforts to sequence and track this virus as it circulates as well as invest highly in tracking the evolution of this virus within our own borders,” said Cameron.

Don’t become a host 

Avoiding infections will give the virus fewer opportunities to mutate and possibly grow into more infectious or drug-resistant strains. Remember, viruses are excellent parasites. They rely on hosts to multiply, spread, and change.

“We are as a global community, but especially in the U.S., giving this virus free rein to infect lots of people, and free rein to evolve to higher pathogenicity,” said the immunologist Cameron. “We know this virus is capable of evolving to be more dangerous.”

The virus can particularly succeed while it’s replicating inside the bodies of people with weakened immune systems (such as those with chronic illnesses, smokers, and older people). “Immunodeficent patients hold onto the virus more,” Dr. Gulick said. “It lingers longer.”

Our daily update is published. States reported 2.0M tests, 262k cases, 130,777 current hospitalizations, and 3,500 deaths. Average hospitalizations and daily reported deaths are at their single-day record. pic.twitter.com/pSRgoYg14w

— The COVID Tracking Project (@COVID19Tracking) January 10, 2021

The virus wants to exploit your body so it can reproduce. Indeed, the coronavirus is “possibly 10 times or more” deadlier than most flu strains, but it often doesn’t kill too quickly. “The main purpose of that virus is to keep you alive,” stressed Dr. Gulick. “If it kills you quickly, it loses its hosts.”   

As of Jan. 11, 2021, Johns Hopkins University School of Medicine has compiled over 90 million reported infections worldwide, nearly a quarter of which have occurred in the U.S. Put another way, we’re giving this virus everything it needs to flourish.

Be hyperaware, say those who know viruses best. “You really don’t want to play games with this,” said Dr. Gulick. 

WATCH: What you need to know about the COVID-19 vaccine

 




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