Virus variants raise alarm bells among scientists, officials
New strains of varying origin may be more transmissible, deadly and resistant to vaccine.
Even as the coronavirus crisis eases in California, federal officials and experts are warning that the dangers of rapidly spreading new strains underscore just how urgent it is to speed up vaccinations.
The worries about the new variants come as Gov. Gavin Newsom this week lifted regional stay-at-home orders in California, setting the stage for counties to resume outdoor restaurant dining unless they decide to maintain stricter local health orders.
The stay-at-home order began rolling out across much of California seven weeks ago. The policy infuriated restaurant owners, but health officials have credited it with avoiding an even greater catastrophe at the state’s hospitals, which have warned that they may need to ration healthcare as workers are stretched thin.
Experts said the new strains underscore the need for the public to be cautious as the stay-at-home order is lifted.
“The concern for me in the way that this comes out is that it will be read as, ‘Happy days are here again. Let’s all go out, because outdoor dining is open again,’ ” UC San Francisco epidemiologist Dr. Kirsten Bibbins-Domingo said. “When, really ... the cases are still really high. They’re coming down, but they’re
still really high.
“It starts to potentially open the floodgates of ‘Cases are coming down; things are back to normal’ ... and that, I think, is the concern,” she added. “And that is sort of the history of how we’ve been doing this here in California.”
Dr. Anthony Fauci, President Biden’s chief medical advisor, warned this week on CBS News’ “Face the Nation” that federal officials “have every reason to believe” British scientists’ conclusions that a strain first identified in the U.K. is deadlier than the original version.
Previously, scientists thought the U.K. variant, B.1.1.7, was merely more transmissible, but new evidence suggests that those who have contracted it are more likely to die, Fauci said.
“When the British investigators looked more closely at the death rate of a certain age group, they found ... a significant increase,” Fauci said. “We need to assume now that what has been circulating dominantly in the U.K. does have a certain degree of increase in what we call virulence — namely, the power of the virus to cause more damage, including death.”
The U.K. strain has been identified in more than 20 states. California had seen 90 cases by Tuesday, second in the U.S. only to Florida, with 92. New York is third, with 22 cases, according to the U.S. Centers for Disease Control and Prevention.
Mounting worry of variants in U.S.
The CDC has warned that the U.K. variant could be the dominant strain in the U.S. by March. Former U.S. Food and Drug Administration Commissioner Dr. Scott Gottlieb expressed particular concern about its emergence in San Diego and Florida, where, he said, it might already be causing 1% or 2% of new infections.
If that’s the case, “they do face the risk of outbreaks with these new variants, because it’s reached a threshold where it may grow quickly enough that our vaccines and our warming weather won’t be enough of a backstop to keep these at bay,” Gottlieb said on “Face the Nation.” “We could certainly face regionalized epidemics because of these new variants.”
An ongoing concern is whether vaccines will be effective against the variants. There is some suggestion that the two vaccines distributed in the U.S., manufactured by Pfizer and Moderna, are protective against the U.K. strain, although there is a “minor diminution” of how effective they are, Fauci said.
But the most concerning new variant studied worldwide is a strain now prevalent in South Africa known as B.1.351, Fauci said. The South African strain has not been identified in the U.S., but it is possible that it has arrived here and hasn’t been detected.
Compared with the U.K. strain, the South African variant “looks like it does diminish more so the efficacy of the vaccine. But we’re still within that cushion level of the vaccines being efficacious,” Fauci said.
Vaccines may need modif ications
It’s possible that officials will need to upgrade the vaccines if circumstances change, Fauci said.
“What we will do and are doing already is making preparations for the possibility that ... down the line, we may need to modify and upgrade the vaccines,” he said. “We don’t need to do that right now. The best way to prevent the further evolution of these mutants is to vaccinate as many people as possible with the vaccines that we have.”
On Monday, Moderna released a statement consistent with Fauci’s comments: Its vaccine remains protective against both the U.K. and South African variants. Nonetheless, Moderna is testing an additional booster dose to increase effectiveness against new strains.
Gottlieb said it’s not surprising that the U.K. variant may be more deadly.
“It was never fully satisfying that the strain could be more contagious but wouldn’t be more pathogenic, wouldn’t get people more sick,” Gottlieb said. If the U.K. strain does allow the coronavirus to stick more tightly to human cells, you could easily come up with reasons why this variant “could be more infective, more virulent and potentially more dangerous.”
Gottlieb said he suspected that the South African variant is in the U.S., even if it hasn’t been detected.
A closely related new strain identified in Brazil — known as P.1 — was identified this week in Minnesota in a person who had recently returned from that country.
California’s homegrown strain
Another strain, believed to be homegrown in California, is sparking concern among scientists at UC San Francisco and CedarsSinai Medical Center in Los Angeles.
Called B.1.426, the strain went from being virtually undetectable to suddenly accounting for some 25% of analyzed viral samples. Its sudden rise and distinctive mutations have made it a prime suspect in California’s vicious post-holiday surge of COVID-19.
One of the mutations in California’s homegrown strain alters the virus’ ability to infiltrate human cells and turn them into virus-making factories. Over multiple generations, even a small improvement in this ability will help a virus propagate more easily, driving up infections, hospitalizations and deaths.
More than 11,000 deaths this month
The latest surge of the pandemic has been by far California’s worst: More than 11,000 COVID-19 deaths have been reported since Jan. 1, a staggering toll that underscores the worst public health crisis in modern times.
More than 5,000 COVID-19 deaths have been reported in L.A. County since New Year’s Eve. The pace of deaths has been so rapid that hospital morgues have been overflowing, and the National Guard has been called in to help transport corpses to the county coroner’s office for temporary storage. In addition, airquality officials have suspended monthly limits on cremations.
In the meantime, evidence is mounting that California is headed out of its worst wave of the pandemic.
The state was recording an average of 27,000 new coronavirus cases a day in the week to Sunday; that’s an improvement from nearly 45,000 for the seven-day period that ended Jan. 10.
L.A. County was recording an average of 8,300 new daily coronavirus cases over the week to Sunday, down from about 15,100 for the seven days to Jan. 13. (It is possible that a reduction in daily coronavirus cases has occurred as a result of declining testing capacity, due to factors such as the conversion of Dodger Stadium from a testing site to a vaccination site.)
The rate at which coronavirus tests are coming back positive has also dropped. In the first week of January, 14.3% of coronavirus tests in California were positive, the most since the early weeks of the pandemic; last week, the positivity rate was 8.1%.
In L.A. County, the positivity rate hit 22% during the final week of 2020; the most recent data show it at 14%.
The number of COVID-19 patients admitted to California’s hospitals remains high, but it too is moving downward.
At the worst point of the summer wave, hospitalizations reached 7,170 in the state. Early this month, they were more than three times worse, climbing to 21,936 on Jan. 6. On Saturday, there were 17,810 COVID-19 patients in hospitals. However, officials say it will take one or two months of declines before hospitals can start to see meaningful relief.
In L.A. County, hospitalizations hit a high of 8,098 on Jan. 5 — more than triple the peak from the summer. By Saturday, the number had fallen to 6,486 — the lowest in a month.
The average daily death toll remains high but has also improved.
About 500 Californians are dying each day from COVID-19, including about 200 in L.A. County.
At the peak earlier this month, about 534 Californians were dying a day, including 241 in L.A. County.
‘The best way to prevent the further evolution of these mutants is to vaccinate as many people as possible with the vaccines that we have.’
— DR. ANTHONY FAUCI, chief medical advisor to President Biden