Prepare: Virus variants could dash our hopes of ‘normal’
WASHINGTON — After what feels like the longest year in any adult life, it finally looked as if COVID-19 was about to be over. All the old disputes about whether to restrict our lives while we waited for a vaccine or just go about our lives to reach herd immunity naturally had been mooted by the lightning-fast production of two good vaccines.
It appears the viruses of South Africa would like a word with us.
As you probably know, a new and more contagious variant has been circulating there. Earlier last week, one of that nation’s leading epidemiologists presented some results from a new study testing whether that variant could be neutralized by the antibody-rich convalescent plasma extracted from 44 patients who had been infected with an older strain of COVID-19 during the country’s first wave. More than 90% of the plasma samples tested were less effective against the new strain than the old one, and almost half showed “no detectable neutralization activity.”
“We do now have very compelling data both from our labs and many other labs around the world to support the fact that these mutations are problematic,” said Penny Moore, a South African scientist who participated in the discussion.
That could mean yet another wave of COVID-19 that could infect at least some people who have already had it — or been vaccinated — as well as those who haven’t. A resurgent COVID-19, capable of reinfecting people, would complicate any attempt to reach herd immunity, whether we go about our lives and let nature take its course or vaccinate everyone who wants it. If the results hold, then we may be in for a rude shock, along with some bitter disagreements over what to do.
To be clear, that finding is preliminary and may not hold. It reflects laboratory tests, not exposures in real human bodies that might be able to quickly adapt to the new variant. It’s also a relatively small sample, which raises the possibility that the antibodies aren’t particularly representative of most patients.
That said, the risk is serious enough that the United States needs to start preparing against the onslaught of this variant, which may well already be on our shores. Unfortunately in America, the policymaking process has been so poisoned by toxic political divisions that we may not do what we can and should.
But the good news is that we have the tool kit to address this — and no, I’m not talking about permanent lockdown. I’m talking mostly about things we should already have been doing to improve our tracking and vaccination capabilities.
Unlike old-fashioned vaccines, the coronavirus vaccines from Pfizer and Moderna are each a kind of modular delivery system that carries information about the virus to our immune systems. New information can be slotted into that system quickly, which means that we might well be able to refresh our vaccines almost as quickly as the virus evolves to get around our immunity.
Moreover, the more comprehensively we’re able to vaccinate our populations, the fewer opportunities the virus will have to hang around in human bodies and develop new ways to evade our immune systems, meaning fewer dangerous new variants can emerge.
The trick is getting to that point. In the short term, that means buying ourselves time by tightening up some restrictions — notably on travel. To reduce the number of new introductions of the problem variants, we need real, central quarantine for all inbound travelers, including U.S. citizens, because the virus doesn’t care what flag we salute. This won’t protect us entirely, because the variants are already here. But even delay is valuable.
We can buy more time by setting up a genetic surveillance regimen like those in Britain and South Africa, which monitor tests for emerging strains. Frankly, we should have done this already.
We also have to get everyone vaccinated, which not only means spending whatever we must to speed up production, but also pushing shots into arms as quickly as we can. With more contagious variants spreading fast, it is better to set up massive drive-through centers and ration by queuing than to let vaccines sit in freezers for weeks while making sure the most deserving people are first in line.
Over the longer term, as problematic strains emerge, we may need boosters, which will mean paying pharmaceutical companies to develop new vaccine cocktails that attack the most worrisome variants. It would also mean somehow persuading most of the population to get vaccinated, because the more herd immunity there is, the slower new variants will spread.
None of this will be cheap, but technically, none of it is particularly difficult. Our biggest problems are political.
The Biden administration had been looking forward to shepherding us through the easiest part of the pandemic — vaccines already in deployment, spring coming, everything likely to be copacetic by fall. Come fall, we could face the ugliest phase yet, when everyone is exhausted by the past year and uninterested in hearing about new problems. Will Biden and his team rise to the challenge? And if they do, will America follow?