State not tracking COVID variant locales
As the dangerous Delta variant of the coronavirus makes its way through Florida, those who live in and visit the state will not know where it lurks.
Should you vacation in Fort Lauderdale with unvaccinated children? Should you venture to amusement parks where masks are not required?
Those decisions must be made without the full picture of where variants of concern are proliferating in the state.
“There are all kinds of databases, but no information available about which counties have cases,” said Marco Salemi, professor of Experimental Pathology at the University of Florida College of Medicine. “That is the information people really need to know.”
“We had zero cases of Delta in March and now we have over 100,” Salemi said, “Whether that continues depends on which areas of the state the cases are in and whether vaccination levels
are at a higher or lower rate.”
Researchers and health officials say Delta, also known as B.1.617.2, is more contagious and could trigger more serious illness, posing a threat to counties with low vaccination rates. But the Florida Department of Health is not making public the locations where the variants are spreading. Other states such as Michigan and Missouri reveal that information.
Florida’s weekly COVID report shows 24 Florida counties have vaccination rates below 40%, leaving residents vulnerable to Delta. Marin County in California announced Tuesday the region has seen two recent outbreaks tied to the highly contagious Delta variant and while dozens were infected, officials said the situation would have been more severe if 90% of the residents had not received at least one dose of a vaccine.
Along with Delta, four additional COVID variants of concern are circulating in Florida — Alpha (from the UK), Beta (from South Africa), Gamma (from Brazil), and Epsilon (from California). Without a comprehensive state tracking system, individual county health departments are choosing whether to share information with the public about local cases of COVID variants.
At the federal level, the Centers for Disease Control and Prevention offers the only public variant tracker available to Floridians to monitor the spread. The tracker includes statewide estimates of the proportion of variants in Florida from a sampling of cases. What Floridians don’t see are the details: whether variant cases appear in people hospitalized, vaccinated, symptomatic, or of a certain age group.
“The state likely is getting more granular level data behind the scenes, but it is not sharing it in any meaningful way,” said Kelly Wroblewski, director of infectious disease programs for the Association of Public Health Laboratories, which contributes to the CDC tracker. “Right now we are not seeing variants cause more illness, and vaccines appear to still be effective, so from a public perspective there’s not much action to take.”
When the Florida Department of Health moved its COVID-19 reports from daily to weekly earlier this month, some data disappeared from public view, including the number of variant cases in the state.
Some Florida universities and private labs are trying to create their own surveillance for the COVID variants. Under contract with the Centers for Disease Control and Prevention, Helix Labs randomly tested about 60,000 positive COVID samples in Florida between Jan. 1 and June 1. Of those, the lab identified 13,544 variant cases.
Helix found the Delta variant in 62 counties in Florida in 13% or more of the samples collected through May 1.
Helix spokeswoman Amy Fisher said while the lab identified the growth of specific variants, it doesn’t know whether variants
infect people who are vaccinated and whether every strain is in every county — key measures to predict future levels of spread.
“We track trends within our own data, but we may not have sufficient coverage across all regions of Florida,” Fisher said. “We do not have individual-level vaccination information so we cannot identify which positive cases would be classified as breakthrough infections, but our reporting to (the Florida Department of Health) should allow local public health officials to identify these cases.”
So far, declining new COVID cases and test positivity rates nationwide indicate vaccines offer adequate protection against Delta and other variants now circulating in Florida.
“In the real world, vaccines are working,” said Dr. David Andrews, an associate professor in the Department of Pathology and Laboratory Medicine at the Miller School of Medicine who leads a pilot program to track variants. “If we see breakthroughs, there will be a lot of concern about variants with a property that has an immune escape. But for the time being that has not been seen or identified.”
Here are the variants of concern in Florida and what is known about how vaccines measure up:
Alpha, first detected in the U.K. This variant is most present in Florida at this time but that could change in the coming weeks. All three vaccines have been found to offer protection from Alpha.
Beta, first detected in South Africa. This strain surfaced in Florida at least two months ago. The CDC says it spreads more easily than earlier versions but Beta remains one of the least represented variants in the state. In a Qatar study published in The New England Journal of Medicine, researchers found Pfizer’s shot was between 72% and 75% effective at preventing infection caused by Beta at least two weeks after the second dose. Moderna found its vaccine was slightly less potent against this variant than the original strain although “above levels that are expected to be protective.” Johnson & Johnson said a phase 3 study found there was 64% overall efficacy and 82% efficacy against severe disease in South Africa, where the Beta variant was first discovered.
Delta, first identified in India. The first case of Delta emerged in Florida in April and now the state has more than 100 confirmed cases, says Salemi, the UF professor. Health officials say being fully vaccinated with two doses makes a difference in protection from Delta. Researchers believe Pfizer and Moderna COVID vaccines offer adequate protection from the Delta variant. A spokesman for Johnson & Johnson said the manufacturer feels confident its vaccine will work against Delta, too. “We are monitoring the B.1.617 (Delta) variant through our ongoing trials, and are testing whether the immune response elicited by our COVID-19 vaccine is also targeting this strain,” the spokesman said. “We expect to have data later this year.”
Epsilon, first detected in California. The CDC says vaccines may be less effective against this variant, but not much clinical data exists. This is the variant with the least number of reported cases in the state since early May.
Gamma, first detected in Brazil. Gamma is the second most prevalent variant in Florida as of June 23 and researchers say there continues to be an uptick. Salemi says he is just as concerned about Gamma as Delta. Vaccines offer slightly reduced protection from Gamma than the original strain so the variant needs to be watched closely, he said. “Mutations are making the virus slightly more resistant to vaccines,” he said. “But overall vaccinations are working.”
Andrews, at the University of Miami, says he has identified emerging strains in Florida from Colombia and Mexico that have not yet reached the CDC’s definition of “variant of concern.” However, Andrews said, he feels confident if a vaccine-resistant variant were to proliferate, the manufacturers of mRNA vaccines like Pfizer and Moderna could respond quickly to create a booster to target the strain.