US faces spread of UK coronavirus strain, raising stakes for vaccine distribution

As a more infectious variant of the coronavirus has now made its way from the United Kingdom to the United States, it may be only a matter of time before it spreads far and wide.

Some experts worry that it may have already done so.

“It may have spread far and wide already, and we’re just catching up to understand what is going on,” said George Rutherford, a professor of epidemiology and biostatistics and the director of the Prevention and Public Health Group at the University of California, San Francisco.

He noted as proof the fact that most of the 32 cases of the variant strain identified in California cannot be traced back to each other.

“It’s not like there is one event with a single set of transmissions,” Rutherford said. “I suspect there may be more to it than we know.”

The U.K. variant, called SARS-CoV-2 B.1.1.7, has been identified in patients in Colorado, Connecticut, Florida, Georgia, New York, Pennsylvania, and Texas, in addition to California.

“I would be surprised if that doesn’t grow pretty rapidly,” Francis Collins, the director of the National Institutes of Health, told the Washington Post on Wednesday.

Recent research from Imperial College London suggests that it may be 40% to 70% more transmissible than previous strains of the virus. However, it does not lead to more severe cases of COVID-19.

While the U.K. variant may have spread, it is not likely to be responsible for the current surge in cases in the U.S.

“I think if it were a bigger driver of the current surge in various parts of the country, we would have found more cases,” said Susan Hassig, an epidemiology professor at Tulane University School of Public Health and Tropical Medicine. “We are doing more genetic testing now. Everyone is looking for the new strain.”

Failing to keep it under control will mean more surges.

“You will see more hospitalizations because there will be an increased number of cases,” said Dr. Manoj Jain, an infectious disease physician at the Rollins School of Public Health. “And with an increased number of hospitalizations and cases, you will see more deaths.”

The U.S. has experienced record numbers in COVID-19 hospitalization and deaths over the last month. The most recent record for hospitalization occurred on Wednesday, when 132,464 patients were hospitalized. The record for deaths occurred on Thursday with 4,081.

Research just released by Pfizer suggests that the vaccine is effective against the U.K. variant, and so, getting a sufficient number of people vaccinated will be key to slowing its spread.

But the vaccine rollout has been slow, with only about 6.7 million people receiving the first dose thus far. And even though the initial efforts have targeted the residents of long-term care facilities, who are among the most likely to be hospitalized and die from COVID-19, it may not be enough to prevent another surge.

“The benefits of those vaccinations probably won’t accrue until February,” said Hassig. “We have a lot of infection already baked in with a lot of hospitalization and mortality from the pre-variant virus, which is going to make January and even part of February challenging. And if you layer on top of that an even more transmissible virus, you’ll have more cases and thus more people in the hospital.”

Shandy Dearth, the director of the undergraduate program in epidemiology at Indiana University’s Richard M. Fairbanks School of Public Health, said, “It’s not just people 75 and older who pass away from this. It’s a disease that can affect pretty much any age, and we don’t see any plans in the immediate future to vaccinate people in their 30s, and there are fatalities among people in their 20s, 30s, and 40s.”

The U.K. variant may also make it more difficult to achieve herd immunity. Herd immunity occurs when a large portion of the population, the “herd,” becomes immune to a virus — through a combination of people getting infected with the virus and people getting vaccinated. The more infectious a disease is, the higher the herd immunity needs to be to stop the spread.

“With the variant strain, you are going to require a much higher percentage of people to be vaccinated or have had the infection to achieve herd immunity,” said Jain. “Previously, we’ve talked about herd immunity at maybe 70%. With the new strain, we’ve got to be talking about something in the range of 90% to 95%, because it is so incredibly infectious, like measles.”

The variant strain was detected in the U.K. in November of last year. Its fast spread led British Prime Minister Boris Johnson to order a lockdown for the U.K. on Monday that included a stay-at-home order. The lockdown is expected to last until Feb. 15.

“They can be effective in a place like London where it has overwhelmed the healthcare system and there are no other options left,” said Jain. “We want to avoid that situation with early detection, surveillance, contact tracing, and containment.”

Dearth argues that the lockdowns in places such as the U.K. aren’t likely to happen here.

“Some of the lockdowns in other countries are very different from the ones we’ve done here,” she said. “We’ve left a lot of things open that other countries did not that were able to control the virus a bit better. I don’t anticipate that happening anytime soon here, if at all.”

 

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