With the worldwide death toll from the coronavirus pandemic topping 2 million on Friday, a new variant of the virus that has begun spreading in the United States has health experts on edge.
“The reason these mutations or series of mutations in particular are our concern is really because of the higher transmissibility as well as the potential to make the existing vaccines less effective,” Yahoo News Medical Contributor Dr. Kavita Patel said.
According to Centers for Disease Control and Prevention data, over 75 cases of this variant, known as B.1.1.7, have been identified in 12 states, including New York, Georgia, Connecticut, Colorado, Indiana, Maryland, Minnesota, Pennsylvania, Texas and Wisconsin. In California, at least 32 cases have been detected, while 22 cases have so far been identified in Florida.
On Friday the CDC predicted the B.1.1.7 variant could become the dominant strain in the United States by March.
The B.1.1.7 variant, which was first reported in the United Kingdom and is considered roughly 50 percent more transmissible than the original, is not the only new strain of the coronavirus to have emerged in recent weeks. Others have been reported in South Africa and Brazil, raising questions about whether the current vaccines will be effective against all of them.
Patel added that while the new mutation does not appear to be deadlier than the previous strain, its rate of transmission is concerning.
“If a hundred people get infected with what we have seen before, and then those same hundred people are infected with the U.K. variant, there will be 50 additional people in that second group that get infected just because that variant is so much more likely to infect other people,” Patel explained. “When you have that many more people getting infected, some of those people are going to the hospital. Some of those people might die.”
For this reason alone, communities where the new, more infectious variant is present may need to consider furthering safety measures, Patel said.
At the moment, most health experts don’t think B.1.1.7 is responsible for the postholiday surge in some areas of the country. However, National Institutes of Health Director Francis Collins told the Washington Post on Wednesday that he wouldn’t be surprised if U.S. cases of the B.1.1.7 variant began to grow “pretty rapidly,” and warned that the U.S. needs to take immediate action to minimize potential damage from this new variant.
One important step to slow the spread of the new variant would be to increase the country’s genomic surveillance capability to be able to track the virus’s evolution, and to be able to trace the new, more transmissible variants.
Unlike the U.K. and other countries, the U.S. so far does not have a robust, centralized system for identifying genetic variants of the coronavirus. However, since November, the CDC has taken steps to ramp up its sequence-based strain surveillance efforts.
With the B.1.1.7 variant now circulating, scaling up vaccination has never been more crucial, Patel said. But, since the vaccine rollout has been sluggish so far, we cannot just wait for vaccines. Patel laid out steps the American public should take right now to help control the spread of the new variant. Luckily, they are not any different from what has been recommended for months to prevent infection by the original strain.
Steps to avoid the spread of the new coronavirus variant
Wear an effective mask properly (over your nose and mouth).
Stay home whenever possible.
Socially distance at minimum 6 feet.
Wash your hands for at least 20 seconds (or sing “Happy Birthday” twice).
Avoid poorly ventilated indoor places.
On masks, Patel noted that it’s important to consider their effectiveness.
“We now know that the quality of a mask matters and how you wear it matters. If you’ve got a very thin piece of cloth that is just covering your mouth, that is not enough protection. If possible, it would be incredibly important to wear a higher-grade surgical mask or some of the more commercially available KN95’s or N95,” Patel said.
Bottom line: The better the mask, the better the protection.
Ramping up vaccination
Regarding the Pfizer-BioNTech and Moderna vaccines approved for emergency use in the United States, Patel said they are believed to work effectively against all of the virus mutations because of how the vaccines work.
The recent variants that have been identified, however, are concerning because they have mutations in an important location of the virus’s genome — the spike protein, which is the pointy structure that gives the coronavirus its crownlike profile, and the key that allows it to enter human cells.
The vaccines currently available were developed to create antibodies to multiple regions of that spike protein. This is why experts are confident that some of the mutations in the newly identified variants won’t affect the efficacy of the vaccines.
“[Vaccines] don’t just work against one form of that spike protein. They help the body create an immune response to multiple aspects of receptors of those spike proteins,” Patel said.
What’s most important now, she said, is actually getting the vaccine administered to people in the United States. As of Thursday, over 29 million doses had been distributed, but only 10.3 million Americans had received the first dose, according to the CDC vaccine tracker — a number that fell far short of the federal government’s projection to vaccinate at least 20 million with the first dose by the end of 2020.
This week the Trump administration reversed course and said it will no longer hold back millions of doses to ensure second doses will be available. And on Thursday President-elect Joe Biden unveiled his $1.9 trillion “American Rescue Plan” to meet his goal of administering 100 million vaccine doses by the end of his first 100 days in office.
Scaling up effective outpatient treatments
Until America ramps up its vaccination numbers, therapeutic treatments should also be bolstered.
“We actually do have treatments that have been helpful in both decreasing the mortality and whether people die from this disease, as well as decreasing their length of stay in the hospital,” Patel said. Treatment involves administering antibodies from patients who have had COVID-19, as well as man-made ones such as monoclonal antibodies. Both of these therapeutics, if given early, can help neutralize infection, helping prevent more serious outcomes.
There have been concerns that some antibody treatments may not work as well if the virus has mutated, according to former Food and Drug Administration Commissioner Dr. Scott Gottlieb. However, so far it is unclear to what extent these new variants evade the antibody treatments we currently have, and further research is necessary to determine that.
Patel said these treatments, which are still expensive, are continuing to be studied extensively. While the outpatient antibody treatments aren’t perfect, they are an option to offer her patients in a clinic setting, and to help relieve the strain on overwhelmed hospitals.
Finally, Patel recognizes that many Americans are experiencing COVID-19 fatigue, but she says now more than ever “the most important thing we can do is to refresh and reinvigorate the basics” of virus mitigation efforts.