A new variant of Sars-CoV-2 - the virus that causes COVID-19 – has been found from coast to coast in the United States and is likely spreading in communities across the nation. It is, at this point, almost surely too widespread to be contained in any specific state or region of our country. This new variant is significantly more infectious, threatening a rapid increase in rates of new cases and a much, much more deadly and destructive pandemic. This demands an urgent rethinking of our current policy responses.
Viruses mutate frequently, but most mutations are either harmless or make the virus less effective. However, evidence indicates that this variant - known as B.1.1.7 – which was first detected in the United Kingdom, is significantly more contagious than previous variants, though the risk of death to any infected individual from this new strain remain similar to the currently dominant one. Experts also expect that vaccines currently being administered will be effective against this new strain.
This strain, and a close cousin found in South Africa and the UK (but not yet in the US) are deeply worrisome for the next stage of the pandemic.
A significant increase in rates of infection will translate into a much, much more deadly pandemic. One epidemiologist, comparing a 50% increase in severity of disease with a 50% increase in infectiousness, found that in a hypothetical in a town with 10,000 infections increased infectiousness would lead to a five-fold increase in deaths over a month – because a lower death rate of a very large number of cases produces many more deaths than a higher death rate but a lower number of cases.
This new, more infectious variant will change the underlying dynamics of the pandemic, with exponential growth in infections making the virus vastly harder to contain and overburdening our stressed healthcare system. Without significant changes in behavior to once again “flatten the curve,” each new case will result in a greater number of subsequent infections than in the past, making superspreader events more likely and more risky, and making even smaller outbreaks more explosive and harder to contain.
This will result in more people being out sick and unable to go to work or work from home, as well as new restrictions on gatherings that will affect local and national business operations.
The new variant also infects a higher proportion of individuals under age 20, raising concerns about social distancing strategies, schools, and universities.
The new strain is estimated to represent about 1% of all infections at this moment but because of its increased contagiousness, the best estimates are that it will be come a majority of all new infections by March.
The US healthcare system is already staggering under the burden of the pandemic caused by the current (old) strain. Many hospitals, and sometimes entire regions, have filled every available hospital bed as the current surge continues to grow. The result is that COVID-19 patients who might otherwise be kept in hospitals are being sent home, and other severe, urgent cases - car accidents, falls, heart attacks - will be asked to manage their care at home.
Los Angeles, for example, has been hit particularly hard in the wake of Christmas; as hospitals have filled up, patients have been asked to wait in tents outside. Ambulances have waited hours to offload patients, and the Army Corps of Engineers has been deployed to bolster reeling hospitals.
We should expect, without further action, that as the new strain takes hold, we will see an additional 10 million infections in the U.S. between now and end of February and during that time, we could easily see an additional 100,000 to 150,000 deaths.
Without aggressive action to limit the spread of the virus, bolster healthcare systems around the country, and accelerate vaccine administration, Los Angeles offers a preview of what many communities are likely to experience over the coming months. The end of the pandemic is on the horizon, and in light of this new accelerated variant, we must deploy every effort to contain spread while we roll out vaccines.
What can we do? Communities need to tighten restrictions on indoor gatherings sooner rather than later. Waiting until the cases accelerate further would be late and unlikely to head off a crisis in hospitals. Second, rapid tests are becoming increasingly available and we must do everything possible to get these test volumes accelerated and more testing out to schools, workplaces, and homes.
And finally, we must redouble our efforts to vaccinate as many people as we possibly can. That means a lot more vaccinations to as many vulnerable people as possible. To do so, we need to:
It is essential we get ahead of this variant as it takes hold across the U.S. If we act aggressively now, we can avoid the worst-case scenario of more suffering, more deaths, and more economic damage that awaits us in the upcoming months.
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