And on Sunday, former Food and Drug Administration chief Scott Gottlieb warned that the Delta variant could lead to a surge of cases in the fall if only 75% of eligible Americans are vaccinated by then.
The variant, which was first identified in India and is also called B.1.617.2, appears to be 60% more transmissible than the variant that is now still dominant in the US, the Alpha variant.
Data from the UK, where the Delta variant makes up about 90% of current coronavirus cases, also suggests that the risk of hospitalization is higher for unvaccinated people with this variant.
The woman, who has not been named, was identified as a 36-year-old living in South Africa.
The coronaviruses gathered 13 mutations to the spike protein, which is known to help the virus escape the immune response, and 19 other mutations that could change the behavior of the virus.
It is not clear whether the mutations she carried were passed on to others, the Los Angeles Times reported.
Some of these mutations have been seen in variants of concern, such as:
The E484K mutation, which is part of the Alpha variant (B.1.1.7, which was first seen in the UK).
The N510Y mutation, which is part of the Beta variant (B.1.351, which was first seen in South Africa).
If more such cases are found, it raises the prospect that HIV infection could be a source of new variants simply because the patients could carry the virus for longer, Tulio de Oliveira, a geneticist at the University of KwaZulu-Natal in Durban and the study’s author, told the LA Times.
But it is probably the exception rather than the rule for people living with HIV, because prolonged infection requires severe immunocompromise, Dr. Juan Ambrosini, an associate professor of infectious diseases at the University of Barcelona, told Insider. Indeed, the woman in the case study was immunosuppressed.
The findings are important for the control of COVID-19 because these patients could be a continuous source of transmission and evolution of the virus, Ambrosini said.
Immunosuppressed patients could carry the coronavirus longer than others
This case could easily have gone unnoticed, de Oliveira told the LA Times.
This was because after the woman was treated in the hospital for her initial symptoms, she displayed only mild symptoms of COVID-19, even though she was still carrying the coronavirus, de Oliveira said.
Scientists only spotted this case because she was enrolled in a study of 300 people with HIV looking at their immune response to COVID-19.
The researchers also found that four other people with HIV had carried the coronavirus for longer than a month, they told the LA Times.
Only one other case of a person with HIV carrying the coronavirus for a prolonged period of time had been published previously.
Some patients who have been immunosuppressed for other reasons have been seen to carry the coronavirus for prolonged periods of time, Ambrosini told Insider. For instance, he said, there have been reported cases of people with kidney transplants testing positive for almost a year.
Health officials in Vietnam have detected a new variant of the coronavirus that’s highly contagious.
The Vietnamese Health Ministry announced on Saturday that scientists have determined the new variant has traces of strains from both the United Kingdom and India, VnExpress reported.
Because the virus has mutations of strains from both countries, it is particularly susceptible to transmission. Officials believe the UK variant is more easily transmissible than other strains. The variant, B.1.1.7, is between 30% to 50% more effective at spreading from person to person than other coronavirus variants, according to UK scientists.
The Indian variant, on the other hand, might make the virus more infectious or may help it avoid the antibody response.
This means variants can spread more easily, make people sicker, escape immune responses, evade tests, or render treatments ineffective, according to experts.
The new variant is able to be transmitted quickly through the air, VnExpress, an international news outlet, reported.
At least four people infected with the coronavirus are carrying the hybrid variant in Vietnam, the outlet reported.
News of the variant comes as India continues to struggle to curb the spread of the coronavirus.
The situation is dire in India as the country continues to report large surges in positive cases. Crematoriums across India have been overwhelmed with bodies and people died as hospitals ran out of oxygen.
Canada is battling a surge of coronavirus infections fueled by new variants which is sickening much younger adults than hospitals are accustomed to seeing.
On Saturday evening, the nation surpassed 1 million recorded coronavirus cases since the start of the pandemic. The third wave of coronavirus has mainly struck the provinces of Ontario, Quebec, and British Columbia, prompting all three to implement new restrictions to stop the spread.
Canada’s chief public health officer, Dr. Theresa Tam, recently announced a 64% increase in new cases involving coronavirus variants – 90% of which involved the B.1.1.7 variant first found in the United Kingdom in September.
Ontario, in particular, has reported an influx of much younger patients in ICUs. Nearly half of the province’s COVID-19 ICU patients are under the age of 60, officials announced this week.
“It’s getting pretty alarming here. It’s spreading quickly, and it’s much faster than the last two waves,” Dr. Kashif Pirzada, an emergency physician in Toronto, told CNN. “The people filling the ICU right now are all in their 30s, 40s, and 50s.”
Pirzada recently tweeted images of cloudy-looking lungs from ICU patients in their 30s.
“As the new variants spread, you will see that COVID-19 is killing faster and younger,” Adalsteinn Brown, a senior science advisor to the Ontario government, said in a press conference this week. “It’s spreading far more quickly than it was before and we cannot vaccinate quickly enough to break this third wave.”
Ontario has enacted a month-long “emergency brake” in response to the surge in infections. The new restrictions will shut down gyms, indoor dining, and personal care services, CBC News reported.
Quebec, meanwhile, has implemented a lockdown in three different cities, shutting down schools and non-essential businesses, and enacting a stricter curfew. British Columbia has also put a three-week ban on indoor dining, worship services, and indoor fitness activities.
Canada has had a remarkably slow vaccine rollout, mainly due to delays in importing doses. The country lacks the capacity to manufacture its own vaccines. As of April 1, just 1.75% of the population was fully vaccinated, and just 11.86% had received at least one dose, according to government data.
Plateauing COVID-19 case rates, and the discovery of coronavirus variants in several states, could mean an “avoidable” fourth surge in COVID-19 cases is on the way in the US, the director of the Centers for Disease Control and Prevention said Monday.
Dr. Rochelle Walensky said the US was at a “fork in the road” in the pandemic, as more people get vaccinated.
She noted several indicators pointed to a concerning trend, including:
The number of new COVID-19 cases reported each day is hovering at a high level of 50,000 to 60,000.
New hospital admissions have also plateaued at 4,500 to 5,000 admissions a day.
Deaths from COVID-19 are declining but remain high, and the rate of decline is slowing.
Some states and regions, such as the Northeast and the upper Midwest, are seeing “a significant rise in cases,” Walensky said.
Coronavirus variants are “spreading rapidly,” she said. The B.1.427 and B.1.429 variant, first identified in California, accounts for 52% of cases in California, 41% in Nevada, and 25% in Arizona, Walensky said.
The B.1.1.7 variant, first identified in the UK, is estimated to be causing 9% of cases in New Jersey and 8% in Florida, she said.
“Taken together, these statistics should serve as a warning sign for the American people,” Walensky said.
Referring to the leveling of COVID-19 cases and hospital admissions seen in the past two weeks, she said she considered them “very concerning.”
She said there would be “another avoidable surge” without immediate action.
Experts have said the rise in cases is most likely due to the “tension” between the desire to open up the country and the risk associated with variants, as STAT reported Saturday.
According to John Hopkins University data, as of Sunday more than half of US states had experienced a growth in new cases in the past two weeks, while 24 states saw a decrease.
The US could be going the way of Europe, she said, where cases are surging after having plateaued, led by the B1.1.7 variant.
Walensky’s warning comes as the US ramps up its vaccination rollout.
Some 24.9% of the US population have received at least one dose of a COVID-19 vaccine, while 13.5% were fully vaccinated as of Monday, according to CDC data.
President Joe Biden has said all US adults should be eligible for a COVID-19 vaccine by May 1, and some states are expected to start vaccinating all adults by April, Insider’s Aria Bendix reported earlier this month.
But experts warn that while vaccination rates rise, the virus can continue to circulate.
Uncontrolled spread of the virus “increases the risk that an even more dangerous variant may emerge,” Dr. Tom Frieden, a former CDC director, told CNN on Monday.
The B.1.1.7. variant is of particular concern, as it has been estimated that people infected with this strain are up to 64% more likely to die from COVID-19, Insider’s Aylin Woodward reported.
“I’m calling the American people to action, whether they’re vaccinated or not, to recommit to doing the right thing,” Walensky said on Monday.
“Take the steps we know work to stop COVID-19. Wear a well-fitting mask, socially distance, avoid crowds and travel, and be ready to roll up your sleeve to get vaccinated when the vaccine is available to you.”
A region of France has been beset by a version of the coronavirus that can hide from standard tests.
The French ministry of health and social affairs announced Monday that among a cluster of 79 COVID-19 cases in Brittany, eight patients were infected with the new variant, but several of them tested negative.
Despite those negative tests, the patients showed typical COVID-19 symptoms.
The new variant does not yet have a alphanumeric designation. But it’s not the first variant that appears able to evade testing. Finnish researchers announced last month that they had identified a strain named Fin-796H with a mutation that made it difficult to detect with some nasal-swab tests, too.
An inability to accurately diagnose infected people could make it harder to curtail the virus’s spread at a time when cases across Europe are already spiking.
Confirming infections with the new variant is tricky
The standard molecular lab tests – known as reverse transcription polymerase chain reaction (RT-PCR) tests – hunt for an infection in a swab from a patient’s nose, looking for the coronavirus’s genetic code.
But according to the French Health Directorate, genetic sequencing revealed that the variant found in Brittany has several mutations on its spike protein that help it evade detection by these diagnostic tests.
Health officials in Brittany eventually confirmed some of the cases caused by the new variant by either testing the patients’ blood for antibodies or collecting samples of phlegm the patients coughed up from inside their lungs and running those through a RT-PCR test.
But neither of those methods are the typical COVID-19 tests, which suggests the new variant could be circulating undetected in France and possibly beyond.
However, one European diagnostics company, the Novacyt Group, announced Thursday that its PCR tests can successfully detect the new variant.
The variant doesn’t appear to be deadlier or more infectious
All eight of the French patients infected with the new variant died of the virus, according to local outlet LaDepeche, but local health officials said that doesn’t necessarily mean it’s more deadly than other strains.
There is no evidence yet that the strain is more transmissible than other versions of the virus. More studies are still needed to figure out whether it can evade vaccines or antibodies from prior coronavirus infections, the French health ministry said in a release.
The variant’s genetic profile shows it doesn’t share any key mutations with B.1.351 and P.1 – the variants first found in South Africa and Brazil, respectively – which are more contagious and can partially evade vaccines.
News of the variant in Brittany came amid France’s third peak of infections.
The average number of daily coronavirus cases there has doubled since mid-December, jumping from less than 15,000 to a near record-high of more than 38,000 on Wednesday. The increase prompted Prime Minister Jean Castex to announce new lockdowns for Paris and the surrounding Ile-de-France region on Thursday.
France has been under a nationwide curfew between 6 p.m. and 6 a.m. for the last two months.
The data is in: People infected with the coronavirus variant first discovered in the UK have a higher risk of dying from COVID-19 than those who get other versions of the virus.
New research published Monday in the journal Nature found that among cases involving the variant, known as B.1.1.7, patients had a 55% higher chance of death within four weeks following their positive test.
The study authors examined roughly 2.2 million people who tested positive in England between September and mid-February, then compared the number of deaths among those with B.1.1.7 to those who were infected with other strains.
After controlling for variables including a patient’s age, sex, ethnicity, and living arrangement, the researchers found that with the original virus, about six out of every 1,000 people in their 60s who test positive might be expected to die. But this number rises to about nine out of 1,000 with B.1.1.7.
“In spite of substantial advances in COVID-19 treatment, we have already seen more deaths in 2021 than we did over the first eight months of the pandemic in 2020. Our work helps to explain why,” Nick Davies, the lead author of the study and an epidemiologist at the London School of Hygiene & Tropical Medicine, said in a press release.
In January and February, 42,000 people in England died of COVID-19.
Mounting evidence shows the B.1.1.7 variant is more deadly
B.1.1.7 was discovered outside London in September, but initial evidence suggested the strain wasn’t more lethal. Then in January, UK Prime Minister Boris Johnson announced the variant was likely associated with higher mortality.
Research published last week in the journal BMJ confirmed that. It found B.1.1.7 to be deadlier than other strains – and even more deadly than the Nature study results suggest.
The BMJ researchers examined nearly 55,000 pairs of people in the UK. Within each pair, one person had tested positive for B.1.1.7 while the other had tested positive for a different coronavirus strain (including the variants from South Africa and Brazil). The members of each pair had similar ages, ethnicities, and geographic locations, and got their positive test results between October and February.
The study found the B.1.1.7 variant was 64% deadlier than the other strains within the four weeks following a positive test.
Johnson’s January announcement was based on research collected by the UK’s New and Emerging Respiratory Virus Threats Advisory Group, which found that on average, people infected with B.1.1.7 in the UK had a 30% higher mortality rate than those with the original virus.
A follow-up analysis from Public Health England analyzed data collected between late November and early January, and found that B.1.1.7 was 65% deadlier than other strains. Researchers from the University of Exeter, meanwhile, looked at samples collected between October and late January and found that people infected with the variant were almost twice as likely to die.
Higher mortality could be related to higher viral loads
The strain’s increased lethality could be chalked up to the fact that people infected with B.1.1.7 have higher viral loads on average, meaning they produce more viral particles when they’re infected. Higher viral loads, multiplestudies show, are associated with a higher risk of death and more severe disease.
“That was the first thing that certainly came to my mind,” William Schaffner, an infectious-disease expert at Vanderbilt University, previously told Insider. “It would make very good sense.”
It’s also possible that the strain’s increased transmissibility simply gives the virus a better chance of infecting more people who are at higher risk of severe illness. A more transmissible strain means people are more likely to get infected if exposed; B.1.1.7 is between 50% and 70% more contagious than the original version of the virus.
This higher transmissibility could be due to several mutations in the genetic code for the virus’ spike protein, which it uses to invade cells. These tweaks may make it easier for the B.1.1.7 variant to spread.
“It may simply be a matter of a more contagious virus getting to more vulnerable people who are older or have underlying health problems like diabetes or lung disease,” Schaffner said.
Yet another possibility is that the variant’s increased transmissibility indirectly contributed to a higher mortality rate due to the stress it put on the UK’s healthcare system. The number of daily COVID-19 cases there skyrocketed in the four months following B.1.1.7’s discovery, jumping from 3,899 new cases on September 20 to more than 68,000 cases on January 8.
The spike in cases strained UK hospitals and healthcare resources, which may have hurt patient outcomes.
“If your cases get out of control, your deaths will get out of control as your health system comes under pressure,” Mike Ryan, executive director of the World Health Organization’s health emergencies program, said in January.
But these shots seem less effective overall against the variant first discovered in South Africa, B.1.351, and the strain found in Brazil, named P.1.
That’s likely because those two variants share a mutation that can prevent the antibodies generated in response to the original virus from recognizing them. This genetic tweak is mostly missing in B.1.1.7, though UK researchers did find 11 cases of B.1.1.7 with that mutation in a set of more than 200,000 samples.
Studies have not found either B.1.351 or P.1 to be more lethal than the original virus.
Spring break, which begins for many colleges this month, could trigger the rampant spread of new COVID-19 variants across the US, a world-leading global health expert told CNN.
While CDC advice remains to stay at home and avoid travel, students opting to vacation at spring break hotspots might accelerate the transmission of highly contagious strains.
“It’s the perfect storm,” Dr. Peter Hotez, founding dean of the National School of Tropical Medicine, told CNN.
Hotez said he is particularly concerned that college students heading to Florida’s beaches could result in a surge of cases of the B117 coronavirus variant, also known as the UK variant.
“You’ve got the B117 variant accelerating in Florida. You’ve got all these 20-year-old kids. None of them are going to have masks. They’re all going to be drinking. They’re having pretty close, intimate contact,” he told CNN. “And then, after that’s all done, they’re going to go back to their home states and spread the B117 variant.”
The B117 variant is believed to be up to 74% more contagious than the original virus. Florida, one of the most popular spring break locations, is currently the epicenter of the highly transmissible strain.
There are 642 cases of the variant in the Sunshine State, more than any other state in the nation, according to the CDC.
“Spring break in Florida could spell disaster for the country,’ Hotez told CNN.
“This is not the time to have a superspreader event for that UK variant, which is what spring break in Florida would look like,” Hotez added. “This is not the time to be sending a bunch of 20-year-olds to Florida, then sending them back, disseminating it across the country.”
Mayor Dan Gelber of Miami Beach, Florida, shares these concerns. He told CNN that spring breakers congregating at bars, hotels, and restaurants “might become the kinds of super-spreaders that I think we saw a year ago.”
On Tuesday, Texas became the largest US state to lift its COVID-19 mask mandate, as a number of states have begun loosening restrictions.
Mississippi, Louisiana, and Michigan also announced easing some restrictions this week, while Iowa, Montana, and North Dakota ditched state-wide mask mandates earlier this year.
The drop in coronavirus cases has been cited in decisions to lift restrictions, and, indeed, most states are down from their fall and winter peaks. However, the nationwide decline in case counts seems to be stalling at numbers that public health officials have said are still too high, prompting warnings that it’s too soon to drop restrictions.
Infectious-disease experts told Insider that while the dropping case counts were promising, it’s too soon to make dramatic changes in restrictions, especially when it comes to masks.
“It’s completely too soon,” Dr. Peter Chin-Hong, an infectious-disease specialist at the University of California at San Francisco, told Insider.
“It goes against the grain of what President Biden is trying to do, which is a national strategy that we never had,” he said. “COVID doesn’t restrict itself by state borders.”
Chin-Hong said individual states’ lifting mask mandates echoed the situation in the US last year, when he said the lack of a national strategy hindered efforts to restrict coronavirus transmission.
Even as President Joe Biden’s administration has ramped up vaccinations, Chin-Hong said coronavirus variants were a big concern.
“The vaccine rollout is progressing everywhere, but it probably won’t be able to protect the population fast enough,” he said.
The experts Insider spoke with all said there were encouraging signs, but that the US was still in a race to vaccinate before virus variants spread more widely.
But he called those cases only “the tip of the iceberg,” given the limited work being done to identify the variants.
The B.1.1.7 variant, first identified in the UK, is known to be more transmissible than the original strain. British scientists have also become increasingly convinced the variant could be deadlier as well.
The variant has been detected in 46 states, and Chin-Hong said it would most likely be the country’s dominant strain by the end of March. If states continue to lift restrictions like mask mandates, it will increase the likelihood for B.1.1.7 to spread.
B.1.1.7 is just one of many coronavirus variants circulating in the US and it’s possible more will emerge, making it an evolving issue with lots of uncertainty.
“We’re entering a phase where it’s harder to know what the near-term future is like,” Andrew Noymer, an infectious-disease specialist at the University of California at Irvine, told Insider.
He said his expectations for what would happen throughout the pandemic – such as the summer and winter surges – had largely been accurate. But, he said, for the first time he felt as if he really didn’t know what the immediate future would look like regarding the pandemic.
Racing to vaccinate
Cindy Prins, an epidemiologist at the University of Florida, agreed it’s too soon to be lifting mask mandates.
“The thing is, we still have COVID circulating and don’t have the majority of people vaccinated,” she said, adding that while case numbers were lower than they were during the holiday surge, they’re still not at ideal levels in most places.
According to data from the Centers for Disease Control and Prevention, more than 80 million doses of COVID-19 vaccines have been administered in the US as of March 3. About 16% of Americans have received their first dose, while about 8% are fully vaccinated.
To reach herd immunity, an estimated 65% to 80% of a population needs to be immune.
The Biden administration is well on its way to achieving its goal of administering 100 million vaccine shots in its first 100 days, and it has plans to further ramp up vaccinations. The president said Tuesday the US will have enough vaccine doses for every US adult by the end of May.
But depending on distribution, it will take months for the doses to be administered.
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases who is also Biden’s chief COVID-19 medical advisor, has said priority groups won’t finish getting vaccinated until sometime in April. And it could take until late summer for all eligible adults to receive their shot.
If the more-transmissible B.1.1.7 variant becomes the most common strain, that leaves a lot of time for it to circulate in environments with loosened restrictions.
“It is really a race against time,” Prins said.
Before dramatically lifting restrictions, she said, states should have a combination of low transmission as well as a high number of fully vaccinated people to reach a “balance where we feel like we’re not going to have widespread transmission.”
“We’ll get to that point,” she said. “But we’re not there yet.”
‘Masks should be among the last to go’
Despite concerns over variants, Noymer of UC Irvine said it’s reasonable for states to reevaluate restrictions as case numbers drop.
“People are getting antsy,” Noymer told Insider. “What you don’t want to have is a situation in which people don’t want to follow any restrictions because they feel it’s all too strict.”
Noymer said loosening restrictions could even have an overall positive effect in some situations. For instance, he mentioned California, where an outdoor-dining ban in the fall sparked outrage and even prompted some restaurants and local jurisdictions to flout the rules.
Noymer considers this a significant problem because it risks some restrictions being viewed as meaningless.
Gov. Gavin Newsom reopened outdoor dining in California late last month, prompting some to wonder whether the decision came too soon. But Noymer said it just brought the restrictions closer in line with reality in some places, which can go a long way in maintaining the public’s trust.
“I’d like to have these orders still have some meaning when in the fall we might face a new wave with variants,” Noymer said.
But as far as what kinds of restrictions can safely be lifted, he said “masks should be among the last to go.”
He said relative to other aspects of life that had been disrupted by the pandemic, masks were a minor inconvenience relative to their public-health benefits.
“We know that masking is really important for prevention,” Prins said, adding that to keep case numbers from rising again it’s crucial for people to continue wearing masks and physical distancing until more Americans can be vaccinated.
Once South African scientists detected a more infectious coronavirus variant in early October, scientists knew it was only a matter of time before the strain reached the US.
At the end of January, the US reported its first two cases of the new variant, called B.1.351, in South Carolina.
California became the latest state to report its own B.1.351 cases on Wednesday. At a press conference, Gov. Gavin Newsom said Stanford University had detected two cases in the San Francisco Bay Area: one in Alameda County and another Santa Clara County. He did not provide further details.
The Centers for Disease Control and Prevention has also identified six cases of B.1.351 in Maryland and one in Virginia.
The variant isn’t spreading as widely as B.1.1.7, another more infectious strain first identified in the UK in September. The CDC has reported more than 930 cases of B.1.1.7 across 34 states so far.
Coronavirus vaccines still appear to be highly effective against B.1.1.7, but scientists are more concerned about B.1.351 because preliminary research found it can partially evade the protection offered by current vaccines.
Moderna, for instance, exposed blood samples from people who’d received the company’s vaccine to B.1.351. They found those samples developed six times fewer virus-neutralizing antibodies than samples exposed to other variants. The company is now exploring the possibility of a booster shot that’s tailor-made to neutralize B.1.351.
Scientists also worry that people who already had COVID-19 could get reinfected with this more transmissible strain.
A race to keep B.1.351 from spreading
The US genetically sequences just 0.01% of its coronavirus cases – around three out of every 1,000 cases. That puts the country 33rd in the world for genetic sequencing, according to the latest data from GISAID, a global database that collects coronavirus genomes.
This sequencing deficit means new variants can easily spread undetected in the population. In all likelihood, B.1.351 entered the US long before South Carolina reported its first cases. Neither of those people had recently traveled, nor was there any personal connection between them.
Even people who previously got COVID-19 could be susceptible, evidence suggests. A recent study of Novavax’s vaccine candidate found that B.1.351 cases were just as common among people who’d previously recovered from infections with other strains as those who had not.
“If it becomes dominant, the experience of our colleagues in South Africa indicates that even if you’ve been infected with the original virus, that there is a very high rate of re-infection,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN last week.
That possibility, combined with B.1.351’s increased transmissibility, could lead to another rise in coronavirus cases, scientists warn. The variant doesn’t appear to be deadlier than the original strain, though.
“When you have more contagious variants circulating and people now feeling free to do things that they weren’t able to do for a while, we do risk having another surge happen in the near future,” Anne Rimoin, an epidemiology professor at UCLA’s Fielding School of Public Health, recently told Insider. “So we need to be watching it carefully.”
For now, scientists hope that vaccinations and other public-health measures will be enough to keep B.1.351 from becoming the dominant strain in the US. More genetic sequencing, they add, could prevent future variants from spreading.
“We’ve got to find ways to get in front of this as opposed to constantly chasing behind it without good surveillance,” Rimoin said. Otherwise, she added, “we’re destined to make the same mistakes.”