The more contagious coronavirus variant that originated in the United Kingdom is spreading quickly across the US, with cases doubling approximately every 10 days, according to a study published Sunday.
The study, which has not yet gone through the peer-review process, paints a dark picture of how rapidly the B.1.1.7 variant will dominate US coronavirus cases if left unchecked.
“These findings show that B.1.1.7 will likely become the dominant variant in many US states by March, 2021, leading to further surges of COVID-19 in the country, unless urgent mitigation efforts are immediately implemented,” the report’s authors wrote.
The research, funded by the US Centers for Disease Control, the National Institutes of Health, and the Canadian Institutes of Health Research, supports the CDC’s prediction late last month that B.1.1.7 will become the “predominant variant in March.” The report was compiled by researchers from several institutions and the lab testing company Helix.
According to the new research, incidences of the variant are growing at roughly 7% per day nationally, slightly slower than in European countries including the United Kingdom, where the growth rate is 10.4% per day. The lower transmission rate could be explained by the limited data available or competition from other even more transmissible variants of the disease, the report said.
The new, more contagious strain and the resulting surge in cases caused UK officials to institute a lockdown, which is still ongoing. UK officials have also warned the variant may have a higher mortality rate than the original.
Although the variant only accounted for roughly 3.6% of COVID-19 cases in the US in the last week of January, it is spreading rapidly and is 35% to 45% more transmissible than other strains circulating around the country, the study’s authors wrote.
They estimated that the variant is doubling in prevalence every 12.2 days in California, every 9.1 days in Florida, and every 9.8 days nationally.
Their research indicated that B.1.1.7 was introduced into the country multiple times, with the earliest being in November 2020. They also said that periods of increased international and domestic travel surrounding Thanksgiving, Christmas, and New Year’s Day provided a “likely explanation” for how the variant made its way into the US and spread domestically.
The emergence of the UK variant, as well as another mutated strain from South Africa, has prompted disucssion among to US inectious disease experts about how best to get people inoculated, including prioritizing second does of vaccines.
The researchers warned there will be dire consequences if the US does not step up its efforts to sequence and track emerging variants of the disease. But the UK variant and other strains are still rare enough that there is time to mitigate their effects, they wrote.
“Unless decisive and immediate public health action is taken, the increased transmission rate of these lineages and resultant higher effective reproduction number of SARS-CoV-2 will likely have devastating consequences to COVID-19 mortality and morbidity in the US in a few months,” the researchers wrote.
The global vaccine rollout is racing against the clock: New, more infectious variants of the coronavirus are spreading worldwide, and it’s unclear how well existing vaccines work against these strains.
For now, vaccines seem effective against the strain identified in December in the UK, called B117. But preliminary research suggests vaccines may be less effective against B1351, the strain identified in South Africa.
“It is all the more reason why we should be vaccinating as many people as you possibly can,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Thursday. “Viruses don’t mutate unless they replicate, and if you can suppress that by a very good vaccine campaign, then you could actually avoid this deleterious effect that you might get from the mutations.”
But the process of getting shots into arms is off to a slow start in many countries. The US has administered more coronavirus vaccines than any other nation, but it has only given out roughly 19 million doses as of Friday.
Scientists worry that the current pace of vaccinations may allow time for too many new strains to emerge. That could lead to a scenario in which scientists must update vaccines regularly.
Michael Worobey, a viral evolutionary biologist at the University of Arizona, recently told the BBC that the emergence of new coronavirus strains could be “a glimpse into the future where we are going to be in an arms race with this virus, just like we are with flu.”
It’s also possible that a deadlier strain will turn up before most people are vaccinated. In that case, coronavirus shots may be routinely required for young people, similar to polio or measles vaccines.
The coronavirus could eventually resemble the common cold
The coronavirus’ future depends heavily on our ability to control transmission quickly. The more people develop immunity – whether through natural infection or vaccines – the faster the virus will reach an endemic state, meaning it would circulate perpetually but no longer hit pandemic-level peaks.
In a recent study, researchers at Emory University and Pennsylvania State University suggested that the coronavirus could eventually resemble a common cold that infects people during childhood.
Under that study’s most likely scenario, kids would get their first COVID-19 infection, on average, between ages 3 and 5. Almost every kid would get infected by age 15. Since pediatric infections are generally mild, there would be no need to vaccinate children beforehand. Infants might also have a certain degree of immunity at birth.
“For the first six months or so of life, or maybe longer if you’re nursing, kids have maternal antibodies from their mother, both from the umbilical cord and from breast milk, so there’s a chunk of time in the first year or so of life when kids aren’t going to get a primary infection,” Jennie Lavine, the study’s lead author, told Insider.
The researchers estimated that reinfections would be even milder – and might even boost immunity against related coronavirus strains.
If vaccinations proceed quickly, the New York Times reported, the virus could reach this endemic state in as little as six months to a year. Fauci recently estimated that life could return to normal in the fall if 70% to 85% of Americans were vaccinated by the end of summer.
But based on observed patterns of other human coronaviruses, the researchers’ model suggested that the new coronavirus would most likely become endemic within five to 10 years. Without speedy vaccinations, in other words, outbreaks could persist for some time.
Updating vaccines for new variants
Vaccines trigger the production of virus-specific antibodies, so that if people get exposed to the virus after being vaccinated, those same antibodies will recognize the virus and destroy it before it has a chance to replicate widely.
In an ideal scenario, coronavirus vaccines would protect against all strains of the virus for several years.
But scientists worry that new coronavirus variants may be different enough from the original that they could evade the antibodies developed in response to vaccines. If that happens, scientists might need to constantly tweak vaccines’ genetic instructions to vanquish new strains. The process isn’t necessarily difficult, but it would mean people would need follow-up shots.
“If we ever have to modify the vaccine, that is not something that is a very onerous thing,” Fauci said Thursday. “We can do that, given the platforms we have.”
But a scenario in which new strains require people to get revaccinated regularly – as is already the case with flu shots – becomes increasingly likely the longer it takes to get the current shots into arms.
It’s also possible, though, that other layers of immunity may protect people from emerging strains. White blood cells known as T cells and B cells also remember foreign invaders, often for longer periods of time than antibodies. A recent study suggested that recovered coronavirus patients had robust T-cell and B-cell immunity for at least eight months. A study of SARS, which is caused by a genetically similar coronavirus, showed that recovered patients had T-cell immunity 17 years after their infection.
A deadlier strain could make coronavirus shots routine
By vaccinating people quickly, public-health officials hope to avoid the worst-case scenario: the emergence of a deadlier coronavirus strain.
“Things that we need to keep looking for that would prevent this from becoming a very mild, endemic thing that doesn’t require vaccination would be if somehow the virus changed such that infections in childhood became more severe,” Lavine said.
In that case, she added, all young people would need to get shots before they acquired their first coronavirus infection.
There’s already some evidence that the UK coronavirus strain could be deadlier than original. The UK’s chief scientific adviser, Patrick Vallance, said Friday that the new variant could have an up to 30% higher mortality rate among some age groups, though the evidence remained “uncertain.”
The good news, however, is that existing coronavirus shots seem to work against it.
“From what we’ve seen so far, the variants being described do not alter the ability of neutralizing antibodies elicited by vaccination to neutralize the virus,” Moderna’s chief medical officer, Tal Zaks, said at the JP Morgan Healthcare Conference earlier this month.
But that makes the task of vaccinating people all the more urgent.
“Everyone will probably get infected sometime,” Lavine said “Let’s make it an infection after the vaccination so that you don’t get really sick from it.”
The White House coronavirus task force sent states a report on Sunday warning that there might be a “USA variant” of the coronavirus. The variant could be fueling the unprecedented number of coronavirus cases and deaths in US, the report said, according to mediaoutlets that obtained the document.
The report suggested this USA variant may be more transmissible than the original version of the virus that emerged in China, much like the new strains identified in the UK (B.1.1.7) and in South Africa (B.1.351).
But there is no scientific evidence yet that a more contagious version of the coronavirus has originated or started spreading in the US.
In a statement to Business Insider on Friday, the Centers for Disease Control and Prevention said: “To date, neither researchers nor analysts at CDC have seen the emergence of a particular variant in the United States as has been seen with the emergence of B.1.1.7 in the United Kingdom or B.1.351 in South Africa.”
Human behavior has a large effect on transmission rates
The task force’s report, according to CNBC, offered little information about how long the new US strain described might have been circulating, nor what mutations were included in its genetic profile.
Scott Gottlieb, a former commissioner of the Food and Drug Administration, told CNBC’s Closing Bell that the task force’s hypothesis about the existence of a USA variant is in part based on the fact that US and UK’s pandemic growth curves are similar.
According to CNN, the task force’s report said: “This fall/winter surge has been at nearly twice the rate of rise of cases as the spring and summer surges. This acceleration suggests there may be a USA variant that has evolved here, in addition to the UK variant that is already spreading in our communities.”
Given the lack of evidence the task force provided, frustrated officials at the CDC tried to get the statements about the suspected variant removed from the recent report, but they were unsuccessful, according to the New York Times.
Even in the UK, the variant is not the only reason for the steep rise in cases.
“Human behavior has a very large effect on transmission – probably much larger than any biological differences in SARS-CoV-2 variants,” Paul Bieniasz, a virologist at the Howard Hughes Medical Institute, previously told Business Insider.
The variant reported in the UK does have an increased reproductive, or R0, value – the average number of people one sick person infects. The number is 1.5 rather than 1.1, the World Health Organization announced in December, which means that 100 sick people will infect another 150, not 110, on average.
But mitigation measures like social distancing and masking play a big role in how much the virus spreads, regardless of its genetic mutations.
The US isn’t sequencing enough genomes to spot new variants
To monitor the many versions of the coronavirus circulating worldwide – each separated by a handful of tiny changes in its genome – researchers genetically sequence samples of the virus and track the changes over time. UK researchers first pinpointed B.1.1.7 this way in mid-September.
But the US is behind many countries when it comes to keeping tabs on new variants. US researchers have genetically sequenced less than .01% of its coronavirus cases: 2.5 out of every 1,000. In total, the US has only sequenced 51,000 coronavirus samples, the CDC reported. In the UK, labs are sequencing 45 out of every 1,000 cases.
That’s likely the reason the US missed the UK strain’s introduction, and also why it would be difficult to identify a new USA variant. The US didn’t report its first case involving B.1.1.7 until December 29. That was at least three weeks after the strain entered the country, according to Charles Chiu, an infectious-disease expert at the University of California, San Francisco.
So far, more than 50 B.1.1.7 cases have been confirmed across six states, and all but one of those people had no travel history, suggesting the strain has been spreading silently for some time.
Even if a possible new USA variant were indeed responsible for an uptick in cases, pinpointing a connection could take months.
“There is a strong possibility there are variants in the United States; however, it could weeks or months to identify if there is a single variant of the virus that causes COVID-19 fueling the surge in the United States similar to the surge in the United Kingdom,” the CDC told Business Insider in its statement.
Dr. Peter Hotez, a vaccine scientist at Baylor College of Medicine in Texas, said in a tweet on Thursday that “there are likely similar homegrown variants in US as well, it’s just that no one is looking.”
“Like everything else in our national public health response, we’ve come up small on virus genomic sequencing,” he added.
A new, likely more contagious variant of the coronavirus is spreading among the community in Southern California amid a surge in COVID-19 that has overwhelmed local hospitals.
At a press conference on Wednesday, San Diego County Supervisor Nathan Fletcher said a 30-year-old man had tested positive on December 29 for the variant, first known to have spread in the United Kingdom.
The man has not been to the UK, he noted.
“Because there is no travel history, we do not believe this is an isolated case in San Diego County,” Fletcher said.
The new variant is believed to be far more contagious than what has previously spread across the United States. It is not, however, seen as more dangerous to those infected, nor is it believed to be resistant to vaccination.
According to San Diego County public health officials, the man infected with the UK variant, known as B117, became symptomatic on December 27.
“We confirmed it at 3 a.m. this morning,” Dr. Kristian Andersen, a professor at the Department of Immunology and Microbiology at Scripps Research, said at the press conference.
“It was only a question of when,” Anderson said of the first known case of the UK variant in California. While not yet as prevalent as other variants of the virus, “We know there are more,” he said. “We don’t know how many.”
The news comes as San Diego hospitals are reporting that they are running out of space in their morgues to hold those dying from COVID-19. Hospitals in nearby Los Angeles, meanwhile, are running out of oxygen to treat those in their over-capacity ICUs.
The first known US case of the variant was detected on Tuesday, a 20-something man in Colorado also testing positive despite no history of recent travel to the UK.