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New coronavirus variants keep popping up. Here’s what we know about them

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Scientists are not surprised to see the coronavirus changing and evolving — it’s what viruses do, after all. And with so much unchecked spread across the US and other parts of the world, the virus is getting plenty of opportunity to do just that.

Four of the new variants are especially worrisome.

“The variants that have been identified recently seem to spread more easily. They’re more transmissible, which can lead to increased number of cases, and increased stress on our already overtaxed system,” Dr. Rochelle Walensky, the newly appointed director of the Centers for Disease Control and Prevention, said in a briefing Wednesday.

What scientists most fear is that one will mutate to the point that it causes more severe disease, bypasses the ability of tests to detect it or evades the protection provided by vaccination. While some of the new variants appear to have changes that look like they could affect immune response, it’s only by a matter of degree.

Governments are already reacting. Colombia banned flights from Brazil, and Brazil banned flights from South Africa. It’s almost certainly too late to stop the spread, and there’s some indication the mutations in these variants are arising independently and in multiple places.

Here’s what’s known about the top four.

B.1.1.7

At the top of the list for researchers in the US is the B.1.1.7 variant first seen in Britain. The CDC has warned it could worsen the spread of the pandemic. It reports more than 300 cases in 28 states — but those are only the cases caught by genomic sequencing, which is hit and miss in the US.

Although hearing about mutant new viruses can frighten people, scientists say they are reassured by what they have found: The human immune system can handle the variants that have sprung up so far, especially B.1.1.7.

“As far as we know it is transmitted in exactly the same way,” Gregory Armstrong, who directs the Office of Advanced Molecular Detection at CDC, told CNN.

That means the same measures already known to reduce spread will also stop the new variants: mask use, social distancing, avoiding large groups or crowds and frequent handwashing.

However, the mutations in the variant help it enter cells more easily — which means if someone, says, breathes in a lungful of air that has virus particles in it, those particles are going to be more likely to infect some cells in the sinuses or lungs rather than bouncing off harmlessly. The worrisome changes enhance the spike protein that the virus uses to attach to cells, meaning people are more likely to become infected by an exposure.

So people need to try harder to prevent spread until vaccination can be sped up.

“In order to interrupt transmission, we are going to need higher rates of what we do to slow transmission,” Armstrong said. “We are going to need to pay more attention to wearing masks. And we will need to increase vaccine coverage.”

There have been some confusing reports about whether B.1.1.7 has caused more severe disease in Britain.

“The most recent data indicate from the UK that it appears to be a bit more virulent in the sense of potentially causing more serious disease,” National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci told a webcast Thursday sponsored by the National Education Association.

B.1.351

The variant first seen in South Africa called B.1.351 or 501Y.V2 was reported for the first time in the US Thursday, in South Carolina.

The two people lived in different parts of the state and neither had traveled recently, although Dr. Brannon Traxler, the health department’s interim public health director, declined to say whether that indicated the variant must be spreading in the community.

It’s been seen in more than 30 other countries, according to the World Health Organization.

“The variant which was first detected in South Africa has spread quickly beyond Africa and so what’s keeping me awake at night right now is that it’s very likely circulating in a number of African countries,” Dr. Matshidiso Moeti, WHO regional director for Africa, said Thursday.

It has a different pattern of mutations that causes more physical alterations in the structure of the spike protein than B.1.1.7 does. One important mutation, called E484K, appears to affect the receptor binding domain — the part of the spike protein most important for attaching to cells.

It could help the virus partly escape the effects of vaccines. “There is more concern about immune escape,” Armstrong said. Vaccine makers and academic researchers are testing samples of this variant, along with others, to see if it can evade the immune response caused by vaccination.

Fauci says even so, there’s an extra cushion of immunity caused by vaccination. It gives some wiggle room. “The good news is the vaccines as they exist now still would be effective against the mutants. The sobering news … as you get more and more replication, you can get more and more of evolution of mutants, which means you always got to be a step ahead of it,” Fauci told CNN on Monday.

“For sure there is a breadth of different kinds of antibodies that can neutralize the virus. These kinds of things in plasma are likely to be resistant to the emerging mutations,” said Dr. Michel Nussenzweig of Rockefeller University, who’s been testing out different mutations against the blood of people who have been vaccinated.

Teams at Columbia University, the Aaron Diamond AIDS Research Center at Columbia University and elsewhere have also been testing lab-made versions of the viral mutations against the blood of vaccinated people and say while there does seem to be a somewhat diminished effect of vaccination, its not enough to weaken protection — yet.

Just in case, Pfizer and Moderna are working to make booster vaccines that would address mutant versions. The design of the vaccines is meant to make that a quick and easy process — just plugging in a new version of the genetic code used to generate the vaccines will do it.

There’s also evidence the changes may help some escape from monoclonal antibody treatments made by Eli Lilly and Co. and Regeneron, also.

P.1

A variant suspected of fueling a resurgence of viral spread in Brazil turned up in Minnesota for the first time this week. It was in a traveler from Brazil, so there’s no indication yet of community spread.

This variant, called P.1, was found in 42% of specimens in one survey done in the Brazilian city of Manaus, and Japanese officials found the variant in four travelers from Brazil.

“The emergence of this variant raises concerns of a potential increase in transmissibility or propensity for SARS-CoV-2 re-infection of individuals,” the CDC said. P.1 also carries the E484K mutation.

L425R

Finally, there’s a new variant seen in California, as well as a dozen other states. “We don’t know yet what the significance of that one is,” said Armstrong. It also has a mutation in the receptor binding domain of the spike protein. It is called L425R and while it’s being found commonly, it’s not yet clear if it’s more transmissible.

Any viral strain can become more common because of what’s known as the founder effect. “The founder effect is a matter of a virus being in the right place at the right time,” Armstrong said. If a particular strain happens to be circulating when transmission increases because of human behavior, that strain will ride along and become more common not because it spreads more easily, but simply because it was there.

It will take more study to show whether these variants can increase the already astronomical spread of the virus. The US has more than 25 million diagnosed cases and more than 430,000 deaths.

“The emergence of variants underscores the need for public health action,” Walensky advised.

“First, get vaccinated when it’s your turn. Also, some people may need help getting vaccinated — please consider helping your neighbors and loved ones schedule or travel to their appointments. Second, wear a mask. Practice social distancing and wash your hands. And finally, now is not the time to travel.”

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New Covid variant and children: CDC doesn’t know if variants cause rare complication in kids

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Multisystem inflammatory syndrome (MIS-C) in children is a troubling complication of Covid-19 infection that can cause heart damage and typically shows up about three weeks after a child has been infected. Many MIS-C cases follow a Covid-19 infection that had no symptoms.

While children are much less likely than adults to be hospitalized or die from Covid-19, children are as just as likely as adults to become infected.

About 2.68 million children in the US have tested positive for the virus as of January 21, according to the American Academy of Pediatrics, and the number of infections has increased recently. Last week alone, 165,480 new child cases were identified through testing, the report said. That’s an 16% increase in child Covid-19 cases over two weeks. Children represent 12.7% of all cases in the US.

The CDC says that as of the end of December, it had reports of 1,659 cases of MIS-C.

If the Covid-19 variants are more contagious, then there is a chance that there could be more instances of MIS-C, but the CDC said it does not have the evidence yet to determine if the variants are leading to more cases.

“All I can say right now is we don’t know,” Dr. Angela Campbell, a CDC medical officer with the Influenza Division, told a meeting of the CDC’s Advisory Committee on Immunization Practices.

“We are very interested in that question,” Campbell said.

The CDC is “certainly concerned” about the variants and is encouraging public health departments to be on the look out for cases, Campbell added. She said the CDC has heard from a handful of states that have said they are seeing more MIS-C cases, but it’s unclear if that is due to the overall surge in Covid-19 cases or if it is related to the variant.

“It’s just not possible to figure that out right now,” Campbell said.

MIS-C has disproportionately affected children of color. There is a sixfold higher incidence of MIS-C among Black children relative to White children. Hispanic children are four times as likely to develop MIS-C and Asian Pacific Islander children are three times as likely to develop the condition as White children, Campbell said.

Children recover with prompt treatment. The CDC advises that parents or caregivers contact a doctor right away if kids have fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes or extra tiredness.

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Health

Why are the coronavirus variants spreading now?

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Since the start of the pandemic, SARS-CoV-2, the virus that causes Covid-19, has been mutating, its genetic code slowly changing as it spreads from person to person across the globe. For most of that time, the mutations didn’t concern scientists. The genetic changes didn’t seem meaningful in terms of how dangerous the virus is. Mutations are normal. Some even weaken the virus.

Now, things are different.

There are three mutated variants of SARS-CoV-2 of particular concern around the world. Researchers do not have the same level of evidence for each: One is more well understood than the others. But in each case, researchers see a seed of something concerning.

There’s B.1.1.7 (yes, all these variants are clunkily named). This variant was first detected in the UK in September. Scientists strongly suspect it’s more transmissible (i.e., contagious) than past versions of SARS-CoV-2, and there’s some preliminary evidence that it might be slightly more deadly.

Then there’s a pair of variants — one discovered in South Africa in October, and another in Brazil in December — that are less well understood. But scientists are beginning to suspect that they might have evolved ways to evade the human immune system, at least a little bit.

A reasonable question you might be asking: Why now? Why have these three variants of concern popped up in such quick succession? The fact that the virus is mutating isn’t new. It’s been mutating all along.

“We’ve had many, many variants in SARS-CoV-2 for a long time now, and scientists have even been tracking these in fairly detailed ways since the summer of 2020,” Emma Hodcroft, a molecular epidemiologist at the University of Bern, says. “The big difference is that, before December, we hadn’t really seen any variants that seemed to be behaving any differently.” (By “behaving differently” she means that the virus itself didn’t seem at the time to be more infectious, or more dangerous in any intrinsic way.)

Hodcroft and others who study the evolution of viruses provide a few overlapping answers to the question “Why now?” None of them perfectly explain what’s going on.

But thinking through them brings us to another, perhaps even more critical question: How might the coronavirus continue to evolve? Will even more variants emerge that challenge our fight against the virus? And what does that mean for the pandemic?

Overall, experts outlined four reasons we’re seeing these variants now. And it all boils down to one thing: evolution.

Reason 1: The virus’s genetic diversity increases over time

First off, it’s helpful to get a refresher on how evolution works. At its core, evolution requires two things: individual differences and natural selection. Evolution is a nonstop process. Organisms — as a group — accumulate change over time through mutations, and the environment helps determine which changes stick around in a population, and which become less prevalent.

Viruses mutate because they’re constantly making copies of themselves in enormous numbers. If you were writing a draft of something millions of times on a computer, extremely quickly, you’d probably make some typos. This has happened millions and billions of times across the globe. The longer the pandemic rages on, the more chances the virus has to evolve.

In the beginning of the pandemic, the viruses infecting people were really similar to one another, because they weren’t that far removed from the original virus that began the outbreak. But now the virus has been changing genetically over the past year, branching out like a family tree. So many genetic changes have accumulated, in different places.

“We have no evidence that the underlying mutation rate is changing,” Sarah Cobey, an epidemiologist who studies viral evolution at the University of Chicago, says. The virus is still making its typos at the same rate. It’s just that those changes start to accumulate the longer the pandemic continues. If you kept copying a book, over and over, making typos in each copy, you’d end up with a somewhat different book than you started with. Likewise, according to Cobey, you’d expect the genetic diversity of the virus to increase over time.

So that’s one major part of it. The virus has just had a lot of opportunities to become something slightly different.

People wait on a tramway dock in Nice, France, on May 11, 2020.
Valery Hache/AFP via Getty Images

But that’s not all of it. The increased diversity doesn’t quite explain why we’re seeing these particular — seemingly more concerning — variants at this particular time. “We are seeing evidence of adaptive evolution,” Cobey says. These variants appear to be either getting better at infecting people or possibly evading the immune system, and they are doing so in similar ways.

Genetic diversity alone doesn’t explain that. Natural selection does.

Reason 2: It’s possible the virus is evolving in response to increasing human immunity

The virus’s increasing genetic diversity only explains part of the story. The other part of the story: natural selection.

Some of the virus’s genetic changes provide an advantage, which has led, in some cases, to these variants outperforming older strains of the virus. “Some of those [genetic] substitutions are actually helping the virus replicate better,” Cobey says, which then can lead to the variants infecting an increasingly larger proportion of people compared to other variants.

Both the P.1 variant found in Brazil and the 501Y.V2 variant found in South Africa have a mutation called E484K, which changes the part of the virus that attaches to human cells (it’s also the part that the immune system most readily recognizes after someone is vaccinated). That mutation, Hodcroft says, “might allow reinfection.” In other words, people who have already been infected with SARS-CoV-2 could potentially be a little bit more susceptible to these variants (though this is still not confirmed).

Hodcroft suspects that both the P.1 and 501Y.V2 variants may have evolved in response to human immunity. And she stresses: What follows is mostly speculative at this point.

In the beginning of the pandemic, no human had been exposed to SARS-CoV-2 before. That means everybody’s immune systems were equally bad at recognizing the virus. If there had been a variant that was good at evading the human immune system, it wouldn’t have risen to prominence because it wouldn’t have outperformed its viral peers.

As Hodcroft explains it: “Even if this [E484K] mutation popped up — which we know it did, we can see that it popped up a few times — it might not have been in a place where this was an advantage.”

In many places around the world, there are lots of people who have already been infected and who have developed some level of immunity to the virus.

So now, variants that can evade the immune system have an advantage. They could grow and replicate where other variants cannot. And that variant could quickly become the dominant one.

“I want to be really clear: We aren’t 100 percent sure, scientifically, that this is what’s happened,” Hodcroft says. “But these are the kinds of things to think about when we think about why we might be seeing different variants now. We’ve changed the rules of the game.”

Reason 3: The virus has spread so far that rare things are starting to happen

The longer the pandemic goes on, the more chances there are for rare — and sometimes consequential — things to happen.

The B.1.1.7 variant might be one of these consequences. It appears to have acquired significant genetic changes over a short period — so many that scientists suspect the variant might have emerged in an immunocompromised person.

In most people, Hodcroft explains, the immune system mounts a full-on assault on the virus, eliminating it in a couple of weeks. “In people that have compromised immune systems, though, there’s a very different dynamic,” she says. “So, for one thing, the virus could be in them for months instead of weeks.” That gives the virus more time to evolve, to accumulate mutations that might make it easier to thwart the immune system.

Many things have to happen for this to occur. Not only does an immunocompromised person have to get the virus (and many immunocompromised people are being particularly cautious), the virus would have to acquire mutations, and then the immunocompromised person would have to spread the virus to another person.

“These are all like ‘super-edge cases,’” Hodcroft says. But “by keeping cases so high, you increase the chance that sooner or later, you’re going to hit that jackpot … we keep rolling the die when we keep the cases up so high.”

Reason 4: Some Covid-19 treatments might have instigated some evolution

The rise of these variants “may have something to do with the use of convalescent plasma,” says Michael Worobey, the head of the department of ecology and evolutionary biology at the University of Arizona.

Convalescent plasma treatments are blood plasma transfusions from people who have recovered from SARS-CoV-2. The idea is that along with the transfusion come antibodies that can help someone else with Covid-19 fight off the disease. The problem is that within certain recipients, the plasma could conceivably also create an environment that favors a stronger variant of the virus.

“So there are cases where the identical [mutations] that characterize the UK variant have also evolved in patients who are chronically infected with the virus and were then given convalescent plasma,” Worobey says. “It’s a perfect storm.” The virus has built up genetic diversity in the patient, and then the convalescent plasma acts as a force of natural selection, choosing among those variants one that could evade antibodies in that plasma.

A scientist works on Covid-19 samples to find variations of the virus at the Croix-Rousse hospital laboratory in Lyon, France, on January 14.
Jeff Pachoud/AFP via Getty Images

Worobey is not saying that this definitely happened with the B.1.1.7 variant, just that it’s possible. (A similar thing, he says, could have happened with using monoclonal antibodies — synthetic antibodies produced as a Covid-19 treatment — on immunocompromised patients.)

It’s not that these treatments never should have been used. In many cases, they may have helped save lives when there are few treatment options for Covid-19. But in the case of using convalescent plasma on immunocompromised people, Worobey says, it may have been “a bit irresponsible.”

The virus will keep evolving. Vaccinations need to happen quickly, and cases need to decrease.

The virus will keep changing, and there will be more variants. Not all will be variants of concern, though.

“I think one thing that we definitely have to keep in mind, particularly in the next few weeks and months, is that a lot of people are now very interested in doing [viral genetic] sequencing and looking for variants,” Hodcroft says. “And that’s fantastic. This is exactly what I’ve been kind of begging for for a long time — for more countries to really dedicate resources to this.” But with the increased vigilance, she says, “we’re going to see a lot of false alarm variants.”

But there also might be more variants of concern in the near future, as the virus is about to get hit by another big selection pressure: vaccines.

If, due to random mutations, there’s a strain of the virus that is just a little bit better at evading the immunity provided by vaccines, it could spread.

That’s why these viral evolution experts want vaccination to happen as fast as possible. Just as partial immunity in a single immunocompromised person can act as a selection pressure for evolution, partial immunity in the population at large can as well.

“What we don’t want is for there to be high levels of virus circulating and spending a lot of time with a partially vaccinated population,” Hodcroft says. “We want to keep case numbers while we’re vaccinating as low as we can.”

That’s because “once you vaccinate hundreds of millions of people, the virus is going to be under really quite intense pressure to evolve [immune] escape variants,” Worobey says. Some of these variants, he warns, “may already be in existence” among the public but have not yet been detected — or may soon form as the pandemic continues. “And those variants, I think, we can expect to sweep up to much higher frequency once vaccination provides this huge selective force.”

Evolution happens when there’s a lot of genetic diversity, which then meets a selection pressure. This is what’s happening as the pandemic continues during a vaccination campaign.

The good news is that, for now, it appears the existing vaccines will still be broadly effective against the variants, and that it’s possible to update the vaccines to account for future changes. But how can we stop more viral evolution from happening in the first place?

“The best way to avoid it is to go back in time and not allow the pandemic to spin so out of control,” Worobey says. “If we had done that, and then vaccinated, then we would have been in a much less dangerous situation.”

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Health

US Coronavirus: Now that new Covid-19 variants are circulating everyday activities are more dangerous, expert says

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“We’ve seen what happens in other countries that have actually had coronavirus under relatively good control, then these variants took over and they had explosive spread of the virus, and then overwhelmed hospitals,” emergency physician Dr. Leana Wen told CNN’s Anderson Cooper.

“If there is something more contagious among us, if we thought that going to the grocery store before was relatively safe, there’s actually a higher likelihood of contracting coronavirus through those every day activities,” she said.

“Wearing an even better mask, reducing the number of times that we have to go out shopping, or in indoor crowded settings, all of that will be helpful,” Wen added.

Dr. Anthony Fauci told NBC Monday wearing two masks is likely more effective in stopping the spread of the virus.

“If you have a physical covering with one layer, you put another layer on, it just makes common sense that it likely would be more effective,” he said.

Send us your questions for President Biden’s Covid-19 team

Moderna says its vaccine protects against some variants

The good news, Fauci told CNN in a separate interview Monday, is that current Covid-19 vaccines are likely to be effective against the new variants.

“The sobering news,” he added, “(is) as you get more and more replication, you can get more and more of evolution of mutants, which means you always got to be a step ahead of it.”

Moderna said Monday its vaccine created antibodies that neutralized Covid-19 variants first found in the UK and South Africa. There are concerns the vaccine may have a somewhat decreased efficacy against the strain first spotted in South Africa, and the company is working on a booster shot aimed at fighting it.

But as Covid-19 evolves, it will be important to prove “time and time again” that vaccines provide protection against new strains, Moderna president Dr. Stephen Hoge said during a panel Monday.

“Until we’ve got this thing sort of fully suppressed and in control, and people are broadly vaccinated or seropositive and protected against it, it’s going to be an ongoing battle for the next couple of years,” he said.

Meanwhile, Johnson & Johnson’s vaccine is currently being tested in South Africa, the US and Brazil, and those results could provide insight into how well it works against emerging variants, one of its developers said. The company has said it could share its Phase 3 vaccine trial data as early as this week.

“If we see the efficacy results … it’ll give us insights not only into whether or not this vaccine candidate is effective, but it’ll also give us insights into whether or not the variants that are circulating in South Africa might be a problem for vaccines,” Dr. Dan Barouch, a Harvard Medical School professor, told CNN.

6% of the US population has gotten a Covid-19 shot

So far, about 19 million people — nearly 6% of the US population — have received at least the first dose of the Covid-19 vaccine, according to CDC data. More than 3.3 million are fully vaccinated.
The numbers are a far cry from where some officials hoped the US would be by now, but President Joe Biden said Monday he is hopeful the country could soon be administering 1.5 million vaccines daily. That’s about a 50% faster pace than the goal of a million doses per day he’s promised since before inauguration.

A White House official told CNN the administration’s official goal remains getting 100 million shots administered in the President’s first 100 days in office.

Across the country, health leaders and state officials have been working to enhance their vaccination strategies and boost the number of shots going into arms.

CVS will begin offering on-site vaccinations at more than 270 locations across 11 states in February, Dr. David Fairchild, associate chief medical officer at CVS Health, said Monday.

“We’re definitely prepared and want to play a large role in helping to get the vaccine out there,” he added. “Our internal goal is to have a capacity to perform 25 million shots a month or more.”

West Virginia Gov. Jim Justice debuted a new online pre-registration system Monday, which allows residents to pre-register to receive a vaccine. Since the system’s launch Monday morning, more than 32,000 residents had scheduled a vaccine appointment, the governor said. That will work alongside an existing hotline that residents can call and pre-register.

Illinois announced it was entering its next stage of vaccinations Monday, opening guidelines to people 65 and older and frontline essential workers including teachers, first responders and grocery workers. The governor added as more doses become available, more mass vaccination sites will open up

Chicago will target 15 “high-need communities based on the City’s COVID vulnerability index,” the mayor’s office said in a news release. The initiative will include “strike teams” that will reach to “those who may be disconnected from more traditional vaccine administration channels,” it said.

“Our city is two-thirds people of color,” Mayor Lori Lightfoot said in a news briefing. “Yet we are falling woefully behind in the number of people of color who’ve been vaccinated today.”

Lightfoot said that of the nearly 108,000 residents who have received their first vaccine dose, only 17% are Latino and about 15% are Black.

Supply still limited

But many states are still struggling with supply.

Kentucky has used about 88% of their first doses so far, Gov. Andy Beshear said Monday, and called on the federal government to send more supply.

Beshear told reporters the state reached an all-time high vaccination rate last week with more than 82,500 doses administered, but highlighted the state could be in the range of 250,000 doses weekly if the supply was there.

Colorado Gov. Jared Polis also renewed a call for more vaccines as the state continues to exhaust the supply allocated by the federal government.

“I continue to urge our federal partners and the new Biden administration in Washington to ramp up vaccine distribution right away,” Polis said in a statement. “Colorado is ready to immediately use three to four times as many vaccines as we are currently getting each week right away.”

The state has so far administered more than 458,400 shots, more than 82,600 of which are second doses.

“The sooner Colorado gets more vaccines, the quicker we can get them into arms, and the faster we can help our small businesses and economy build back stronger,” the governor said. “We’re ready and welcome renewed federal assistance to get the job done.”

CNN’s Lauren Mascarenhas, Chris Boyette, Taylor Romine, Gisela Crespo, Omar Jimenez, Amanda Sealy, Andrea Diaz, Leslie Perrot, Maggie Fox and Naomi Thomas contributed to this report.

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UK doctor warns world may need annual COVID-19 vaccine due to variants

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The emergence of new variants of the virus that causes Covid-19—including one in the U.K. that British officials say could be more deadly than earlier versions—signals a future in which health authorities are locked in a cat-and-mouse battle with a shape-shifting pathogen.

Faster-spreading coronavirus strains that researchers fear could also make people sicker or render vaccines less effective threaten to extend lockdowns and lead to more hospitalizations and deaths, epidemiologists caution. But, they said, it doesn’t mean the contagion can’t be contained.

“We’re living in a world where coronavirus is so prevalent and rapidly mutating that there are going to be new variants that pop up,” Anthony Harnden, a physician who advises the U.K. government, told Sky News. “We may well be in a situation where we end up having to have an annual coronavirus vaccine” to cope with emerging strains.

SERIAL KILLER INVITED TO GET COVID VACCINE BEFORE ELDERLY IGNITES OUTRAGE

People exercise along the bank of the River Thames in London, Saturday, Jan. 23, 2021, during England’s third national lockdown since the coronavirus outbreak began. The U.K. is under an indefinite national lockdown to curb the spread of the new variant, with nonessential shops, gyms and hairdressers closed, and people being told to stay at home. (AP Photo/Kirsty Wigglesworth)

As the new variant in the U.K. has spread across the country, hospitals have been under more strain than they were in the first wave of the pandemic in the spring, and the national Covid-19 death toll is expected to surpass 100,000 in coming days. But in the week ended Sunday, new daily cases were down 22% from the previous seven days.

Matt Hancock, the U.K.’s health secretary, said that was because of national restrictions in place since the start of the year. But in a television interview, Mr. Hancock warned, “We are a long, long, long way” before cases would be low enough for restrictions to be lifted.

The U.K. variant is one of several that have emerged in recent months to cause concern among researchers. Others have emerged in South Africa and Brazil.

Anthony Fauci, President Biden’s chief medical adviser for the Covid-19 pandemic, said on CBS on Sunday that U.S. authorities need to expand genomic surveillance to identify variants of the virus.

Dr. Fauci said current vaccines remain effective. “What we will do and are doing already is making preparations for the possibility that down the pipe, down the line, we may need to modify and upgrade the vaccines. We don’t need to do that right now,” he said. “The best way to prevent the further evolution of these mutants is to vaccinate as many people as possible with the vaccines that we have currently available to us.”

Jeffrey Barrett, director of the Covid-19 Genomics Initiative at the Wellcome Sanger Institute, said the huge number of cases around the world has given the virus a lot of opportunities to evolve in ways not seen earlier in the pandemic.

“We’re going to have to really contend with these new variants in the virus in the next phase of the pandemic,” he told an online seminar last week. “Something happened that basically allowed a new constellation of mutations to arise,” presenting scientists with new challenges.

The variants likely delay the day when life can get back closer to normal thanks to vaccines and raise the prospect of outbreaks of infections periodically even after large numbers of people are inoculated. And their emergence also suggests that international travel restrictions—where governments impose bans on people coming from places where more troubling versions of the virus are prevalent—could be in place intermittently for years.

The likelihood that many people in poorer countries won’t have access to vaccines for some time suggests that more new variants will be incubating around the world even if levels of immunity in the developed world are high enough to curb the virus’s spread.

The U.K. announcement on Friday that the British variant that now dominates infections across the country—and is also well-entrenched in the U.S.—could be more deadly than earlier versions of the virus is preliminary and could be unduly pessimistic.

It is based on the assessment of an expert advisory panel to the government that in turn used four separate academic studies of raw data to decide that there was a “realistic possibility” that the variant was deadlier.

The studies suggested that a greater proportion of people with this variant were ending up in the hospital or dying. It didn’t suggest that once in the hospital a patient was more likely to die than if he or she had been hospitalized with an earlier variant.

Faster-spreading variants imply that, for any given level of restrictions, cases will rise more rapidly or fall more slowly than with earlier versions. That suggests lockdowns, other things being equal, would have to last longer to bring cases down.

FAUCI SAYS UK COVID-19 STRAIN COULD ‘CAUSE MORE DAMAGE,’ US WILL TEST FOR VACCINE EFFICACY

So far, scientists haven’t seen evidence the British variant, first identified in someone in the southeast of England in September, is more resistant to vaccines. But another variant first identified in South Africa has a mutation that could lower the effectiveness of vaccines.

As vaccination programs roll out across the world, they should start to reduce the numbers of people who are seriously ill. If vaccines also confer some immunity as well as prevent serious illness—something so far unknown—they will turn the case curve downward.

Vaccine-resistant variants would slow such downward momentum until scientists tweak vaccines to capture the new variants, too. Some new vaccine technologies, such as those used in the two mRNA vaccines now authorized in the U.S., could be adjusted relatively quickly to deal with new mutations.

Coronaviruses mutate less frequently than certain others, such as influenza viruses that demand an annual vaccination to cope with new variants. However, the virus responsible for Covid-19 appears to be mutating frequently enough to suggest that vaccinated people may need further shots periodically to keep up their protection from the virus.

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The good news in the U.K. is that its vaccination program is moving ahead rapidly, faster than any of its European peers. Up to Saturday, nearly 6.4 million people have received at least one coronavirus vaccine dose, and Mr. Hancock said three-quarters of people over the age of 80, as well as people in three-quarters of nursing homes across the country, had received a shot.

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Health

U.S. Coronavirus Cases Are Falling, but Variants Could Erase Progress

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Still, the country continues to average nearly 190,000 new cases each day, more than any point of the pandemic before December. Deaths from the coronavirus are still extraordinarily high, with more than 4,300 deaths announced on Wednesday, the second-highest daily total of the pandemic. And in some places, there has been no progress at all.

Virginia is reporting some of its highest infection numbers yet. New outbreaks are raging in South Carolina. And in parts of Texas, including around San Antonio and along portions of the Mexican border, case numbers are as high as they have ever been. The county that includes Laredo is reporting more than 500 cases each day, a per capita figure more than twice as high as Los Angeles County, which is also struggling.

In places that have seen a slowing of new cases in recent days, local and state health officials were sharing positive — but tentative — news about the virus.

“Everything’s moving the right way,” a smiling Dr. Allison Arwady, the commissioner of public health for Chicago, said at a news conference on Thursday, noting that because of encouraging metrics in the city, museums have reopened, gyms are allowing group classes and more restrictions could be loosened in the coming days. Epidemiologists say that cases rise and fall in cycles controlled almost entirely by human behavior, and some experts worried that new openings of businesses, permitted because of sinking case numbers, might just set off new surges once more.

Gretchen Musicant, the Minneapolis commissioner of health, said that officials in the state were “encouraged, but wary” of the situation, and that they continue to be watchful as Minnesota begins reopening certain sectors of the economy once again.

“We’re watching to make sure that those reopenings don’t escalate our rates again,” Ms. Musicant said.

As epidemiologists warn about the spread of new variants, health officials are racing to vaccinate as many people as possible. As of Thursday, nearly 2.4 million people had been fully vaccinated. More than half of states had administered less than 50 percent of the doses shipped to them.

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Health

A Covid-19 peak? Variants muddy forecasts for coming months

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Hospitalizations for Covid-19 in the United States are falling after having hit record levels this month — a welcome sign that the winter surge may finally be leveling off. But as new, potentially more contagious variants of the virus circulate, coronavirus modelers warn that the U.S. is by no means out of the woods yet.

The emergence of new variants isn’t altogether surprising, but experts say that without a better understanding of how these strains affect things like transmissibility and the effectiveness of existing vaccines, it’s difficult to know how the pandemic may play out.

“There’s so much up in the air, and the new variants have thrown a huge monkey wrench into our ability to model things,” said Dr. Jeanne Marrazzo, a professor of medicine and director of the division of infectious diseases at the University of Alabama at Birmingham. “All of those things make the crystal ball very cloudy.”

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Although hospitalizations and the number of new infections in the U.S. both declined compared to the previous seven days, Covid-19 deaths are still rising. The country surpassed 400,000 deaths this week, and on Wednesday it set a daily record, with 4,131 reported deaths, according to an NBC News tally.

It’s estimated that the coronavirus has undergone thousands of mutations since it was detected in humans. Many ended up being inconsequential, but scientists are concerned about any alterations that could make the virus more contagious or make the available vaccines less effective.

Evidence from the U.K. has shown that one such variant, known as B.1.1.7, spreads more easily from person to person, although it doesn’t seem to make people sicker and it appears to be susceptible to vaccines. A report released last week by the Centers for Disease Control and Prevention said the U.K. variant could become the predominant strain in the U.S. by March.

New variants have also been reported in South Africa, Brazil and the U.S., with a flurry of research underway to characterize the changes. Early lab experiments suggest that the vaccines made by Pfizer and BioNTech and by Moderna may be less effective against the variant identified in South Africa, but the research wasn’t done in humans, and the findings have yet to be peer-reviewed.

As variants emerge, it will be crucial to adhere to measures to slow the virus’s spread and pick up the pace of vaccinations to keep all of those figures from spiking, said coronavirus modeler Alessandro Vespignani, director of Northeastern University’s Network Science Institute.

That’s because a more contagious variant is likely to result in more cases overall, which adds even more strain on health care systems that are already overburdened.

“It’s a bit of a race against the emergence of new strains that are more transmissible,” Vespignani said. “If we roll out the vaccine fast enough and keep epidemic levels low, that will also slow down the variants and buy us more time.”

The distribution of vaccines has been problematic, with some states running out of their supplies while others have struggled to administer all the doses they were receiving.

And there are concerns that the U.S. isn’t doing enough to track genetic changes in the virus by sequencing genetic codes. Not knowing specifically what variants are present in the country makes it harder to protect those at risk, said former CDC official Ali Mokdad, a professor of global health at the University of Washington. It also makes it more challenging for modelers to project how the pandemic may unfold.

“If we don’t stay on top of what’s circulating, we may have a homegrown variant that is more transmissible than the one we’ve seen in the U.K., and we wouldn’t know,” he said.

Mokdad is part of the Institute for Health Metrics and Evaluation at the University of Washington, which developed one of the most widely cited coronavirus models. Its current projection shows that while the number of new infections is decreasing in the U.S., Covid-19 deaths aren’t expected to peak until early March.

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Still, Mokdad said, there are ways the U.S. can avoid additional spikes in hospitalizations and deaths, even with the emergence of new variants.

“We have to do what we know is effective — social distancing and wearing a mask,” he said. “We can’t celebrate prematurely, because if everyone assumes the worst is behind us, that’s when we’ll see peaks again.”

And although models anticipate that deaths will continue to rise for several more weeks, it’s possible to flatten the curve if people remain vigilant, Vespignani said.

“Every forecast is not a deterministic outcome,” he said. “We can do something to change the trajectory.”

Denise Chow

Denise Chow is a reporter for NBC News Science focused on the environment and space. 



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