Rapid Spread Of Variants Across Europe Is A Dire Warning For The U.S.

(Posted on Wednesday, February 17, 2021)

Random variation is an essential component of all living things. It drives diversity, and it is why there are so many different species. Viruses are no exception. Most viruses are experts at changing genomes to adapt to their environment. We now have evidence that the virus that causes Covid, SARS-CoV-2, not only changes, but changes in ways that are significant. This is the fourteenth part of a series of articles on how the virus changes and what that means for humanity. Read the rest: part one, part two, part three, part four, part five, part six, part seven, part eight, part nine, part ten, part eleven, part twelve, and part thirteen.

Cases of Covid-19 are now found across all continents, but the global rollout of vaccines and declining case rates in several countries have brought hope to many. Globally, four vaccines have been approved for full use and six have been granted emergency authorization for limited use. As of mid-February 2021, more than 181 million doses have been administered across 79 countries. However, declining case rates in some areas do not tell the full story and as we are now witnessing the rapid spread of new variants. The efficacy of the current vaccines against these variants has not yet been confirmed and it is possible we are entering a new stage of the pandemic.

The highly transmissible SARS-CoV-2 variants have now become the dominant strains in the UK (B.1.1.7), South Africa (B.1351) and South America (P.1). The B.1.1.7 UK variant accounts for approximately 96% percent of all new COVID-19 infections recorded in the United Kingdom. Worse still, a new study from the UK Government shows that the B.1.1.7 variant is more transmissible and linked to increased hospitalizations and deaths when compared to other forms of the virus. This gives us a disturbing preview of what is to occur in the U.S. in the following weeks and months if we do not implement vigilant public health protocols and rapidly expand genomic surveillance.

The UK variant accounted for a third of all viral samples examined at three major laboratories in England in December 2020, just over two months later the variant now accounts for 96% of all viral samples in the UK.

In France, the UK variant is responsible for 15% of positive PCR tests cases nationwide (as of February 11, 2021) and over 37% of positive tests in the Île-de-France region. Biogroup performs 25% of the RT-PCR tests carried out in France and developed the graphic below to demonstrate the UK variant’s prevalence across France from February 1 – 7, 2021 based on their testing.

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Data from the UK, Denmark, Belgium and Switzerland collectively demonstrate that the UK B.1.1.7 variant predictably overtakes previously dominating strains progressing from 20% to 80% of the circulating viruses in just 4 weeks. The data suggests that after a few weeks of enhanced transmission, these countries can expect new epidemic waves early as mid-March as demonstrated in the below model.

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Seven variants of U.S. origin have been discovered and CDC director Dr. Rochelle Walensky has projected that the UK variant could become the dominant virus by March. We have already seen evidence of how quickly the California variant B.1.429 and the collection of viruses with the 677 mutation expands through the population. In mid-December 2020, the B.1.429 variant accounted for almost one-third of all cases in Southern California. By late January 2021, the B.1.429 accounted for more than 50% of all isolates tested as measured by Cedars Sinai Hospital. The emergence of the B.1.429 variant coincides with a sharp increase in infections as well Covid-19 related hospitalizations and deaths in Southern California.A preprint study shows that between December 2020 and January 2021, the collection of viruses with the Q677H mutation represented 27.8% and 11.3% of all SARS-CoV-2 genomes sequenced from Louisiana and New Mexico, respectively.

More recently it was reported in the mainstream press that two variants of concern B.1.1.7 UK variant and the California B.1.429 variant may have combined their genomes to form a heavily mutated hybrid version of the virus, with properties yet to be determined.

With more variants and mutations than any other country, the U.S. will soon be facing similar or even more dire challenges than Europe if swift action is not taken to stop the spread of variants. We risk losing the progress we have made in declining case rates and unleashing a new epidemic. The U.S. currently sequences less than 1 percent of all coronavirus test samples. It is likely that the variants are spreading faster than the limited data we are recording.

This is simply unacceptable when we have the capacity for far greater surveillance. We need a Federal strategy that coordinates and standardizes the reporting process from different labs. Failing to invest in a national strategy for genomic surveillance would echo the failure to establish a national testing infrastructure in the pandemic’s early days. A costly mistake we cannot afford to repeat.

Not only do variants need to be identified through genomic sequencing but they also need to need to be characterized so we can develop appropriate defensive strategies whether they be public health measures or medical developments. Until we know how each variant evades or reacts to natural or acquired antibodies, those who have been vaccinated need to remain cautious and follow public health guidelines. Now is not the time to be loosening Covid-19 restrictions as many U.S. states are.

Danish public health officials, who have one of the most robust surveillance systems, warn other countries not to ignore genomic sequencing of variants. They emphasize if it were not for their extensive monitoring, they would be feeling a false sense of confidence and would risk exposing their population to dangerous variants by rolling back restrictions.

There is a growing consensus amongst the scientific community that this pandemic will eventually evolve into an endemic. This means we will continue to deal with variants as they arise. As we develop systems to gather more data and learn more about how the virus mutates and how that impacts our immunity, this process will get easier. But until then, we cannot begin to roll back restrictions until we have a clear picture of how the rapidly spreading variants will affect us.

Read the article on Forbes

Orginally published on Forbes on February 17, 2021