Variants Rise in Some States, Adding Urgency to Vaccine Push
(Bloomberg) -- U.S. officials and public-health experts are again raising alarms about the resurgence of Covid-19 cases in some regions, and are particularly concerned about the role variants are playing in states including Michigan and New Jersey.
The developments could augur a long-feared possibility: That another surge could occur even as states are flinging open vaccine eligibility criteria, trying to get shots in arms as quickly as possible.
In Michigan and Minnesota, infections are mounting swiftly and new hospital admissions of confirmed or suspected Covid cases are up about 70% and 32%, respectively, from recent lows, according to U.S. Department of Health and Human Services data.
The pace of daily Covid-19 hospital admissions, meanwhile, has stopped its slide in New York and New Jersey -- despite the vaccine campaign -- and begun to inch higher.
The four states have vaccinated between 19% and 21% of their populations, in line with the U.S. overall, according to Bloomberg’s vaccine tracker.
Another major outbreak could blunt the benefits of even widespread immunization in the U.S., said Nicholas Reich, an associate professor at the University of Massachusetts, Amherst, who works with the Centers for Disease Control and Prevention to better predict the virus’s trajectory.
These worries underscore the high stakes of the vaccination campaign, and come as many states have been lifting restrictions after a prolonged, deadly surge last fall and winter. In addition to the emergence of variants that spread more quickly, a combination of loosening rules and pandemic fatigue are likely contributing factors, while events like spring break could have consequences in the weeks to come.
“We’re on the last straightaway, the last lap of this leg of the race, and it seems in some places the variants are just pulling ahead, just a little bit. But it’s so close,” Reich said. “Another four weeks and I’m not sure they’d be able to pull ahead.”
The CDC has named five variants as “variants of concern”: the B.1.1.7 strain from the U.K.; P.1, from Brazil; B.1.351 from South Africa, as well as B.1.427 and B.1.429, both from California. Most are more transmissible and can hamper how well drugs known as monoclonal antibodies neutralize the virus. B.1.1.7 also likely increases the disease’s severity, according to the CDC.
Last week the U.S. added about 55,000 new daily cases on average, about a fifth of levels from the first week of January, though the number of confirmed infections inched up from the previous week. CDC Director Rochelle Walensky pointed to the slight increase at a Monday briefing and said the Northeast and upper Midwest are starting to see more significant rises.
Meanwhile, hospital admissions are plateauing nationally, which is concerning because hospitalizations had been consistently declining in January and February, she said. Deaths from Covid are still falling but the pace of that drop diminished in the past week, according to Walensky.
The latest numbers should “serve as a warning sign for the American people,” Walensky said. “The continued relaxation of prevention measures while cases are still high, and while concerning variants are spreading rapidly throughout the United States, is a serious threat to the progress we have made as a nation.”
The resurgence in Michigan began in ski areas before spreading more broadly, said David Rubin, a physician and director of PolicyLab at Children’s Hospital of Philadelphia, which has been modeling the spread of Covid-19.
“This is not subtle. This looks more like Europe,” Rubin said. “If that can occur in Michigan, I don’t see any reason why that can’t occur in Illinois, which is just a few weeks behind, and the New York metropolitan area.”
In New York City, senior health adviser Jay Varma at a briefing Monday said more infectious variants are contributing to a plateau in cases and that officials were “very concerned” about them.
Data suggest B.1.1.7 is at least one of the culprits. In Michigan, the faster-spreading variant that emerged in early February probably accounts for about 55% of total cases, according to data from testing company Helix. No one is verifying enough variants to fully understand their prevalence, but Helix has been testing for S gene target failure in Covid-19 positive samples, which it says is a key characteristic of the variant first identified in the U.K.
The spread of more contagious variants like B.1.1.7 led to Michigan’s recent rise in Covid cases, Governor Gretchen Whitmer said at a Friday briefing. At the event, Joneigh Khaldun, the chief medical executive for the state and chief deputy director for health in the Michigan Department of Health and Human Services, said confirmed infections have risen 77% since February and warned that the state “could potentially be at the beginning of another surge.”
Lynn Sutfin, a public information officer for the department, said it was hard to assess the Helix data because the company hadn’t been in direct contact.
“At this time, we do not have enough evidence to determine if B.1.1.7 is the dominant variant in our state and will need more scientific evidence to make that determination,” Sutfin said in an emailed response to questions.
Also playing down the variant threat was New Jersey State Health Commissioner Judith Persichilli, who said at a Trenton virus update Monday that there have been 400 reports of CDC variants of concern in the state, the vast majority of which were the B.1.1.7 variant, but added that “we have no variants considered of high consequences.”
Variants are one of “multiple factors at play,” said Adam MacNeil, a CDC epidemiologist, adding that prior surges in the U.S. weren’t necessarily associated with new strains. He said while B.1.1.7 has become prevalent, regional variation has also emerged, including another variant known as B.1.526 taking off in the New York area and the prevalence of two California variants in the state.
Two variants the agency has been most concerned about evading vaccine efficacy -- B.1.351 and P.1 -- remain rare in the U.S., which is a good sign, MacNeil said.
A continuing mystery in recent months had been why, despite variants having been confirmed across the U.S., states aren’t necessarily seeing cases and hospitalizations rise to the same degree.
Some experts predicted Florida might be among the first states to backslide after B.1.1.7 became dominant there, but that hasn’t materialized in the case and hospitalization numbers. What’s more, the percentage of presumed B.1.1.7 cases is no longer increasing at the exponential pace that it had been before, according to the Helix data: It hit 50% B.1.1.7 and then essentially leveled off.
Another worry is that Americans are clearly starting to relax their behavior. Traffic at U.S. retail and recreation venues in the past week is just about 10% below the pre-pandemic baseline, after falling by about 50% during the first lockdown, according to Google Community Mobility Reports. Workplace traffic, which also collapsed by half, is back up to 26% below baseline.
Between spring fever and spring break, a resurgence may be inevitable. But the U.S. also has advantages now that it didn’t have late last year, including warmer weather and vaccines, said PolicyLab’s Rubin.
“The question is what is the amplitude of that bump going to be,” Rubin said. “I think we need to go on offense again.”
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