The emergence of more coronavirus variants is fueling concern of a spring surge.
Some experts think it is inevitable.
“These variants are very clearly going to cause an increase in the number of cases than we would have seen otherwise,” said Dr. Manoj Jain, an infectious disease physician at the Rollins School of Public Health. “There is no doubt about that.”
The surge may be upon the United States. The precipitous decline in COVID-19 cases that began in early January appears to have stalled. On Sunday, the seven-day average of cases was 67,175 based on data from the COVID Tracking Project. That is a small increase from the seven-day average of 64,397 a week prior. Hospitalizations and deaths, which lag infections, are still declining.
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Yet, experts are reluctant to say that a spring surge will be anywhere near as bad as the recent winter one. Rather, it seems more likely to slow the recent decline in cases, hospitalizations, and deaths but not undo it.
A spring surge will depend in part on how infectious the variant strain are.
“These new variants are more transmissible, which means it is easier to transmit them from one person to another,” said Angela Clendenin, instructional assistant professor of epidemiology at Texas A&M School of Public Health. “But the thing that people need to understand is that is what viruses do. They mutate.”
The United Kingdom strain, known as B.1.1.7, is estimated to be 40%-70% more transmissible than the original virus. It spread rapidly in the U.K. in late December, threatening to overwhelm hospitals and leading Prime Minister Boris Johnson to order a lockdown.
It is the variant that seems most likely to cause a new rise in cases. Thus far, 2,400 cases of the U.K. variant have been confirmed in 46 states. Since the genetic sequencing needed to detect variants is not in widespread use in the U.S., the number of cases is almost surely much higher. The Centers for Disease Control and Prevention projects that the U.K. variant will become the dominant strain in the U.S. in March.
A new variant has also developed in California that is also more transmissible. The California variant comes in two forms, known as B.1.427 and B.1.429.
Researchers led by Dr. Charles Chiu at the University of California, San Francisco, have found in laboratory tests that the California variant is 40% more effective at infecting human cells than other variants of the virus. The researchers also found that people infected with the variant carry nearly twice as much virus in their nose as people infected with earlier strains. They estimate that cases caused by the variant double about every 18 days.
Another variant, dubbed B.1.526, was first detected in New York City in November. It’s not clear yet if it is more transmissible, but a recent study by researchers at CalTech found the variant in over 25% of samples tested in February.
Clendenin also suggests that the recent winter weather in the U.S., combined with the Super Bowl, will also lead to a new surge.
“During the massive winter storms we just had, people could have picked up Covid from someone they didn’t know,” said Clendenin. “If people had been going somewhere for the weekend and they got stuck during the storm somewhere, they could easily come into contact with people they otherwise wouldn’t.”
Additionally, friends likely gathered at home to enjoy the Super Bowl, much like what happened during Thanksgiving and Christmas. Many experts blame get-togethers during the holiday season as major spreaders of COVID-19 that led to the large increases in cases during the winter.
Whether the surge will stress hospitals as previous surges have done will depend heavily on how quickly people 65 and over are vaccinated.
“People over 65 need to be vaccinated,” said Jain. “Indeed, only one dose is effective at preventing severe disease, and a 12-week gap between the first and second dose should be considered.”
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The U.K. variant does not appear to be any more resistant to vaccines than previous strains. But the California and New York variants do. Dr. Chiu’s team found that the California variants was two times more resistant to antibodies produced by the Pfizer and Moderna vaccines. The New York variant contains a mutation that makes the coronavirus more able to elude vaccines. A team of scientists at Columbia found a 12% rise in virus samples from New York City with that mutation by mid-February.
