Since the cases of COVID-19 in the US began their steep post-holiday decline, Americans have been anxious about the threat of yet another obstacle on the long road to recovery: a possible “fourth wave” of infections driven by the most recent variant and UK contagious disease known as B.1.1.7. Experts, however, have viewed Florida as a thermometer – the place where a fourth wave would likely break first.
After all, Florida has more documented B.1.1.7 cases than any other state. It also reversed precautions more quickly than most. If a peak is coming, the thought was, Florida is where it all started.
Except … it hasn’t started yet.
Quite the contrary, in fact. After peaking on January 8 at just under 18,000, Florida’s average daily case count dropped by almost 75%; today it dropped to 4,800. Hospitalizations dropped by half in the same period, as did Florida’s positivity rate (which now stands at 5.9%). And while other states, like New Jersey, New York, Rhode Island, South Dakota, Tennessee and Idaho are starting to see cases stabilize – or even increase – as residents relax and restrictions are loosened, case numbers and Florida hospitalizations continue to fall by about 10 percent each week.
“We have a thermometer to see if the B.1.1.7 strain will hit the USA – Florida,” Dr. Eric Topol of Scripps Research Çrotand earlier this week. “And there is no sign of an increase in cases. So far so good. “
The key phrase, as always during this unpredictable pandemic, is “so far”. Just because a fourth wave driven by a variant has not yet reached Florida (or the United States as a whole) does not necessarily mean it will not, and nothing increases the risk of another wave more than unmasked and reckless internal meetings – in full – restaurants with capacity; in crowded bars; at private parties – with many unvaccinated people. Events such as the 300,000-person motorcycle rally this week in Daytona Beach are still risky. Like all Americans, Floridians must exercise caution.
Still, the good news from Florida It is an encouraging sign for the rest of us. This does not mean that America is out of danger. But it does suggest that we can emerge sooner than we thought.
Here’s why.
B.1.1.7 continues to spread in Florida. A month ago, it was responsible for about 4% of all COVID-19 positive samples in the state; last week, it accounted for more than 40 percent. This rapid spread is consistent with everything we know about the variant – that is, it is 40 to 50 percent more transmissible than previous versions of the virus. At some point this week, B.1.1.7 became the dominant variant in Florida and is now responsible for more than half of the infections in the state.
This seems frightening, especially since B.1.1.7 is also estimated to be 64 percent more lethal in unvaccinated people than its SARS-CoV-2 predecessors. But the problem is this: there is a difference between 51% of a large number and 51% of a smaller number. Even though B.1.1.7 constitutes an increasing proportion of COVID-19 cases in Florida, the overall number of cases continues to decline. The numerator may continue to grow, but the denominator continues to decrease. By itself, B.1.1.7 does not appear to be causing more COVID.
It was not always so. When B.1.1.7 was established in England, Ireland, Israel and Portugal, his overall case count exploded; Rigid blocks have turned the tide, but now similar B.1.1.7 outbreaks are terrorizing Estonia, Hungary, Poland, Jordan, Italy and the Czech Republic. Regardless of what is happening in Florida, B.1.1.7 is still very dangerous.
So, what’s going on in Florida? Some force, or forces, appear to be exerting more downward pressure on the transmission than any upward pressure that B.1.1.7 is capable of gathering.
Immunity is probably the most powerful of these forces. It is estimated that 30 percent or more of Floridians have already contracted COVID-19, which helps them to resist future infections. Approximately 18% of the population received at least one dose of vaccine. There is overlap between these two groups, which means that about 40% of Florida residents now have some protection against COVID.
In comparison, only 7% of Italians were bitten and less than 10% were infected. Since B.1.1.7 does not seem to escape either vaccine-induced immunity or infection, the share of susceptible individuals in a state like Florida is relatively small and is decreasing with each vaccination.
So, there is a time to be considered. In places like England and Ireland, B.1.1.7 picked up at the end of last year – just in time to intensify the outbreaks triggered by cold weather holiday gatherings. In Florida, however, the variant only gained momentum after the holidays ended and cases started to fall. Transmission generates transmission, and even an opportunistic variant like B.1.1.7 will have more difficulty in reversing a downward trajectory than inclining an upward one.
Florida’s climate probably also worked against B.1.1.7. Researchers are still learning how the climate affects the virus, but some studies suggest that when the air is moist, the drops fall to the ground more quickly, so people are less likely to be infected; other studies have suggested possible correlations between transmission and sunlight (or pollen, or wind). Regardless of where science finally arrives, Florida has the mildest winters in the continental United States, with daytime highs ranging from 64 ° F in Tallahassee to 77 ° F in Miami and nightly lows that tend to last in the 50s or 60s years old. Translation: In January, February and March, it’s easier to be outdoors in Florida than in most other places.
Of course, Florida residents for months have enjoyed more “freedom” to congregate indoors (without masks) than many of their fellow Americans, a fact that Republican Governor Ron DeSantis is proud of. But that only strengthens the case for fourth-wave optimism. If a state with a lot of B.1.1.7 and without a lot of restrictions is still doing well, shouldn’t the rest of the country take this as a sign of hope?
The attempted answer is yes. America’s overall immunity figures are almost identical to those in Florida: 30% infected, 19% vaccinated, about 40% protected to some degree. Spring is 10 days away; the weather will only get hotter. And cases and hospitalizations continue to fall across the country at 10 to 15 percent a week.
B.1.1.7 will continue to spread, in Florida and elsewhere. Eventually, he will become “dominant”. But if this predominance does cause a fourth wave of infections, it seems a little less likely each day.
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