The race between variants and vaccines is heating up, with the discovery of more worrisome variations of the coronavirus in California this week, despite increased inoculations and many Bay Area counties easing public health restrictions.
Public health officials on Wednesday confirmed California’s first case of a variant called P.1 that is wreaking havoc in Brazil; was found in a San Bernardino County resident. They also announced a fourth case in California of a variant of South Africa, this one in Santa Clara County. This case was in an individual who has not traveled anywhere recently, raising concerns that the variant is spreading in the community, albeit at very low levels.
These two variants are somewhat resistant to antibodies and can make vaccines less effective. Meanwhile, three more variants that are more infectious than previous versions of the virus are spreading rapidly across the state – two home grown variants now account for more than half of all cases in California.
The increase in variants is worrying, but not unexpected. In fact, the variants are consolidating at a slower pace than public health and infectious disease experts feared, raising hopes that vaccinations will keep them out. A fourth wave may not be entirely preventable, but it seems more and more likely that it will not be as destructive as the previous waves.
In other words, California and the Bay Area may be leading the race.
“This is no time to take your foot off the accelerator. We have to stay on course and increase the pressure on vaccines, ”said Joe DeRisi, co-president of Chan Zuckerberg Biohub, which does genomic sequencing for state and local public health agencies. “But I am still very optimistic. We are going in the right direction. “
Variants have been the source of major outbreaks around the world in recent weeks, mainly in parts of Europe, including the United Kingdom, and in Brazil. The UK’s most infectious variant, called B.1.1.7, is the most common culprit.
The global situation worries public health experts in the United States with a potential fourth wave here and, in fact, cases are starting to stabilize and even increase in some parts of the country. The Centers for Disease Control and Prevention have warned that B.1.1.7 may be dominant in parts of the country by the end of this month or early April.
But California is doing better than most other places. Although variants are appearing more frequently, they are not as widespread as experts feared they would be now. Variant B.1.1.7 represents only about 1% of the cases that are sequenced in the state.
Coronavirus cases across the state are falling week after week, although not as drastically as earlier in the month. Daily admissions and cases returned to October levels. Deaths are also falling. The winter wave is over.
Counties are reopening at a very fast pace. Only 10% of the state remains in the most restrictive purple layer. Next week, three counties in the Bay Area – Marin, San Francisco and Santa Clara – are expected to join San Mateo County at the orange level, the second least restrictive. This would allow them to expand indoor restaurants and open outdoor bars, music venues and family entertainment operations, such as bowling alleys.
Most counties plan to allow the full range of activities allowed by the state, although San Francisco officials say they will take a slightly more conservative approach. At a meeting of the Board of Supervisors committee on Tuesday, Dr. Sara Cody, Santa Clara County health officer, said she would open up all state-sanctioned activities, but advised residents to remain cautious.
“Just because something is open doesn’t mean it’s safe or necessarily a good idea,” said Cody. “We are still in a race between the emergence of new variants and our ability to vaccinate. We still need to be very cautious with everything else we do – wear masks, distance ourselves and not gather in crowds ”.
Santa Clara County has identified more cases caused by variants of the coronavirus than anywhere else in the bay area, but it is also doing much more genomic sequencing than its neighbors. The county found 15 cases of B.1.1.7 and two of the four cases of the state variant in South Africa.
All variants are of concern in part because they have mutations that make them more infectious, to varying degrees, than previous versions of the virus. The UK variant is believed to be up to 80% more infectious and can also cause more serious illnesses. California variants, by comparison, can be about 10% to 20% more infectious.
Dr. Chris Farnitano, health officer for Contra Costa County, said that case reports that are stabilizing in New York City, along with outbreaks in parts of Europe, concern him about the reopening, especially as more variants appear. Your county discovered its first two cases of variant B.1.1.7 this week.
“A month ago was when they opened the covered restaurant in New York, and since then, the cases have not come up,” he said. “We know that every time we opened in the past, we had another wave. The only thing different now is the vaccine. And, as New York City is showing, they still haven’t gotten enough vaccine to keep reducing cases. There is still a risk that if we open up too quickly and these variants really consolidate, we may start to lose the race. ”
Sill, infectious disease and public health experts said there are signs that enough people have already been vaccinated in California to reduce cases and, most importantly, hospitalizations and deaths. About 23% of Californians received at least one dose of the vaccine. The cases plummeted mainly in nursing homes, which were often the source of deadly outbreaks during the pandemic.
It is possible, experts say, that California has a fourth increase – but that it would not be so destructive because vaccines prevent the worst results.
“I am notified of all deaths in the county. And last week was the first one I remember since last spring, when I was not notified of any deaths. Seven days in a row, ”said Dr. Matt Willis, Marin County health officer. “This may just be another sign of what the new normal looks like.”
Erin Allday is a writer for the San Francisco Chronicle. Email: [email protected] Twitter: @erinallday