The growing number of cases of the highly contagious variant of the coronavirus, first identified in Britain, is raising concern about a future increase in southern California, one of two focuses of the new strain of concern in the country.
© Provided by The LA Times
Valerie Dunlap, 67, on the left, from Granada Hills, and Cookie Lewis, 68, on the right, in Valley Village, make their way with others in line only by appointment to get vaccines for coronavirus protection at the Balboa Sports Complex in Encino. (Mel Melcon / Los Angeles Times)
Scientists are increasingly expressing deep concern that it is essential to keep coronavirus transmission low and increase vaccinations quickly, saying that it is possible that hospital systems will become overloaded again if the UK variant gets out of control. The UK variant was identified in 467 people in 32 states, with Florida at the top of the list with at least 147, and California with at least 113.
The UK variant – officially known as B.1.1.7 – is expected to become the dominant variant in a matter of weeks; LA County officials announced the second confirmed case of the variant on Saturday, which they say is “spreading across the county”. At least two cases have been identified in San Bernardino County.
San Diego County has the largest group of known cases of B.1.1.7 in California – at least 109 confirmed cases and 44 additional cases epidemiologically linked to known variant cases, officials said last week. San Diego County health officials announced last week the first death linked to B.1.1.7, a 71-year-old man suspected of being infected with the new strain, which was a domestic contact from someone who was confirmed to have infected by the variant. Two people were hospitalized with the variant.
The average age of patients with B.1.1.7 is 30, but the age group of those infected is between newborns and 77 years, said Dr. Wilma Wooten, a San Diego County health officer.
The growth of variant B.1.1.7 “requires that we remain vigilant, not to be complacent, to continue to take all necessary precautions to delay the spread,” warned Nathan Fletcher, chairman of the San Diego County Board of Supervisors.
Coronavirus variant B.1.1.7 led to a rapid spread of the disease in Britain, Portugal and Ireland, and quickly became the dominant strain in those countries, Natasha Martin, associate professor in the Infectious and Global Diseases Division at UC San Diego Saúde, told the Board of Supervisors last week.
“It is estimated that this particular variant is 50% to 70% more transmissible than the previous variants, leading to outbreaks of cases,” said Martin. “There is recent evidence that it can also lead to higher mortality.”
The first detection of variant B.1.1.7 in California occurred on December 30 in San Diego County. It is now estimated to represent 5% of the circulating strains, said Martin.
“The question is not whether this strain will become dominant, but how long it will take and what effect it will have on our epidemic trajectory, given its greater transmissibility,” said Martin.
A major problem is that the growing dominance of B.1.1.7 can dramatically worsen the California pandemic. Currently in California, the number of effective reproduction – the average number of people to whom a contagious person transmits the coronavirus – is around 0.8, meaning that each infected person in California now transmits the virus to less than one person, which explains why the pandemic is improving now.
But if B.1.1.7 becomes the dominant strain, with a 50% to 70% increase in transmissibility, the number of breeding could become greater than 1, and it could dramatically increase cases, warned Martin.
Scientific simulations suggest that authorities and the public need to operate with exceptional caution in reopening the economy, said Martin.
Even a decent vaccination plan is no match for the UK variant if people abandon mask use and physical detachment in the same way they did before Thanksgiving, according to a simulation presented by Martin.
If people reject masking and physical detachment practices as they did in the fall, San Diego County is likely to see its current rate of new coronavirus cases – now about 1,500 new cases per day for a weekly period, at the latest down in about two months – increasing to as many as 7,000 new cases per day, in addition to a level “that would overwhelm our health systems,” said Martin.
That would be far worse than anything that San Diego County has experienced in the pandemic so far. San Diego County peaked about 3,600 new cases of coronavirus a day in the seven-day period that ended on January 12.
“This scenario … would overburden our health systems,” said Martin. “There is some emerging data that B.1.1.7 [strain] it’s more lethal. Therefore, we can expect even more deaths than we are seeing now for each case. “
Reducing the amount of circulating virus would delay the expansion of variant B.1.1.7, said Martin.
“I can’t emphasize enough – with the emergence of B.1.1.7 and other strains that can be more transmissible and potentially more lethal – now is the time to double the reduction in transmission and expand vaccination,” said Martin. “In the coming weeks, we urgently need to focus all efforts on reducing transmission, ensuring a robust response to vaccination and approaching reopening with caution.”
Concern over tension, as well as the continuing high number of daily cases, prompted Wooten of San Diego County last week to maintain a local order that prohibits restaurants from allowing al fresco dining between 10 pm and 5 am. San Francisco also kept placing an order requiring meal customers to leave the outdoor dining areas until 10 pm
This is a different posture from that of LA County, which on Friday allowed outdoor dinners to be resumed, not only during the early hours.
LA County Public Health Director Barbara Ferrer said on Monday that the UK variant has not yet dominated LA County so far. She asked people to continue to be cautious – wear masks, continue to distance yourself physically and stay at home as much as possible – and, if you dine in outdoor restaurants, follow the new rules as much as possible.
They include dining at a table with family members only, with a maximum of six people and spaced at least 2.5 meters from other tables. Outdoor dining areas should have at least two non-contiguous sides that are completely open to increase the flow of breezes to dissipate the virus particles exhaled, and guests should wear masks when their servers approach.
“This is what we are trying to do now: keep the numbers as low as possible while we wait to get more vaccines and really speed up the rate of vaccinations,” said Ferrer.
Restaurants and other dining venues have been the source of the second highest number of confirmed community outbreaks in the past 10 months, according to data from San Diego County, covering about 20% of identified outbreaks.
Wooten told supervisors that he felt uncomfortable allowing restaurants to reopen for outdoor dinner service late at night because restaurants that did this often changed to parties – a situation where people are much more likely to mix with people from other families, expelling their respiratory particles in other people’s faces while speaking, and dramatically increases the risk of a super spreader incident because people who drink do not wear masks.
“I am uncomfortable with the number of cases we still have with changing that specific order at the moment,” said Wooten.
© (San Diego County)
Restaurants are the source of the second highest number of coronavirus outbreaks in San Diego County. (San Diego County)
Currently available vaccines are believed to be effective against variant B.1.1.7.
The authorities also expressed concern about the variant identified in South Africa, known as B.1.351, and its closely related variant from Brazil, known as P.1. The South African variant has been detected in two cases in South Carolina – in different parts of the state that have no epidemiological link – and one in Maryland. The Brazilian variant was identified in a single case in Minnesota.
The South African variant was also of concern because vaccines are less effective against the virus, although “it was not yet below the threshold where you would expect some degree of effectiveness,” said Dr. Anthony Fauci, the government’s leading infectious disease expert. from United States.
However, scientists and government officials are now working on an additional boost injection, in case authorities feel it is necessary to protect against new strains.
“This is a warning for all of us,” Fauci told reporters during a news conference on Friday. “We will continue to see the evolution of the mutants. That means … we will have to be nimble to adjust promptly to make versions of the vaccine that, in fact, are specifically targeted at any mutation that is really prevalent at a given time.”
This is also another reason to increase vaccination efforts as quickly as possible. “Viruses cannot mutate if they don’t replicate,” said Fauci.
It is no coincidence that the increase in problematic mutations is occurring in countries where the coronavirus has spread. “Letting the virus run wild, like [the U.S. and] Brazil, yes, puts everyone in danger “, Dr. Ashish Jha, dean of Brown University School of Public Health, tweeted.
The emergence of the UK strain may mean that summer – instead of being a period of silence for the coronavirus – may actually result in a higher prevalence of the coronavirus than scientists would have expected, Dr. Scott Gottlieb, former commissioner US Food and A Drug Administration told CBS’s “Face the Nation” program on Sunday.
“What is likely to happen is that the prevalence will be high in certain regional hot spots. Therefore, we will have hot spots of infection and perhaps epidemics in parts of Florida, parts of southern California, because of B.1.1.7. They never are really going to come out of it, but the rest of the country will see prevalence drop, “said Gottlieb.
A silver lining for the South African and Brazilian variants, however, is that – unlike the UK variant – they do not appear to be more transmissible than the dominant strain of the virus, said Gottlieb. This means that “we have time to get control of these variants and develop new reinforcements that can protect them, reinforcements from the vaccine,” said Gottlieb.
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, offered a far more dire prediction than Gottlieb did in an interview on Sunday on the NBC News “Meet the Press” program. Osterholm suspected that the UK variant’s appearance is similar to watching a hurricane form, and predicted a further increase in the next six to 14 weeks.
“And if we see that happen – what my 45 years in the trenches tell me that we will see – we will see something that we have not yet seen in this country,” said Osterholm. “This hurricane is coming.”
Paul Sisson of the San Diego Union-Tribune contributed to this report.
This story originally appeared in the Los Angeles Times.
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