Variants increase in some states, adding urgency to vaccine boost

Photographer: Johnny Milano / Bloomberg

American officials and public health experts are again warning of the resurgence of Covid-19 cases in some regions, and are particularly concerned about the role that variants are playing in states like Michigan and New Jersey.

Developments may portend a long-feared possibility: that another outbreak could occur even when states are setting vaccine eligibility criteria, trying to get vaccines as soon as possible.

In Michigan and Minnesota, infections are increasing rapidly and new hospital admissions for confirmed or suspected Covid cases have increased by about 70% and 32%, respectively, from recent casualties, according to data from the Department of Health and Human Services from United States.

The pace of Covid-19’s daily admissions to hospitals, in turn, stopped falling in New York and New Jersey – despite the vaccination campaign – and began to increase more and more.

The four states vaccinated between 19% and 21% of their populations, in line with the United States in general, according to Bloomberg’s vaccine tracker.

Another major outbreak may diminish the benefits of even widespread immunization in the United States, 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 path of the virus.

High risk

These concerns underscore the high risks of the vaccination campaign, and occur because many states have lifted restrictions after a prolonged and deadly increase last fall and winter. In addition to the emergence of more rapidly spreading variants, a combination of loosening rules and pandemic fatigue are likely contributing factors, while events such as spring break may have consequences in the coming weeks.

“We are on the last straight, the last lap of this leg of the race, and it seems that in some places the variants are advancing a bit. But it is so close, ”said Reich. “Four more weeks and I’m not sure if they will be able to move forward.”

The CDC has named five variants as “variants of concern”: strain B.1.1.7 of the United Kingdom; 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 the ability to neutralize the virus by drugs known as monoclonal antibodies. B.1.1.7 is also likely to increase the severity of the disease, according to the CDC.

Last week, the US added about 55,000 new daily cases on average, about a fifth of the levels in the first week of January, although the number of confirmed infections has increased from the previous week. CDC director Rochelle Walensky pointed to the slight increase at a news conference on Monday and said the Northeast and Upper Midwest are starting to see more significant increases.

Meanwhile, hospital admissions are stabilizing across the country, which is worrisome because hospitalizations have declined consistently in January and February, she said. Deaths in Covid are still falling, but the pace of that decline slowed last week, according to Walensky.

The latest numbers should “serve as a wake-up call for the American people,” said Walensky. “The continued relaxation of prevention measures while cases are still high, and while variants are spreading rapidly across the country, United States, is a serious threat to the progress we have made as a nation. “

CDC director warns of possible “preventable outbreak” of Covid-19

The resurgence in Michigan began in the ski areas before it spread more widely, said David Rubin, physician and director of PolicyLab at Children’s Hospital of Philadelphia, which has modeled the spread of Covid-19.

“This is not subtle. This is more like Europe, ”said Rubin. “If that can happen in Michigan, I don’t see any reason why it can’t happen in Illinois, which is just a few weeks ago, and in the New York metropolitan area.”

In New York City, senior health advisor Jay Varma at a meeting on Monday said that more infectious variants are contributing to a plateau in the cases and that officials are “very concerned” about them.

Variants emerge

The data suggest that B.1.1.7 is at least one of the culprits. In Michigan, the fastest-spreading variant that emerged in early February probably accounts for about 55% of all cases, according to data from testing company Helix. No one is checking enough variants to fully understand its prevalence, but Helix has tested the failure of the S gene in positive Covid-19 samples, which he says is a key feature of the variant first identified in the UK

B.1.1.7 in Michigan

Percentage of samples showing the main characteristics of variant B.1.1.7

Source: Helix Covid-19 Surveillance Dashboard

The spread of more contagious variants like B.1.1.7 has led to the recent increase in Covid cases in Michigan, Governor Gretchen Whitmer said at a briefing on Friday. At the event, Joneigh Khaldun, the state’s chief medical officer and deputy chief health officer for the Michigan Department of Health and Human Services, said that confirmed infections have increased by 77% since February and warned that the state “could potentially be at the beginning of another wave. “

Lynn Sutfin, the department’s public information officer, said it was difficult to evaluate Helix’s data because the company had not made direct contact.

“At the moment, we do not have enough evidence to determine whether B.1.1.7 is the dominant variant in our state and we will need more scientific evidence to make this determination,” said Sutfin in an email response to the questions.

Also minimizing the threat variant was New Jersey State Health Commissioner Judith Persichilli, who said in a Trenton virus update on Monday that there were 400 reports of worrying CDC variants in the state, the vast majority of which were B .1.1.7 variant, but added that “we do not have variants considered to have major consequences”.

‘Multiple Factors’

Variants are one of the “multiple factors at play,” said Adam MacNeil, an epidemiologist at the CDC, adding that previous outbreaks in the United States were not necessarily associated with new strains. He said that although B.1.1.7 has become prevalent, regional variations have 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 with which the agency is most concerned with preventing the vaccine’s effectiveness – B.1.351 and P.1 – remain rare in the United States, which is a good sign, said MacNeil.