Variants are on the rise in some states, making pressure on the vaccine more urgent

Photographer: Johnny Milano / Bloomberg

U.S. officials and public health experts are again raising the alarm about the resurgence of Covid-19 cases in some regions, and are especially concerned about the role variants play in states such as Michigan and New Jersey.

The developments could predict a long-dreaded possibility: that another wave could occur, even as states break open the criteria for vaccine eligibility, in an effort to get weapons in their arms as soon as possible.

In Michigan and Minnesota, infections are on the rise, and according to data from the U.S. Department of Health and Human Services, new hospital admissions of confirmed or suspected Covid cases are up about 70% and 32%, respectively, from recent lows.

Meanwhile, the pace of daily Covid-19 hospital admissions has stopped in New York and New Jersey – despite the vaccination campaign – and has started to pick up.

According to Bloomberg’s vaccine tracker, the four states have vaccinated between 19% and 21% of their population, in line with the US at large.

Another major outbreak could weaken the benefits of even widespread immunization in the US, said Nicholas Reich, associate professor at the University of Massachusetts, Amherst, who is working with the Centers for Disease Control and Prevention to better predict the virus’s trajectory .

High stakes

These concerns underscore the high stakes of the vaccination campaign, and it’s because many states lifted the restrictions after a protracted, deadly wave last fall and winter. In addition to the emergence of more spreading variants, a combination of relaxed rules and pandemic fatigue is likely contributing, while events like spring break could have repercussions in the coming weeks.

“We’re on the last lap of this leg of the race lately, and it looks like the variants are just a little ahead in places, just a little bit. But it’s so close, ”said Reich. “Four more weeks and I’m not sure they will be able to move forward.”

The CDC has listed five variants as “variants of concern”: the UK B.1.1.7 strain; 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 communicable and can interfere with the extent to which drugs known as monoclonal antibodies neutralize the virus. B.1.1.7 is also likely to increase disease severity, the CDC said.

Last week, the US added an average of about 55,000 new daily cases, about a fifth of the levels from the first week of January, although the number of confirmed infections increased gradually from the previous week. CDC Director Rochelle Walensky pointed to the slight increase during a briefing on Monday and said the Northeast and Upper Midwest are beginning to see more significant increases.

Meanwhile, hospital admissions are leveling off nationwide, which is worrying as the number of hospital admissions had steadily declined in January and February, she said. The number of deaths from Covid is still declining, but the pace of that decline has slowed over the past week, Walensky said.

The latest numbers should “serve as a warning sign for the American people,” Walensky said. “The ongoing relaxation of prevention measures while cases are still high, and while variants are involved, is rapidly spreading through the United States, poses a serious threat to the progress we have made as a nation. “

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The Michigan resurgence started in ski resorts before spreading more widely, said David Rubin, a physician and director of PolicyLab at Children’s Hospital in 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 only a few weeks behind, and in the New York metropolitan area.”

In New York City, senior health adviser Jay Varma said at a briefing Monday that more contagious variants are contributing to a plateau in cases and officials were “very concerned” about it.

Variants emerge

Data suggests that B.1.1.7 is at least one of the culprits. In Michigan, the faster-spreading variant that emerged in early February is likely to account for about 55% of total cases, according to data from testing company Helix. No one is verifying enough variants to fully understand their prevalence, but Helix has tested for the failure of the S gene target in Covid-19 positive samples, which it says is an important feature of the variant first launched in the UK was identified.

B.1.1.7 in Michigan

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

Source: Helix Covid-19 Surveillance Dashboard

The spread of more contagious variants such as B.1.1.7 led to the recent surge in Covid cases in Michigan, Governor Gretchen Whitmer said at a briefing Friday. Speaking at the event, Joneigh Khaldun, the state’s chief medical executive and chief deputy director for health at the Michigan Department of Health and Human Services, said confirmed infections have increased 77% since February, warning that the state “ may be present could be at the start of a new wave. “

Lynn Sutfin, an information officer for the department, said it was difficult to assess the Helix data because the company had not had direct contact.

“At this point in time, we don’t have enough evidence to determine whether B.1.1.7 is the dominant variety in our state, and we need more scientific evidence to make that decision,” Sutfin said in an email reply to questions.

Judith Persichilli, New Jersey’s Health Commissioner, also said there have been 400 reports of troubling CDC variants in the state, the vast majority of which are B.1.1.7. variant, but added that “we don’t have variants that are believed to have high impact.”

‘Multiple factors’

Variants are one of “multiple factors at play,” said Adam MacNeil, a CDC epidemiologist, adding that previous peaks in the US were not necessarily related to new species. He said that while B.1.1.7 has become widespread, regional variation has also emerged, including another variant known as B.1.526 that is taking off in the New York region and the prevalence of two California variants in the state.

Two variants that the agency was most concerned about bypassing vaccine efficacy – B.1.351 and P.1 – remain rare in the US, which is a good sign, MacNeil said.