Thursday, March 4, 2021

COVID B.1.1.7 - How Widespread Is It in the U.S. and How Worried Should We Be?

Very. The latest Covid-19 variant is highly infectious. We need to heed the advice of healthcare authorities

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At a glance

  • The B.1.1.7 variant is a new strain of the coronavirus that causes Covid-19
  • It is, according to emerging evidence, up to 50% more transmissible (infectious) than the original virus.
  • There is no evidence to suggest it is more lethal (dangerous) than the original strain, but for reasons explained below, it may claim far more lives.
  • It has already been found in ten states (76 cases) in the U.S. and will be the leading cause of Covid-19 in the U.S. by March

It’s getting difficult to keep up with all the names. SARS-CoV-2, Covid, Covid-19, and now the variants or strains. New strains were expected and many have already been identified. It’s what a virus does as it cycles through its various phases of evolution and in some ways, it’s encouraging to see the original virus keep to this well-established pattern of viral evolution. 

Adapting to thrive

It means we can, to a certain degree, predict where the SARS-CoV-2 virus will go next, and with the evolution of the new mRNA delivery mechanism for a vaccine, we can rapidly develop new vaccines to counter any new strains that prove resistant to the original vaccines and the antibodies they produce. Scientists continuously monitor and sequence the virus, looking for new variants and changes that tell us if the virus is evolving.

Typically, a virus will mutate as it spreads through a population, but with imperfect fidelity. It is a living organism with two purposes. Survival and reproduction, which, in the long run, is fortunate for us. The reasons for these adaptations are simple. It makes no sense for a virus to kill off all its hosts and it mutates in response to our body’s reactions to its presence. That would leave it with nowhere to go which can on occasion happen. 

To overcome this danger, typically many viruses will over time become more infectious. 

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Often, coupled with this increase in infectiousness is a trade-off. A virus will shed some of its potency in exchange for mutations that allow it to be more easily spread. In other words, it becomes less “viral” or dangerous to those it infects. What that means to you and I is that over the course of a virus’s evolution, the effects of contracting the new variations of the virus will gradually lessen. In other words, it becomes less lethal to its host (us) to ensure its own survival.

This is a rule of thumb and not all viruses always obey this curve. There are outliers who will veer off and develop more deadly strains or combine with other strains to form new viruses. They are usually short-lived, if contained properly and caught early. This is the key to the effective control and destruction of a virus. Containment, and it’s one of the reasons Covid-19 has crippled us. We failed to contain the original strain.

What is B.1.1.7

Until the media come up with a more catchy name, B.1.1.7 is one of the new variants or strains of the original SARS-CoV-2 virus and was first detected in the United Kingdom in late 2020. It is now spreading through the United States at an alarming rate and this article will examine what we currently know about it, how dangerous (viral) it appears to be, and how widespread it now is. 

We will also examine the efficacy of the current vaccines against this strain and why experts are concerned about B.1.1.7.

For readers interested in the specific genomic changes in the new variant, here is a quick summary. You can read a more detailed analysis here. The B.1.1.7 lineage accounts for an increasing proportion of cases in parts of England. The number of cases, and the number of regions reporting B.1.1.7 infections, are growing.

B.1.1.7 has an unusually large number of genetic changes, particularly in the spike protein. Three of these mutations have potential biological effects that have been described previously to varying extents:

  • Mutation N501Y is one of six key contact residues within the receptor-binding domain (RBD) and has been identified as increasing binding affinity to human and murine ACE2.
  • The spike deletion 69–70del has been described in the context of evasion to the human immune response but has also occurred a number of times in association with other RBD changes.
  • Mutation P681H is immediately adjacent to the furin cleavage site, a known location of biological significance.

According to a recent report this week from the Center for Disease Control (CDC), entitled Emergence of SARS-CoV-2 B.1.1.7 Lineage — United States, December 29, 2020–January 12, 2021, the CDC first became aware of this VOC(Variant of Concern) in December last year. You can read their assessment of the variant and its impact in the link above. Here is their lead statement along with relevant extracts.

A more highly transmissible variant of SARS-CoV-2, B.1.1.7, has been detected in 10 U.S. states.

As of January 13, 2021, approximately 76 cases of B.1.1.7 have been detected in 10 U.S. states.† Multiple lines of evidence indicate that B.1.1.7 is more efficiently transmitted than are other SARS-CoV-2 variants (13). The modeled trajectory of this variant in the U.S. exhibits rapid growth in early 2021, becoming the predominant variant in March.

The new strain has also been detected by testing in US wastewater plants, indicating how widespread it now is in the general population.

According to the CDC report, by March, and possibly sooner, this new variant will surpass the original virus as the leading cause of Covid-19 in the U.S., the disease that results from contracting SARS-CoV-2. It is far more infectious than the original strain, but is it less or as lethal as the original virus?

Lessons from the United Kingdom

Arguably, the best place to assess the potency of the U.K. variant is in the U.K. Their population has been exposed to it for far longer than in the U.S. and we can therefore form a reasonably strong case for the dangers associated with contracting B.1.1.7, allowing us to address the key question. Is it more or less viral(lethal) than its parent, the original SARS-CoV-2 virus?

Evidence to date from the U.K. suggests no difference in the viral effect of the variant when compared to the original strain. In other words, it doesn’t pose a greater or lesser risk to your health than the original SARS-CoV-2 virus, so on that front, if you contract the variant or the original virus, your body stands the same sort of odds coping with either. There is still uncertainty about the impact of the new strain on children and young adults, and their vulnerability to it.

You might think that no change in the potency of the more infectious virus is a relief, but it actually isn’t and we will explain why below.

Transmission rates of B.1.1.7

Even with mitigation in place, in the U.K. the new variant has proven 50% more infectious than the original strain. Left to spread unchecked, if this had been the original strain, America would now be sitting with double the infected population and probably twice the number of dead.

The U.S. currently finds itself in a very precarious situation, with ICU beds in short supply and medical services strained to breakpoint, both in terms of resources and personnel. Even basics like oxygen are in short supply. Six months ago, if you developed serious complications from Covid-19, you could rely on access to care, a ventilator, and a bed in ICU. 

That is no longer a given and in some states, very sick Covid-19 patients evaluated as being beyond the reach of medicine, are often left at home to die. There simply aren’t enough resources to go around. Another spike on top of what the country is currently experiencing will break the camels back.

This factor alone makes the new variant far more dangerous to those who develop severe Covid-19 complications. The number of people and the age demographic for those developing serious symptoms is also shifting. Being young (below 50) no longer offers a ‘get out of jail free’ card. While not all cases are fatal, the long term effects, felt up to a year later, are proving debilitating in many healthy adults who contract Covid-19. The future financial impact of this group on the American economy has yet to be quantified, but it will be significant. 

Get sick from Covid-19 and there simply may not be any recourse to medical attention. You may end up dying at home. 

That is the major consideration that should be at the forefront of every American’s concern about contracting the virus and developing Covid-19 in 2021. We also don’t know for certain if contracting the first strain will stop you from cathing B.1.1.7. Americans have every reason to very concerned.

It is imperative, now more than ever, that you heed the advice of CDC and healthcare officials to stop the new variant delivering a death blow to healthcare services and killing another 800K Americans. Remember it is twice as infectious, and without access to medical help, deaths will soar.

Are the Covid-19 Vaccines effective against B.1.1.7?

This recent article from Nature explores this question in-depth and while some results are still outstanding (due in this week) initial findings look like we’ve managed to dodge a bullet and that the Pfizer vaccine will in fact offer protection against the variants. 

The first lab results are trickling in and many more are expected in the coming days, as researchers rush to probe the viral variants and their constituent mutations in cell and animal models of SARS-CoV-2, and test them against antibodies elicited by vaccines and natural infections. A preprint published on 8 January found that a mutation shared by both variants did not alter the activity of antibodies produced by people who received a vaccine developed by Pfizer and BioNTech. Data on other mutations and vaccines are expected soon.

“Both variants” refer to the South African variant, another new strain that has been shown to share the elevated levels of transmission enjoyed by B.1.1.7.

A Time for Action

It is very difficult to reach a public that has been exposed to months of Covid-19 rhetoric and denial, but it is imperative that authorities and the media get on board with this now and get the message out. The time for being diplomatic has passed and it is now time to speak the truth and highlight the treacherous road that lies ahead for America. A little educated fear instills the desire for self-preservation and encourages actions that we know slow the spread of the virus.

We need to slow the spread, now more than ever, to allow the painfully slow process of vaccination time to take effect in the population. Here’s the other worrying fact to emerge and highlighted in the CDC article referenced above. Previous figures for “herd immunity” from vaccination had been based on the original virus and now need to be re-assessed with the introduction of this new strain that increases the risk of transmission.

Higher vaccination coverage might need to be achieved to protect the public.

This will require time. We know how to slow down the virus and these steps are proven to slow the transmission in a population. This what we and every other American need to do NOW to buy healthcare and the country the time it needs. This has moved beyond politics and is now about survival and saving lives.

  • Wear a mask! If you go out, if you are around other people, in crowds, in shopping centers, anywhere where you encounter strangers you do not live with, WEAR A MASK. Investing in a decent one, at least N95 or higher may very well save your life. Bandanas and cloth are not as effective, and while they are better than nothing, your life is well worth the few dollars a decent reusable maks will cost.
  • Wash your hands frequently, sterilize your home, and try to reduce your physical contact with objects and people that may have been exposed to the virus.
  • Mind the gap. Keep your distance and be anti-social for a little while. It’s not the end of the world and you won’t die from a little self-isolation. Covid-19, on the other hand, may kill you. We are strong and we are resilient, we have simply forgotten this in a society that panders to weakness, There is a multitude of ways to engage socially without the need for physical contact. Explore these and avoid people for a while, if you can. 
  • Get vaccinated. Yesterday if possible. Pester your state’s health board, hound your governors, chase your mayors, make their lives a living hell until you’ve all been vaccinated. It’s your ticket back to normality and for the aged and at-risk, it’s a lifeline you cannot ignore. The longer we postpone vaccination, the greater the risk of yet more variants emerging and God forbid, an antigenic shift, the formation of an entirely new virus. 

A last thought, imparted, to those who may not be concerned by Covid-19 and think they are beyond the reach of the virus. If you or a loved one are involved in a traffic collision and require hospitalization, you might find yourself left outside the hospital, dying in the ambulance, assuming you could find one.

There may simply not be any beds left open. 

You may also think you’re not in an at-risk category, but as our experience with Covid-19 expands, so too does our understanding of the groups that are in danger from the disease. These groups are updated and expanded constantly and it would be to your benefit to keep up to date with these changes. Here is the latest extensive list, courtesy of the CDC. 

The SARS-CoV-2 virus affects all of us and we defeat it together or continue burying our loved ones. America, it really is all up to you now, to the people. When the dust settles, there will be no one else more accountable. Let’s all do our part.

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CONFIRMED GLOBAL CASES
115,919,846
Updated on March 4, 2021 3:45 pm
GLOBAL DEATHS
2,574,103
Updated on March 4, 2021 3:45 pm
ACTIVE GLOBAL CASES
21,788,707
Updated on March 4, 2021 3:45 pm
The article lives here COVID B.1.1.7 - How Widespread Is It in the U.S. and How Worried Should...
Dr Robert Turnerhttps://cre8tive.media
Robert is a Founder of Medika Life. He is a published author and owner of Cre8tive Digital Media. He lives between the Philippines and the UK. and is an outspoken advocate for a better internet. Global access to basic healthcare and eradicating racial and gender bias in medicine are key motivators behind the Medika website and reflect Robert's passion for accessible medical care.

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