The coronavirus variant that flooded Britain is now the dominant form of the virus circulating in the United States, raising fears that it will lead to a surge in hospitalizations and deaths.
Variant B.1.1.7 represented approximately 44% of all COVID-19 cases over the last two week span estimated by US Centers for Disease Control and Prevention – four times as much as the next most common variant.
In Pennsylvania, it accounted for 28% of cases sequenced over a four-week span and 32.8% in New Jersey. Many of the newest cases have entered younger people and associated with youth sports.
Because variant B.1.17 has taken root in the US, the country faces a potential fourth wave, even as vaccinations are open to nearly all US adults. COVID-19 cases and hospitalizations already started beating upwards and mortality also stopped decreasing.
Still, two new ones research offers some assurance that the variant may not be more severe than previous forms of the coronavirus. The study found B.1.1.7 to be more contagious but did not appear to lead to higher hospitalization and death rates – contrary to previous research.
In January, some English studies suggest that patients infected with variant B.1.1.7 have a higher risk of severe disease and death. At the time, the researchers said more data were needed to confirm their findings.
A new study, published in Lancet Infectious Disease, examined hospitalized samples of COVID-19 patients and found no association between variant B.1.1.7 and severe illness. However, patients infected with B.1.1.7 carried a higher viral load – a sign of increased transmission.
Another new study, published in Lancet Public Health, looking at the relationship between B.1.1.7 and the type and duration of COVID-19 symptoms. Again, the researchers found nothing to suggest that the variant worsened the patient’s symptoms.
With variants spreading rapidly in the US, vaccination is taking a higher priority. But nOr everyone agrees on the best way to do it.
Some experts believe the US should delay doses of both Pfizer and Moderna vaccines as part of efforts to get the initial dose in more people – as has been done in the UK. That will increase the number of people who have immunity to the virus.
A trio of health experts including Ezekiel J. Emmanuel, deputy director of the Healthcare Transformation Institute at the University of Pennsylvania, advocates following the British approach in an opinion printed by USA Today.
The snippet was printed before federal officials suggested a single-use suspension of the Johnson & Johnson vaccine.
“We just need to adopt the sensible evidence-based policy used in the UK: Vaccinate as many people as possible with just one dose, delaying doses of both Pfizer and Moderna vaccines,” they wrote. “After adopting this strategy, the UK has vaccinated 46% of the population and effectively avoided the second wave of B.1.1.7 which was highly contagious.”
They said the US needed to vaccinate about 40 million people to reach the same level as Britain, adding “it is our best hope to extinguish the fourth wave triggered by variant B.1.1.7.”
Recent research has shown that only one dose of the mRNA vaccine 80% effective and offers protection for about 12 weeks. They say this provides a window for more people to get vaccinated with the first dose.
Other experts agree with this approach, including Dr. Atul Gawande, a surgeon and medical writer, said The New York Times. Gawande tweeted, “Getting as much vax as possible is now urgent.”
But several experts, including Dr. Anthony Fauci, opposes administering vaccines in a way that was not done during clinical trials.
Fauci, director of the National Institute of Allergy and Infectious Diseases, the word last month the US will not follow the UK’s approach to vaccination.
He said the lower level of protection might encourage the development of new variants and foster distrust in vaccines. So far, there has been no evidence that the delay in the second shot led to more variants.
The UK is also under a tight lockdown in response to a spike in B.1.1.7 cases. There has been no talk of such a lockdown in the US.
The study published by The Lancet confirms that the B.1.1.7 variant spreads more easily than the previous form, although they did not consider it more virulent.
In the study The Lancet Infectious Diseases, researchers analyzed data on 496 people who had been hospitalized in London and tested positive for COVID-19. Genome sequencing showed that 198 patients had infections caused by variant B.1.1.7. Only 341 of the 496 patients whose samples were submitted for genome sequencing.
Overall, there was no significant difference in the rates of severe infection or death between patients with B.1.1.7 and other COVID-19 patients. The analysis showed that 36% of patients with variant B.1.1.7 infection experienced severe illness or death compared to 38% of other COVID-19 patients.
The investigators found patient B.1.1.7 had a higher viral load and tended to be younger and with fewer pre-existing medical conditions. This may represent “The spread and potential for increased transmission of this variant in the community or differences in the likelihood of hospital admission,” they wrote.
Although their findings contradict previous reports that the variant is more lethal, the investigators say the variant’s tendency to infect more younger people could be a “subtle hint” that the variant causes more severe disease “if patients with B.1.1.7 are present. hospitalized more often. “But they didn’t find this in their analysis.
The Lancet Public Health Study is based on data from 36,920 COVID-19 positive people who used the COVID-19 Symptoms Study app between September 28 and December 27. These researchers, from the US and UK, also looked at COVID-19 surveillance data from the UK
They found that when the variant spread to different regions, there was no change in COVID-19 symptoms or duration. They also found no change in admission to hospital. And less than one percent of app users end up reinfected 90 days after their initial infection, indicating that the current vaccine offers adequate protection against the variant.