U.S. officials and public health experts are sounding the alarm again over the resurgence of Covid-19 cases in some areas, and are particularly concerned about the role variants play in states such as Michigan and New Jersey.
The developments could portend a long-feared possibility: that another surge could occur even as states open up vaccine eligibility criteria, trying to get vaccinated as quickly as possible.
In Michigan and Minnesota, infections are rising rapidly and new hospital admissions of confirmed or suspected Covid cases have increased by about 70% and 32%, respectively, from recent lows, according to US Department data of Health and Social Services.
The pace of daily Covid-19 hospital admissions, meanwhile, has halted its decline in New York and New Jersey – despite the vaccination campaign – and has started to increase slightly.
The four states have vaccinated between 19% and 21% of their population, in line with the entire United States, according to Bloomberg’s Vaccine Tracker.
Another major outbreak could dampen the benefits of even widespread vaccination in the United States, 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 trajectory. virus.
These concerns underscore the high stakes of the vaccination campaign, and come as many states lifted restrictions after a prolonged and deadly wave last fall and winter. Besides the emergence of variants that spread faster, a combination of easing rules and pandemic fatigue are likely contributing factors, while events like spring break could have consequences in the weeks to come.
“We’re in the home stretch, the last lap of this stage of the race, and it looks like in some places the variations are just getting ahead, just a little bit. But it’s so close, ”said Reich. “Four more weeks and I’m not sure they could move forward.”
The CDC a named five variants as ‘variants of concern’: UK strain B.1.1.7; 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 interfere with the ability of drugs called monoclonal antibodies to neutralize the virus. B.1.1.7 likely also increases the severity of the disease, according to the CDC.
Last week, the United States added about 55,000 new cases daily on average, about a fifth of the levels for the first week of January, although the number of confirmed infections was slightly higher from the week before. CDC director Rochelle Walensky pointed to the slight increase in a Monday briefing and said the northeast and upper Midwest were starting to see larger increases.
Meanwhile, hospital admissions are leveling off nationwide, which is concerning as hospitalizations have steadily declined in January and February, she said. Covid deaths continue to decline, but the pace of that decline has eased over the past week, according to Walensky.
The latest figures should “serve as a warning signal to the American people,” Walensky said. “Continued easing of prevention measures while cases are still high and, while worrying, are spreading rapidly United States, poses a serious threat to the progress we have made as a nation.
CDC director warns of possible ‘preventable surge’ from Covid-19
The resurgence in Michigan started in ski areas before spreading more widely, said David Rubin, doctor and director of PolicyLab at Children’s Hospital in Philadelphia, who modeled the spread of Covid-19.
“It’s not subtle. It’s more like Europe, ”said Rubin. “If it can happen in Michigan, I see no reason why it can’t happen in Illinois, which is just a few weeks late, and in the New York metro area.”
In New York City, senior health adviser Jay Varma at a briefing Monday said more infectious variants were contributing to a plateau in cases and officials were “very concerned” about them.
The 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 likely accounts for about 55% of the total number of cases, according to data from testing company Helix. No one is testing enough variants to fully understand their prevalence, but Helix tested the failure of the S gene target in samples positive for Covid-19, which he said is a key feature of the variant first identified. times in UK.
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 in a briefing Friday. At the event, Joneigh Khaldun, chief state medical director and deputy chief health officer at the Michigan Department of Health and Human Services, said confirmed infections had increased by 77% since February and warned that the state “could potentially be at the start of another wave.
Lynn Sutfin, public information manager for the department, said it was difficult to assess Helix data because the company had not been in direct contact.
“At this time, we don’t have enough evidence to determine if B.1.1.7 is the dominant variant in our state and will need more scientific evidence to make that determination,” Sutfin said in a mail response. electronic questions.
New Jersey State Health Commissioner Judith Persichilli also downplayed the threat of the variant, who said in a Trenton virus update Monday that there had been 400 reports of CDC variants of concern in the state, the vast majority of which was the B.1.1.7 variant, but added that “we don’t have any variants considered to have significant consequences.” ”
Variants are one of the “multiple factors at play,” said Adam MacNeil, a CDC epidemiologist, adding that previous outbreaks in the United States were not necessarily associated with new strains. He said that while B.1.1.7 has become widespread, regional variations have appeared as well, 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 that the agency has been most concerned about evading vaccine effectiveness – B.1.351 and P.1 – remain rare in the United States, which is a good sign, MacNeil said.A lingering mystery in recent months has been why, despite variants confirmed across the United States, states aren’t necessarily seeing cases and hospitalizations increase to the same degree.
Some experts predicted that Florida could be among the first states to retreat after B.1.1.7 became dominant there, but that did not materialize in the number of cases and hospitalizations. In addition, the percentage of suspected cases of B.1.1.7 is no longer increasing at the exponential rate it had previously, according to data from Helix: it reached 50% of B.1.1.7 and then essentially fell. stabilized.
Another worry is that Americans are clearly starting to relax their behavior. According to Google Community Mobility Reports, traffic to retail and leisure sites in the United States over the past week is roughly 10% below the pre-pandemic baseline, after falling by around 50 % during the first lock. Workplace traffic, also halved, is back until 26% below the reference level.
Between spring fever and spring break, a resurgence may be inevitable. But the United States also has advantages now that it didn’t have at the end of last year, including warmer temperatures and vaccines, PolicyLab’s Rubin said.
“The question is, what will be the magnitude of that bump,” said Rubin. “I think we have to start the attack again.”
– With the help of Shelly Banjo, Elise Young and David Welch
(Updates with comments from Whitmer and the CDC Epidemiologist)