Mutant strains of the coronavirus are spreading through the world’s population even as we vaccinate more people. Here's a look at how it's all playing out in Virginia.
What exactly are these variants?
A variant is a mutation of a virus at the genetic level. As viruses spread, they change in order to gain a foothold, creating essentially a new branch on a family tree. There are thousands out there. The discussion about them recently is more limited to the few that have gained a foothold and are potentially dangerous. “This is evolution playing out in front of our eyes,” said Bryan Lewis, a research associate professor with the University of Virginia’s Biocomplexity Institute, which has done coronavirus analysis for over a year.
Which ones have been found in Virginia?
There are five of what the Centers for Disease Control and Prevention calls “variants of concern.” All are now present in Virginia, according to the state Department of Health. That includes variants that originated in the United Kingdom and South Africa, as well as two from California. State health officials just confirmed the fifth, out of Brazil, on Friday.
How prevalent are they here?
The B.1.1.7 variant, which was first identified in the U.K., has recently become dominant in Virginia, according to the Biocomplexity Institute. Around 60% of transmissions happening right now in the state are of that strain, Lewis said.
That’s not too surprising, considering the CDC says B.1.1.7 is now dominant in the U.S. at large. This variant is considered to be about 50% more transmissible than the original strain, meaning it can more easily jump between people and quickly raise the overall number of cases.
The South Africa variant is not quite as contagious but is catching up, Lewis said, making up roughly 10-20% of infections in Virginia. The California variants are at lower levels so far. The state doesn’t have data broken down by region. But Raul Gonzalez, a scientist with the Hampton Roads Sanitation District, said last month that a program tracking variants through wastewater had found evidence of the ones from the U.K., Brazil and South Africa in local samples.
“We definitely are seeing an increased proportion of COVID that’s of the U.K. variant,” Gonzalez added Monday.
How do we find them?
The state health department has received more than 670 reports of variants of concern, nearly 80% of which have since been identified as B.1.1.7. But how do we know?
Virginia has a few approaches to its surveillance of the variants, said Dr. Brandy Darby, a veterinary epidemiologist with the department who’s been part of its COVID-19 health information team. For one, if forensic epidemiologists see a concerning situation, such as an outbreak moving through a group of people more quickly than they’d expect, they send samples for full genome sequencing at a state public health lab.
Darby said the lab already tests at least 10% of positive COVID-19 samples in Virginia, and scientists take a subset of those to look for variants and other possible genetic changes to “keep tabs on the virus.” Then there are private or academic labs that do their own genome sequencing. If they identify a concerning variant they notify the CDC, which then lets VDH know.
Lewis of the Biocomplexity Institute, however, noted that Virginia is fairly limited in its ability to get a full picture. Because sampling is usually done based on specific cases, and not in huge amounts statewide, it’s hard to know just how rampant the variants are.
The institute’s estimates try to factor that in, inferring that what we see is only a fraction of what’s happening in our communities. In the U.K., for example, the nationalized health system infrastructure already in place allowed for much more routine testing, and has provided much of what we know about that variant.
What’s the big deal?
The biggest concern with the variants is that they tend to be more transmissible, infecting more people in a shorter amount of time. For every instance of an infected person, then, officials can expect to see it spread to more others than it originally would have.
There’s no solid evidence of any of the variants actually causing more severe disease. However, there has been concern about “breakthrough infections” due to the South African and Brazil variants evading vaccines. There’s been some lab work that shows levels of protection may not be quite as robust with those strains, Darby said, but real-world scenarios haven’t quite borne that out.
Do the COVID-19 vaccines protect against the variants?
The short answer is yes. While there are those concerns about certain variants’ ability to elude immunity, the bottom line from data worldwide is that the vaccines protect people against severe illness. They might not always protect against infection — vaccinated people may be at more risk of contracting the disease under some variants, though it’s still rare.
But people would still be nearly ensured not to be hospitalized or die from it. “While variants are a concern, vaccine hesitancy is the largest long-term risk to containing the impact of the pandemic,” the Biocomplexity Institute wrote.
What can we do?
The same things we do to protect against the virus more generally: Get vaccinated, wash your hands, distance yourselves from others and keep wearing those masks.
“The good news is all the tools we have in our toolbox are going to continue to keep us safe,” Darby said. The variants “are here, they’re out there. It’s just something people should be aware of.”