LONDON – On Jan. 4, British Prime Minister Boris Johnson made yet another somber coronavirus-related address to the nation: A COVID-19 variant first identified in Kent, England, was thought to be between 50%-70% more infectious. In a little over a week, hospital admissions had increased by nearly a third. Deaths had risen by 20%. Johnson ordered the country’s third full national lockdown since the start of the pandemic.
“That means,” Johnson said, gravely, “the government is once again instructing you to stay at home. You may only leave home for limited reasons permitted in law, such as to shop for essentials, to work if you absolutely cannot work from home, to exercise, to seek medical assistance such as getting a COVID test or to escape domestic abuse.”
On Monday, amid a dramatic drop in coronavirus infections, Britain’s leader will unveil his plan for unwinding one of the world’s strictest COVID-19 lockdowns. Only Cuba has tougher restrictions in place, according to an index of government measures compiled by Our World in Data, a research unit attached to Oxford University.
The COVID-19 Government Stringency Index looks at nine different national coronavirus response indicators including school and workplace closures, travel bans, and limits on public and family gatherings. Thomas Hale, one of the researchers behind the index, said it does conceal some local and regional variations – particularly in places such as the U.S., where city, state and federal authorities rely on a patchwork of coronavirus measures – but overall it is still instructive.
Out of a possible score of 100, Britain hit 86.11 on the index on Feb. 18.
The U.S. figure was 68.06.
In Cuba, where even road access to the Caribbean nation’s capital Havana is restricted, the number is 90.74.
‘Like wildfire’: B.1.1.7 may soon dominate across the US
American public health officials will be watching what Johnson says closely, not least because the Centers for Disease Control and Prevention (CDC) believes that by as early as the end of next month B.1.1.7, the more transmissible COVID-19 variant originally identified in Britain in September, is likely to be the dominant one circulating within U.S. borders.
The U.S. has seen peaks and declines of COVID-19 cases since the first infections were reported in North America in January 2020, but there are concerns that the B.1.1.7 variation is among a number of different COVID-19 variants that could help precipitate a so-called fourth wave of American coronavirus infections.
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Trevor Bedford, an epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle, said in a Twitter thread on Thursday that a steady decline in U.S. coronavirus cases that has brought levels back to where they were in late October could be threatened by the “rapid take-off of B.1.1.7.” He said there is evidence that the B.1.1.7 variant “will reach 50% frequency in the U.S. perhaps by late March.”
However, Bedford noted that it was unclear whether B.1.1.7 would “‘win’ against further improvements to seasonality and immunity,” meaning, among things, warmer temperatures and higher vaccinations rate across the U.S.. “I’m not sure at this point how much of a spring B.1.1.7 wave to expect,” he said.
In the U.S., there were 1,523 cases of B.1.1.7 reported across 42 states as of Feb. 18, according to CDC data. To put that in perspective, though new coronavirus infections in the U.S. have been falling broadly for about a month, the daily new case count for February is still averaging about 95,000, according to a USA TODAY analysis of Johns Hopkins University data. Across February, U.S. coronavirus deaths have averaged about 2,520 per day.
In Britain, new daily coronavirus case counts have been hovering at about 12,000 for the last week. Christina Pagel, who leads a team of researchers at University College London who apply mathematics to problems in health care, said the B.1.1.7 variant now makes up about 90% of new cases in Britain.
Concerning new variants have also emerged from Brazil, South Africa and California. Researchers say the U.S. is almost certainly undercounting cases of the B.1.1.7 variant. The case count has more than quadrupled since Jan. 27.
“It (B.1.1.7) spreads so easily, like wildfire. It’s really caught us by surprise,” Carl Waldmann, the director of an intensive care unit at a hospital in Reading, in southeast England, told German state broadcaster Deutsche Welle.
‘We are sinking’
As the more contagious variant tore through Britain in January, the government warned that hospitals were on the verge of being overwhelmed. There was a steady stream of pleading testimony from doctors, nurses and other healthcare workers documenting B.1.1.7’s impact for the public to studiously abide by Johnson’s lockdown.
“It’s brutal and we are sinking,” said Sarah Addis, an emergency room doctor at a hospital in York, in northern England, on Jan. 8. “Quite simply we are being overrun. And we are starting to see younger and sicker COVID patients,” she said.
On Jan. 20, some 1,820 people died in Britain from coronavirus, the largest number of fatalities reported in a single day since the pandemic began — and almost double the peak from an earlier wave of infections in April, according to Public Health England.
Amid the soaring death toll, British hospitals cancelled all elective surgeries. Appointments for cancer diagnoses were halted. Many healthcare staff were redeployed to coronavirus intensive care units even though they lacked specialized training. Ambulances full of coronavirus patients queued up outside hospitals waiting for beds.
Johnson is expected to announce a phased return for some schools starting March 8. It’s not clear if other rules around gatherings, non-essential retail and hospitality will be relaxed. He recently clamped down on international travel, adding mandatory hotel quarantine for travelers arriving from some countries to a negative COVID-19 test.
With the exception of Israel, Britain has administered more vaccines per 100 people than any other advanced economy, according to Our World in Data. However, there is little concomitant data to show how well the vaccine is impacting new U.K. infections.
‘We can’t control this thing with half-measures’
Simon Clarke, a professor in cellular microbiology at the University of Reading, said that in addition to the B.1.1.7 variant being more contagious there is an emerging body of evidence suggesting it could be more lethal, a possibility that was initially raised by British scientists before being downplayed. He said there is anecdotal evidence from hospitals, not confirmed by studies, that the B.1.1.7 variant could be harming more younger people. However, he cautioned it was too early to drawn firm conclusions.
He also expressed concern for how the U.S. would deal with the B.1.1.7 variant if, as expected, it becomes entrenched as the dominant variant by the spring.
“U.S. coronavirus waves have been based on slower-moving variants,” Clarke said.
“If a faster-moving one such as B.1.1.7 starts to take off then you are going to have yourself a problem if you’re not prepared to do a strict, broad-based national lockdown,” Clarke added, noting it was his perception that the U.S. doesn’t seem willing to do this.
To take just a few examples: Unlike in Britain, not all U.S. states have restrictions on travel for leisure, many states offer exemptions for broader rules that allow restaurants to stay open and many have resisted calls for entertainment venues, gyms and personal care businesses such as hair salons and tattoo parlors to be closed. It is largely up to local officials to decide whether and how to impose most U.S. coronavirus restrictions.
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Other countries in Europe that have not recently imposed lockdowns as strict as Britain’s have struggled to keep rising cases of the B.1.1.7 variant in check.
“If you want to get B.1.1.7 under control lockdowns just have to be that much tougher,” said Kit Yates, a professor of mathematical biology at the University of Bath, England.
Yates said he believes that when schools in Britain reopen coronavirus cases are likely to rise again despite new evidence that the B.1.1.7 variant’s transmissibility may not be as high as originally thought. It may in fact, he said, be closer to between 30% to 40% more contagious than that of the more commonly found variants in the U.S.
Pagel, the University College London researcher, said that Britain’s latest lockdown has reduced new cases of coronavirus by about 60%. “That’s the good news,” she said. “The bad news is that we can’t control this thing with half-measures.”
She said that if the U.S. can’t or won’t order a national lockdown similar to Britain’s to deal with the B.1.1.7 variant than its best hope may be to “vaccinate its way out.”
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However, Pagel cautioned that if the variant first detected in Britain is allowed to circulate too freely in the U.S. there is a risk it could lead to an even more aggressive variation smart enough to evade current vaccines or better target younger people.
She added that with the old variant you can have cases falling quite rapidly so its looks like everything’s OK even while the new variant is spreading.
“Effectively, you have two epidemics going on at the same time where one is shrinking, and one is growing,” she said. “That’s exactly what happened in the U.K. and seems likely for the U.S.”
Contributing: Chloe Laversuch, The York Press; Mike Stucka, USA TODAY