Déjà vu all over again – three times!

We’re just beginning to learn about a new virus that’s started to spread in a country across the ocean and is killing a lot of the people it infects; we see horrifying scenes of overcrowded hospitals and new graveyards quickly filling up. Sure, a small number of cases of that virus have now been detected in the US, but few people in the US are very concerned about it. Since we have such a robust public health system and we’ve blocked travel from the affected country, it’s hard to believe that we won’t be able to keep the new virus under tight control.

Of course, a few malcontents point out that the new virus might already be spreading inside the US, since our ability to test for the new virus – even in people who have unexplained sicknesses – is woefully inadequate. But who listens to those people, anyway?

Of course, that is the situation the US was in almost exactly one year ago with the novel coronavirus. But it’s also the situation we’re in today. In fact, we’re in that situation three times: for the UK, South African and Brazilian variants of the novel coronavirus.

The three variants have two things in common: First, they all spread much faster (50% faster, in the case of the South African variant) than the “normal” coronavirus strain. This means they kill many more people simply because so many more people become infected. While some believe each of the variants is also more lethal (i.e. it kills a higher percentage of the people it infects), this isn’t proven.

And second, they can’t be distinguished from the normal coronavirus by existing Covid tests. They can only be identified through genetic sequencing. And the US is currently around 43^rd in the world in terms of having sequencing capacity deployed around the country. We’re currently sequencing a small fraction of 1% of all Covid samples – far below what would be needed actually to control the spread of any of these variants.

The three cases differ. The UK variant was first identified in September and for at least a month or two has been the dominant coronavirus strain in the country. It has now been found in many places in the US, so it will be impossible to prevent it from becoming widespread here – all we can do at this point is prepare for the onslaught.  Fortunately, at least the two vaccines already approved in the US seem to be almost as effective against this variant as against the normal strain.

The South African variant was announced six weeks ago, and beside causing an “enormous spike of cases and deaths” in South Africa, it has been discovered in at least 32 other countries, including the US (including in people who have not visited South Africa recently and haven’t been in contact with anyone who has).

But the Brazilian variant sounds like it may be the worst of the three. So far, it has been mainly found in one Amazonian city, Manaus. But it has completely overwhelmed that city. The WaPo article linked above says that, compared to the first wave of the virus this spring (which was considered terrible), the new variant “didn’t take 10 days to overwhelm Galvão’s hospital. It took 24 hours.”

“Even in a city as traumatized as Manaus, the horror has been unlike anything doctors have seen. The oxygen quickly ran out. Dozens of hospital patients have died of asphyxiation. Scores more, unable to get care, have died at home. Every half-hour, one doctor said, a funeral procession rumbled toward the cemetery. “We had a plan,” Galvão said. ‘We increased the availability of beds. But even with that, there was strangulation.”

But this variant is perhaps much worse than the UK and South African variants because it may be more lethal as well:

Doctors and front-line health workers are describing a dangerous new chapter in the struggle against the virus. The shift came suddenly: It wasn’t just the surge in patients but the severity of their cases. People started arriving at hospitals significantly sicker, lungs chewed up with disease.

“What has been said before, that this is a strain more transmissible but not more severe — that’s not what is happening in Manaus,” epidemiologist Noaldo Lucena said. “This isn’t a feeling. It’s a fact.

However, even that might not be the worst of it. To understand why, you need to understand that in Manaus, as well as other cities in Brazil, the coronavirus was essentially allowed to take its course last year, without a lot of steps to restrain it. As a result, scientists in December reported that about ¾ of the city’s residents had already contracted Covid (this has been disputed, since there was so little testing in the first wave that some of the cases that were diagnosed as Covid may not have actually been that), meaning that herd immunity had already kicked in. However,

Soon after the holidays, deaths and hospitalizations exploded. The hospital system buckled. The number of confirmed coronavirus deaths at home rose from a total of 35 from May through December to 178 so far this month, according to city health officials.

If a large portion of the population, after having had Covid and presumably carrying antibodies to it, was reinfected with the new variant, this may not bode well for the prospect that vaccines will be effective against the Brazilian variant. And that won’t bode well at all for the prospect of controlling this variant in the US. This week, the first person infected with this variant was discovered in Minnesota.

I would love to hear any comments or questions you have on this post. Drop me an email at tom@tomalrich.com.