This week Fred and I discuss the new variant that the British researchers highlighted over the holiday period and led to a reaction from various countries and around the world
Many European countries banned travel originating in the UK and the US followed suit requiring a negative COVID19 test.
Genetic Phylogeny NextStrain
So, what is the new variant – B117 has changed to the spike protein and appears to be more infective although precisely why is still not fully understood. The UK variant also appears to spread faster although given the holiday period and what appeared to be higher non-compliance with public health advice as evidenced by the high travel numbers and online pictures of events and activities taking place it will be hard to separate out these effects
We also discuss the vaccine rollout which managed to produce a large number of doses before the end of the year but then stalled trying to get the vaccine into the arms of those in the highest priority groups
Join Dr Luis Saldana, Fred and myself for our COVID Insights to Action Discussion webinar taking place every Wednesday at 4pm ET. Our training modules are available to help businesses, education facilities and employers get their employees, staff, customers and students back to work and school safely in the context of COVID19
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick, I’m the incrementalist here with incremental insights for better business and better health for 2021.
Fred Goldstein
Yes, fantastic. We’re in the new year. This is Fred Goldstein with accountable health. And I’ve been working with Nick and others and helping companies reopen and continue to operate during the COVID pandemic, a lot of stuff going on at that year end, we took a little bit of a break. And now all sorts of new news, people getting worried about a lot of things. And one in particular, is this whole idea of this mutation of the virus. So Nick, why don’t you give us a bit of background on that, and let’s get into this discussion on it.
Nick van Terheyden
Yeah, so, b 117, for shorthand, is how it’s been named. Essentially, it appears to be more transmissible documented in the UK that have a genomic surveillance program that is tracking and looking at the gene sequencing. And just for the benefit of people from a visual, if you haven’t seen that chart that shows all the various genetic drifts of the virus. There are many, many strands to this. This is not the only one. This is what viruses do. This particular type of virus has a tendency to mutate slightly faster than others, it’s part of the normal development process. But what’s worrying is it seems to be more transmissible. And of course, that creates a problem because it expands or increases the number of infections. But immediately, particularly given the timing, if we’d had this three months ago, we might have been able to say, Gosh, I can see that. My question. And, you know, my thinking around this is can we attribute the increase in cases that we’ve seen directly to this? And how much is it impacting different countries while in the US? Do we know, I think we’ve heard of one documented case, or at least, you know, one genomics surveillance. But is this conflating data that, I would say partly, we’ve seen massive increase in travel? And certainly online, I’m seeing lots of evidence of people not following all of the recommendations that we know help mitigate the virus. What do you think from?
Fred Goldstein
Yes, I looked at this, it’s interesting, because what the UK is apparently doing is sequencing randomly 10% of all positives, results they get, they send the lab, and then they sequence it. And what they’ve seen is, in September, they first picked this variant up. And they’ve seen that its relative ratio of how many people are infected with it has gone way up. And so if you would think about that, over a period of time, you’d probably say, Well, if all of these viruses were variants were equal, and we then had, whether it was Christmas or Thanksgiving, or the holiday period, they would all rise at a relatively the same rate, or at least the rate this was 80% of the population to begin with, would stay at 80%. But now you’re seeing this switch to this new variant. So clearly, there’s something to it, they’ve talked about the fact that it may bind more strongly to the, to the cells. And so as you pointed out, each of these variants is normal. Some of them actually make us the virus less contagious or less ill, and the virus always is trying to find that balance. If it gets too lethal, like Ebola, it just doesn’t have the opportunity to spread over time. But if it and so it, is that sort of a thing that goes on with viruses all the time, and we’ve got to watch it, obviously. But I do think it’s interesting to note that I think it’s now in about three states, because we picked it up in Florida and a person. And I think I saw something in usa today that it was in 33 countries now. But I think, you know, in the US point, we can’t be certain that it’s not in all of the states because we don’t have that 10% genomics surveillance. Right. Right. And this gets to an issue we’ve been facing in the US with everything we’ve touched, whether it’s trying to get people to follow through with the recommendations, what are the recommendations? Do we have appropriate contact tracing, and the ability to do that? And now Do we have vaccine distribution, which I think we’ll get to, but each of these is clearly we’re not doing enough genomic tracing. So as you said, it’s probably all over the place at this point. And,
Nick van Terheyden
and that question, so if that’s the case, is there any point in closing the borders, in fact, the US didn’t close its borders, a lot of European countries Did I think it was temporarily, you know, but ultimately, if it’s already here, We’re shutting the gate after the horses bolted?
Fred Goldstein
You’re exactly right. I think there’s nothing there yet. And I was gonna use the exact same phrase you did about the horse bolting or leaving the barn. It’s here. The question is, what do we do about it, Nick? And I think, you know, it’s pretty straightforward. So how do we try to deal with this new variant? Is there something different?
Nick van Terheyden
No, I think all of the recommendations remain the same. So physical distancing, wearing a face covering and you know, cleanliness, washing your hands, I think, you know, we’ll probably have a show about cleaning surfaces, because I think there’s a change or a shift as usual as things do. I think the big concern is around vaccination. So can the virus customize and, and essentially, evolve around the vaccine. That’s what people are worried about least, you know, certainly I am. And, you know, everybody that thinks about this deeply, we don’t know, it will probably have some impact. But if nothing else, what it’s doing is increasing the number of cases. So even if you have a very effective virus, vaccine, you’re still going to see more cases. And that means more potential spread, even as the vaccination campaign is working. Which brings us to the vaccine distribution, which, unfortunately, we produced a lot of doses, but we failed, or stalled at the point of actually getting in the arm. So I’m aware, certainly at least of some individuals who’ve received it, I heard in New Mexico, they have a public site, anybody can go register. And they’re actually getting vaccines in arms and doing a pretty good job where other states are failing. How do we fix this front?
Fred Goldstein
Yeah, this isn’t a fascinating problem, because it’s really not complicated. But it’s a logistics issue. It’s how do you execute against it and create a plan that says we’re going to get shots in people’s arms. And we know we wanted to get health care workers first, maybe it was the over 65, some states might have done over 60. But setting up those systems should have been done. It’s not rocket science, for sure. And that it hasn’t been done in many states is just really disheartening. And I’m seeing it here. each county is using different approaches. I know that down in St. Augustine, they had a miles long line of people trying to get vaccines in one place, they required you to sign up, but people showed up who didn’t sign up, and they gave it to them. And now I hear that some may even be using Eventbrite to schedule vaccines. Now, that may be a good idea, because people know how to use it. But at least having thought these issues through we had plenty of time.
Nick van Terheyden
Right. And, you know, if I was to pick one thing out of that it would be statewide, or actually nationwide. But you know, except statewide, and, you know, an overarching strategy that sort of encompasses the whole state and takes account, I know, counties are different, the good Lord, we’ve got to get this, right, because we’ve produced 20 million, and maybe 2 million in arms, I’m not sure where we are exactly, but a fraction of what’s available, it’s just being stored. That’s insane, we have to get this and the faster we do it. And I think we’re going to be talking about this for some weeks to come.
Fred Goldstein
Absolutely. And one interesting thing that just I just happen to catch this morning is they’re considering cutting the maternal vaccine in half. And seeing if that is potentially a way to then spread it to more people. But again, you’ve still got to get it out there, get people scheduled, get the injection done, follow up with them get the second one done. So you can see now there’s a bit of a scramble going on, which is right
Nick van Terheyden
and added to that scramble is you know, there’s some push to say let’s just get one vaccine and not worry about the booster dose. And you know, the the some basis for that. But ultimately, the challenge with this is we’ve got such vaccine resistance, that potentially people are way you’re changing all the rules. So we have to think very carefully. We have to get this right. And we have to get it right first time, in my view,
Fred Goldstein
right. And when you think about this, also and take that back to we’re now in a race between the newer variant of the virus and the vaccine. And I also want to bring up one more point, a lot of people have said, well, the new variant, it’s just as it’s just as virulent, or is it creates as much illness as the old one, it’s not any more deadly, or having more severe symptoms, etc. But that’s a false way to look at that new variant, because it’s so much more contagious. So more people will get sick in a given period of time, which means more people are in the hospitals, which further overloads the systems and that’s why you’ve got to look at this. So with that, thank you very much, Nick. It’s been once again a fantastic start to 2021. Glad to be here hopefully a better year than last year. This is Fred Goldstein, with accounting. Hello, thanks so much for listening.
Nick van Terheyden
And this is Dr. Nick. I’m the incrementalist here with incremental insights for better business, better health.
