Why This Coronavirus Increase Is Different As Variants Pull Ahead - Landekic
Nick Landekic, Guest MINDSETTER™
Why This Coronavirus Increase Is Different As Variants Pull Ahead - Landekic
Many public health experts including Dr. Michael Fine, Dr. Ashish Jha, and Dr. Rochelle Walensky have warned another COVID surge is upon us, and it’s a race between vaccinations and variants. At least in Rhode Island, it looks like our state’s virus-friendly policies are letting variants pull ahead in this deadly fight.
While infections are fortunately down from the horrific nightmare in January that brought 1,000-1,800 new cases each day, for the past month Rhode Island has been stuck with a dangerously high infection rate of 33-37/100,000/day. This is the same as it was during the worst of the first spike a year ago - and getting worse. Last April we were experiencing 200-400 new COVID cases each day, and for the past two weeks, we have been averaging similar numbers and even higher.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTRhode Island has consistently had among the five highest infection rates in the country for most of the pandemic and the fourth-highest death rate. Last year those infection levels resulted in extensive safety measures, yet now bring reopenings of bars and indoor dining in restaurants. We are our own worst enemy and continue to shoot ourselves in the foot by letting infection levels stay dangerously high.
As the French saying goes, “The more things change, the more they remain the same”.
Yet there are important differences now compared with a year ago.
1. More younger people are now becoming infected – and are driving the current surge.
Many people believe COVID is a problem for older people, and that being younger somehow exempts one from risk. While a year ago most infections and deaths happened in those over 50, it’s no longer the case. Over the past year, COVID has increasingly been afflicting younger people. The current surge is happening mostly in those under age 39.
The graph below shows the proportion of COVID cases in Rhode Island, and total cases, over the past year. The percentages show the proportion of COVID cases in those under age 39.
In the first two months of the pandemic last year, only 28%-42% of cases were in people under age 39. Now for the past two months, those under 39 account for 63% of all cases.
Increasingly this means adolescents and teenagers. In March 2020 only 3% of COVID cases were in those under 18. This March they accounted for 22% of all COVID cases.
Though children may generally be at less risk of serious disease, they can be carriers and bring COVID home to their parents and grandparents - perpetuating the spread of infection. In the current surge, they are likely the leading edge in spreading infection, and particularly, variants.
The current surge in Rhode Island is being driven by younger age groups, and the pandemic will not be contained until this is brought under control.
2. Children are not immune from infection.
It was originally believed COVID was not a serious problem in children. Now we know they are not immune from risk. Children are particularly susceptible to a still uncommon but increasingly observed condition called Multiple Inflammatory Syndrome, MIS-C. This is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.
To date, there have been 3,185 reported cases and 36 deaths in children from MIS-C.
3. We know more about how the virus is spread.
A year ago it was thought most infections were spread by physical contact. We were constantly washing our hands raw. Now it is understood the virus is primarily airborne. It is spread by people talking, coughing, and sneezing. You can get infected in as little as 5 minutes from an infected person 20 feet away.
Yet Rhode Island continues to increase the opportunities for spreading disease by allowing indoor dining in restaurants at near full capacity, and reopening bars and other indoor venues despite overwhelming evidence that doing so results in increased infections.
The rules of contagion are simple: allowing unmasked people to gather indoors spreads infection.
Allowing bars to be open and indoor dining in restaurants will kill people.
How badly do you really need that burger or drink?
4. There can be significant long-term consequences to having COVID – for people of all ages.
COVID was initially thought to be another respiratory infection like influenza. Many people believed it was all over after getting through the acute phase. We know much better now.
Long COVID is a major problem, such as chronic fatigue even months after the original infection. 76% of people can still have health problems six months after their infection.
There are many kinds of potential lingering health problems, including heart damage, found in 60%-78% of COVID survivors, brain damage and cognitive impairment, with 85% of survivors having long-term neurological problems.
COVID is most definitely not like the flu. If you get infected, you could be paying the price for the rest of your life.
5. The variants are here – and they are a problem.
All viruses mutate, and SARS-CoV-2 is no exception. Evolution selects for mutations that increase the virus’s chances for survival – often at the expense of the host. While most mutations are irrelevant, a number of variants have emerged that show increased risk of transmission, or a greater chance of death, or less susceptibility to vaccines or antibody treatments – or all of these.
Variants that are more easily spread quickly become the dominant strain. They are driving the current surge in infections in Europe, and are increasing here. Dr. Philip Chan of the RIDOH estimates that 40% of our current COVID cases are now due to variants.
Several variants known to be more easily transmitted, or associated with greater risk of death, or suspected of being less susceptible to vaccines, have been identified in Rhode Island.
Variants of concern already confirmed in Rhode Island include B.1.1.7 (the “U.K.” variant, both more easily spread and more lethal), P.1 (“Brazilian”, which may have the triple threat of being more easily spread, more lethal, and against which vaccines could be less effective), and others.
Experiences in other states and countries show variants will continue to increase, as will the problems they pose. Rhode Island has problems on multiple fronts, including a low rate of genomic sequencing to identify variants and thus lacking an effective early-warning system, the unwillingness to take action to contain outbreaks, and most of all, allowing a high infection rate to continue – which is a breeding ground for creating more variants.
6. Being safe is good for a state’s economy.
There have been endless arguments about safeguarding our lives and health vs. the state’s economy. Both the current and previous Governors have consistently come down on the side of money, with a willingness to trade our health and lives in hopes of short-term economic gains. Putting aside the morality of prioritizing money over our lives, these actions seem to be driven by a misguided belief that protecting health is mutually exclusive from financial interests.
The experiences of other states and countries have shown that economies thrive not only when people feel safe, but actually are safe to go out and spend money. The pushes by the Governor to continue to reopen bars and restaurants in the belief that it’s ‘good for the economy’ is mistaken and short-sighted.
A perfunctory look at states with generally lower infection rates suggests that employment is higher where infections are lower. The following table compares year-end unemployment rates in states that have generally had lower infection rates with those with higher rates (using as a proxy the number of days the state has had infection levels assessed as “critical” by covidactnow.org). While there are many factors driving employment and economic activity, a cursory examination suggests that while unemployment levels in these states were all roughly similar before the pandemic (year-end 2019), those that allowed higher levels of infection to happen also have experienced greater unemployment:
Real-world experiences seem to show that the interests of protecting health and lives, and the economy, are aligned and not contradictory. If Governor McKee is truly serious about “jobs”, the first thing he should do is make Rhode Island one of the safest states instead of one of the most infected and dangerous.
7. Vaccinations will be a regular part of life going forward.
Rhode Island has come a long way with vaccinations. From dead last in vaccination rates, to currently 10th for at least one shot and 4th for fully vaccinated. We should thank the National Guard for their role in helping to bring order to the chaos that paralyzed our state.
As much as we don’t want to hear it, vaccination is not going to be a one-time thing. The reality is we will almost certainly need to get regular booster shots, both because immunity can wear off, and the continued rise of variants that may be increasingly resistant. A recent survey of epidemiologists – the experts who know better than anyone else – warns that mutations could render the current COVID vaccines ineffective in a year or less.
The lesson is that if we want to stay safe, Rhode Island is going to have to learn how to efficiently, effectively, and quickly distribute vaccines on an ongoing basis for the foreseeable future, because we’re likely to need booster shots at least once a year for a long time to come. If we can’t figure that out, it’s going to be very hard, and dangerous, to live here.
8. A little patience could go a long way
Just because Rhode Island allows something doesn’t necessarily mean it’s safe or smart to do it. The experts who know the most about the pandemic, such as Dr. Rochelle Walensky and Dr. Anthony Fauci urge patience and not jumping too soon to reopen too fast.
These are not people who stand to profit in any way. They have dedicated their lives to protecting public health and saving lives. Maybe we should listen to them.
The next time you read about yet another relaxation of a safety measure in Rhode Island, consider if partaking of the allowed activity would really be in your best interests of health and safety, or if it’s to let someone else make money at your risk?
“Holding tight until more folks vaccinated key to winning this race.” - Dr. Ashish Jha, Dean, Brown University School of Public Health
Nick Landekic a retired scientist and biotechnology executive with over 35 years of experience in the pharmaceutical industry.