Random variation is an essential component of all living things. It drives diversity, and it is why there are so many different species. Viruses are no exception. Most viruses are experts at changing genomes to adapt to their environment. We now have evidence that the virus that causes Covid, SARS-CoV-2, not only changes but changes in ways that are significant. This is the twenty-third part of a series of articles on how the virus changes and what that means for humanity. Read the rest: part one, part two, part three, part four, part five, part six, part seven, part eight, part nine, part ten, part eleven, part twelve, part thirteen,part fourteen, part fifteen, part sixteen, part seventeen, part eighteen,part nineteen,part twentypart twenty-one,  part twenty-two, and part twenty three.

After a period of decline, we are now seeing a rise in Covid-19 cases globally and in the U.S. According to WHO, there was a daily increase of 84,383 cases globally as of February 25, 2021, bringing the total number of current  global confirmed cases to 421,406. (Figure 1). John Hopkins is reporting 77,804 new cases in the US as of February 25, 2021. This demonstrates a steady increase from the 55,195 new cases reported in the U.S. on February 21, 2021, as seen in the chart below (Figure 2). A disturbing trend that should caution us against the complacency that some governors are showing by rolling back state Covid-19 restrictions.  

Chart of Global Covid-19 cases reported by WHO
Figure 1: Global Covid-19 cases reported by WHO WHO
Graph of Covid-19 cases in the United States from the last two weeks
Figure 2: Covid-19 cases in the United States from the last two weeks JHU CSSE COVID-19 DATA

As I have written in prior columns for Forbes, the increase in cases is likely due to the spread of the highly transmissible UK B.1.1.7, South African B.1.351, and Brazil P.1 variants. These dangerous variants have shown evidence of increased viral load which is associated with increased disease severity and mortality.  

We simply need to look at the U.K. to see how these variants can quickly become a dominant strain and lead to a surge in cases. The B.1.1.7 UK variant now accounts for approximately 96% percent of all new COVID-19 infections recorded in the U.K. We are now seeing similar patterns play out around the world, as the rapidly mutating variants signal a new stage of the pandemic.   

After months of plummeting case rates and a swift vaccination rollout, India is now experiencing a sudden spike in cases. The spike has been most pronounced in the western state of Maharashtra, where an Indian variant N440K has been identified and nearly 7,000 cases were detected earlier this week. That accounts for a significant portion of India‚Äôs overall confirmed 16,577 cases (Figure 3) as of February 25, 2021. 

Chart of confirmed in Covid-19 cases in India over the past two weeks.
Figure 3: Confirmed in Covid-19 cases in India over the past two weeks. JHU CSSE COVID-19 DATA

With the UK B.1.1.7, South African B.1.351, and Brazil P.1 variants and our own home-grown variants the CAL.20C, the 677 mutations, and now the New York B.1.526 variant all active in the U.S. we cannot afford to be complacent. These new developments remind us that the pandemic is far from over and the variants could lead to a new surge in cases. 

In a prior column for Forbes, I detailed the public health measures that need to be put into place if we are to prevent the spread of the variants. I will summarize them again here. Increasing vaccinations is a critical step but until we have comprehensive data on the efficacy of all approved vaccines against the variants, those who are vaccinated must continue to wear masks, sanitize, physically distance, and avoid indoor activities. The federal government needs to incentivize quarantining both financially, as well as with medical supplies and shelter if necessary. Non-essential travel must be avoided at all costs and testing must be a requirement of domestic and international travel. 

Finally, the Biden administration needs to continue to scale up the genomic surveillance system and link that information with robust contact tracing, so we may have a greater understanding of how the variants are spreading.

By swiftly implementing and following these measures, we can help avoid a rapid rise in Covid-19 cases stemming from the variants, as we have seen play out overseas.