The news of coronavirus variants now circulating in New York comes at an unfortunate time, with many New Yorkers eyeing more relaxed precautions now that relief from the vaccines was finally in sight. But the alarming rise in the number infected by one variant, dubbed B.1.526, should give us all pause.
B.1.526 first appeared in late November and now accounts for about 25% of all coronavirus genomes sequenced in New York. Its ability to spread so rapidly is likely due to a set of mutations in the spike protein that increase viral infectivity, allow the virus to replicate more quickly, and keep the virus circulating in the body for longer.
While that alone is concerning, it could become much worse. Some of the mutations — like E484K and D253G — have been seen in other variants and are known to give the virus a leg up against our immune system. The well-studied E484K mutation alone has been shown to diminish our body’s ability to neutralize the virus, even among those recently vaccinated.
Mutations that allow the virus to evade our immune response, give the virus a greater chance of surviving inside our bodies. Combine that with a mutation that allows the virus to replicate more quickly and the virus now poses a very real and immediate threat. A higher viral load is associated with more severe illness and a greater chance of death. This means this new New York variant may not just be more transmissible and more capable of evading our immune defenses, it may also prove to be more deadly.
I, like every other New Yorker, was hopeful that the recent decline in new cases and the accelerated rollout of Covid vaccines was a sign that soon we could return to a greater sense of normalcy. But having studied this variant’s mutations and as a long time investigator of infectious diseases, I am no longer so hopeful. To keep this variant from spreading even further, all of us must double down on our efforts to contain its spread.
First, we should all be more careful when leaving our homes than we’ve ever been before. It’s not enough now to mask up with our usual one or two cloth masks. Now’s the time to pull out the harder core PPE: N95 or KF94 masks and our face shields. Wearing a quality mask and face shield have been proven highly effective at preventing transmission even in indoor hospital settings.
Second, those eligible for vaccination should get their shots as soon as they can. Even though this variant may be better able to evade our immune responses, studies of variants with similar mutations have shown that while the vaccines may not be as effective compared to the wild type virus, they can still provide some protection. Those who can should take every bit of help available to them.
Third, if you’ve been sending your children into school but you have the luxury of keeping them home, now’s the time to reconsider that option. The mutations in this variant give the virus greater affinity, meaning they can latch on more effectively to our ACE2 receptors. Many experts believe that one of the reasons why Covid-19 may not have been as prevalent in children was because they have fewer ACE2 receptors. Now, with a variant with higher affinity, this may no longer matter as much and our children may become much more susceptible to infection, transmission, and the risk of more serious disease.
Finally, if you do unfortunately fall ill, isolate yourself immediately from those you love and make sure that you and those around you who were exposed quarantine for at least 14 days and ideally three weeks, not the seven to ten days that many schools and businesses require. We know from other studies that these variants can linger in the body for longer and you may transmit the variant unknowingly if you or those exposed break quarantine too soon.
These New York variants have been circulating for a while now and if you’ve escaped them so far, consider yourself lucky. We also know that other variants — some known like the South African one and others still unidentified and potentially even more transmissible — are circulating as well. We have a rare opportunity today, with new cases still on the decline, to contain the spread of these new variants and prevent another major outbreak. It won’t be easy. But remember all we fought for a year ago next month, when we were thrown into the throes of alarm and despair when the city first locked down. If we don’t take the right steps now, we may all be condemned to repeat it.