India is in the throes of a devastating surge in COVID-19 cases. The wave of infections, propelled by a new variant of the coronavirus, could spill into the United States. Indeed, the Indian variant—“lineage” is the scientific term—is already here.
With most states reopening and governors and mayors relaxing mask mandates as pandemic fatigue sets in, realistically just one thing can spare Americans from another spike in cases, experts say.
The country must double down on its successful vaccination campaign. Getting tens of millions more jabs in arms in the coming weeks could block the new lineage’s transmission pathways—and stop it cold.
Welcome to Rabbit Hole, where we dive deep on the biggest story. It’s for Beast Inside members only. Join up today.
“What protects us from another surge is immunity,” Jeffrey Klausner, a clinical professor of preventive medicine at USC who previously worked at the Centers for Disease Control and Prevention, told The Daily Beast.
But there are worrying signs that vaccine uptake—the rate at which people step up to get their shots—has already peaked in the United States. A sharp decline in uptake could leave tens of millions of people unprotected for months or longer.
That might give the new lineage space and time to grab on. “If the Indian variant were to establish in a landscape of lowered social measures and moderate level of population immunity, then it will spread,” Edwin Michael, an epidemiologist at the Center for Global Health Infectious Disease Research at the University of South Florida, told The Daily Beast.
“We are in a perilous moment with the rise of variants and pandemic fatigue,” warned Lawrence Gostin, a Georgetown University global health expert.
The Indian lineage might not actually be from India. But it’s in India that scientists first detected it, way back in October. It took months for the lineage, which geneticists call “B.1.617,” to become dominant in the South Asian country.
Once it did, it helped to drive a spike in infections. India, which with 1.37 billion people is the world’s second most populous country, had managed to drive new infections down to just 11,000 a day as recently as mid-January. Last week the country logged a record 233,000 new cases a day, on average
There’s a lot we don’t know about B.1.617. We don’t know whether it’s more virulent. We don’t know for sure whether it can evade, even partially, any of the vaccines in use across the roughly two dozen countries where the lineage has spread.
But geneticists have identified two key mutations in the Indian lineage. The E484Q and L452R mutations both affect the spike protein that the virus uses to grab onto and infect our cells.
It’s because of these twin genetic changes that some experts refer to the lineage as a “double-mutant”—although other experts warn that all coronavirus lineages feature numerous mutations.
Mutations affecting the spike protein are a hallmark of several new and more dangerous forms of the coronavirus, most notably lineages from South Africa, Brazil, and the United Kingdom. The U.K. lineage B.1.1.7 is partially responsible for the current spike in COVID-19 cases in Michigan and several other U.S. states.
Scientists detected the first U.S. B.1.617 case in California in late February. So far, the lineage is fairly rare in this country. But if the U.K. lineage taught us anything, it’s that a new and more transmissible lineage can become dominant fast. The Indian lineage could very well fuel its own U.S. surge in coming weeks.
We know how to beat it. Social distancing and masks work against all coronavirus lineages, of course. But with masks and business restrictions becoming deeply unpopular among right-wingers, America’s governors and mayors are practically racing each other to unwind social-distancing measures.
Fortunately, there’s another way to win. As far as we know, the two vaccines with emergency approval from the U.S. Food and Drug Administration—two-shot jabs from Moderna and Pfizer—work just fine against B.1.617.
That should come as no surprise. The same vaccines have also proved effective against other new lineages.
(In a controversial move last week, the FDA froze distribution of a third vaccine, from Johnson & Johnson, after a handful of recipients of the vaccine experienced unexpected blood clots. Experts stress that the Johnson & Johnson vaccine is still safe and effective. European regulators also briefly paused distribution of the single-shot jab but have since allowed it to resume.)
After an intensive several months of inoculations, more than half of Americans over the age of 18 have gotten at least one dose of vaccine. That’s 130 million people with some vaccine-induced immunity. Tens of millions more Americans have some lingering natural immunity after catching, and recovering from, COVID.
With as many as 4 million shots going into arms per day in recent weeks, the United States appeared to be well on its way to achieving population-level “herd immunity,” which experts agree could require around two-thirds of the country to have some kind of immunity.
Herd immunity gives a virus so few pathways for transmission and mutation that it effectively isolates and starves it. A hundred million more vaccinations, and Americans could squash B.1.617 and all other forms of the coronavirus.
But those last jabs could be harder to administer, and might take longer, than the roughly 30 days it took to administer the last 100 million.
Average daily vaccinations rose steadily after the FDA first approved the Moderna and Pfizer vaccines late last year. With the strong support of the Biden administration, U.S. states administered a combined 4.6 million doses on April 10.
But after that, average daily doses began to decline. This despite the White House making all American adults eligible for the vaccines starting Monday.
Even taking into account the millions of doses of the Johnson & Johnson vaccine that the FDA abruptly removed from circulation, vaccine supply isn’t really the problem in the United States. “Vaccine hesitancy” could be the problem.
“We are approaching a point where everyone who wants a vaccine will get one,” Jennifer Reich, a University of Colorado sociologist who studies immunization, told The Daily Beast. Increasingly, it seems the people who are left are the ones who have reservations.
They might wrongly believe the shots are ineffective, unsafe, or cause disease. They might be among the millions of conservatives who associate vaccines with liberal government.
They might even believe the lie that tech-billionaire Bill Gates is somehow using vaccines to secretly slip tracking devices into Americans’ bloodstreams.
Whatever their reason, two out of three unvaccinated Americans recently told Axios-Ipsos pollsters they were either “not likely at all” or “not very likely” to get a shot.
That could threaten the country’s ability to reach herd immunity. And it could open the door to B.1.617 and future lineages.
Klausner for one said hand-wringing over vaccine hesitancy is unjustified. “Vaccine hesitancy was something created by the media to sell news. In reality, people across the spectrum are getting vaccinated at high rates.”
And holdouts can be convinced, Reich stressed. “New information is showing that vaccines provide good protection against transmission. Knowing that should help people feel the vaccine is useful.”
Even if Klausner is right, the numbers don’t lie. For whatever reason, vaccine uptake is slowing in the U.S. And even if holdouts are the problem and can be convinced, that convincing takes time.
That’s exactly what the virus wants. Time to infect more people, and mutate into more new forms, before the transmission pathways close.
All that is to say, the pandemic is far from over—even in one of the most vaccinated countries in the world. New lineages are coming at us fast. And millions of our friends, family and neighbors seem reluctant to do the easy thing to stop them.
