New COVID Variants and What They Mean

One thing about anticipating the worst is that you’re not surprised when it arrives. For months, Santa Barbara doctors and health officials have watched new strains of COVID-19 approach the county’s borders, working to vaccinate the maximum number of people possible with the little vaccine they’ve received, and organizing a variant research team involving UC Santa Barbara, Cottage Health, and Pacific Diagnostic Lab.

On March 18, the first evidence of the B.1.1.7 variant, a mutation first detected in England, was announced by County Public Health, after being discovered through a Centers for Disease Control monitoring program. That the two individuals who carried the variant had already recovered while in quarantine indicates how long it took to verify that the even more contagious coronavirus was in the county.

The two cases were unrelated, and neither had traveled recently, Public Health stated. Dr. Henning Ansorg, the county’s health officer, was unable to say where in Santa Barbara County the two lived, but he could say that neither was hospitalized while infected and that neither had been vaccinated. They must feel very lucky.

Not only is the U.K. variant 50 percent more transmissible, Nature published a report this week that said it was 61 percent more likely to cause death than non-B.1.1.7 variants, said Dr. Lynn Fitzgibbons, who is Cottage’s infectious disease specialist and a member of the local variant team.

The United Kingdom’s virus surveillance is greater than most countries’, including the United States, which is why it was found there first, many reports say. It’s in the lineage of the SARS-CoV-2 variant that’s caused severe outbreaks across Europe, and B.1.1.7 dominated England in two months’ time in the late summer. But it has a local competitor.

“The models from the Centers for Disease Control in January predicted that the U.K. variant would become dominant by March,” said Fitzgibbons. More than a million travelers poured through U.S. airports during Thanksgiving and the winter holidays, and B.1.1.7 first appeared in San Diego in December. “However, they didn’t take into account the West Coast variant,” she said.

That bug is the one that prevails in Santa Barbara, based on the Local Variant Task Team’s research, which began to be posted at Public Health’s dashboard this week. Of the 37 samples reduced to their genomes at Carolina Arias’s lab at UC Santa Barbara, 17 were the West Coast variant (the others were not variants of concern). Next week, 60-80 more sample results should become known. It takes about a week to sequence the virus’s genome, at a cost of about $50 each for just materials, not lab time, human power, or instruments. UCSB is supporting most of the costs, but funding is welcome.

“As of today, the West Coast variant is about 20 percent more infectious,” Fitzgibbons said. At the CDC, the West Coast version reached “variant of concern” status very recently and began climbing the charts upward behind the U.K. variant, as its circulation increased. Asked whether variants were the great concern, or if it were spring break, post-Super Bowl spread, and the traveling public, Ansorg answered, “All of the above!” And the new, more permissive red tier for Santa Barbara adds its own uncertainties.

Fitzgibbons said knowledge of the presence of variants meant “understanding the enemy better and defeating it,” because they have had an effect on treatments. For instance, “the West Coast variant proved to be so resistant to the monoclonal antibody treatment bamlanivimab that we use in early treatment of the disease,” she said, that Health and Human Services had stopped sending it to the western states. The other two or three monoclonal antibody treatments continue to work, thankfully.

As do the three vaccines so far available in the Unites States; they are effective against both the U.K. and the West Coast variants, although slightly less well against the local bug, Fitzgibbons said.

The new variant actually consists of two notable mutations, called B.1.427 and B.1.429. Compared to the CDC’s count of 413 cases of the U.K. variant in California as of March 18 — and 5,567 nationwide — Governor Newsom counted 1,834 cases of the West Coast variant in California last week. And that’s only what’s been found so far in a country and a state just beginning to ramp up their genomic sequencing of SARS-CoV-2.

The new discovery of the U.K. variant in Santa Barbara is clearly a case of community spread of unknown origin. And just as clearly, the two cases are not the only B.1.1.7 infections in the county; they’re only the ones we know about.

Fitzgibbons expressed worry over the rapid path of evolution in SARS-CoV-2, the virus that causes COVID-19. “It’s possible an even more concerning variant could be ahead,” she theorized. One that resisted other monoclonal antibody therapies or the clever antivirals developed over the last year, or even one that was actually more contagious. And there is the recurrent concern over re-infection when a new variant pops up.

When it came to protection from the new variants, “regardless of what flavor of virus is circulating in the community,” Fitzgibbons said, “masking, distancing, choosing outdoors over indoors — all these things continue to be successful no matter the variant reported this week.” Ansorg added emphatically the need to stay isolated when sick.

More than 32,000 people have recovered from COVID-19 in Santa Barbara County, a stride toward herd immunity that is hurried along by the ongoing vaccinations. Like a parasite, coronavirus grows in its victims, with the ability to mutate as it travels from host to host. Preventing that is the goal for Public Health and the medical community, and a beneficial outcome of the more than 132,000 vaccine doses in the arms of Santa Barbarans.

The vaccination effort is a very necessary one, Fitzgibbons said: “We really can’t risk letting one of the variants take hold and get out of control.”