Policy

 As new coronavirus strain detected in three states, vaccines fall short

A new variant of SARS-Cov-2 thought to be more transmissible was discovered in Colorado’s eastern plains and San Diego, California. At the same time, federal vaccination rates are lagging far behind projections.

A woman dressed in protective gear walks away from a doorway at the Good Samaritan Society nursing home on December 30, in Simla, Colorado. A Colorado National Guard soldier who was deployed at an ongoing Covid outbreak at the nursing home is the first person in the U.S. to have tested positive for a more contagious Covid-19 variant. Photo credit: Michael Ciaglo, Getty Images

Update: Since this article was published, the B.1.1.7 variant has been detected in Martin County, Florida, making for three states where the new strain has been spotted. 

As the U.S. passes another grim record for Covid-19 deaths, a new strain of the novel coronavirus thought to be more transmissible has been identified in two states. The B.1.1.7 variant, first identified in the United Kingdom in September, was detected in a small town in Eastern Colorado and in San Diego this week.

The new strain of SARS-Cov-2 is thought to be 50% to 70% more transmissible, thought not necessarily more deadly. The concern is that it could drive more community spread, which could result in more hospital and ICU beds being filled, said the Colorado Department of Public Health and Environment’s Chief Medical Officer, Dr. Eric France.

“We need to be aggressive with vaccination. It appears this vaccine we estimate will be just as effective with the new variant as it was with the old,” he said at a Thursday press conference. “If we see cases start to come up, and if our own sequencing finds this has been driven by the variant, we may have to act quicker and more broadly in our thinking.”

One Colorado National Guard member tested positive for the new strain of SARS-Cov-2, and another one is presumed to have it. Both were responding to an outbreak at the Good Samaritan Society nursing home in Simla, Colo., where all 26 of its residents and nearly two-thirds of its staff had tested positive for Covid-19.  The Good Samaritan Society in Simla declined to comment for this article.

According to preliminary testing results, there isn’t any evidence that the B.1.1.7 variant is currently circulating in the nursing home, state epidemiologist Dr. Rachel Herlihy said in a press conference. Most of the cases with the outbreak took place before the two National Guard members arrived on Dec. 23.

“Therefore, we’re also looking into the second possibility, the possibility that exposure happened outside of the Simla facility,” she said.

Neither of them had traveled outside of the U.S., indicating potential community transmission.

Another case of the variant was identified in San Diego, after a man tested positive and results were confirmed at Scripps Research. He, too, had no history of travel outside of the U.S.

“This shouldn’t be a surprise and there are likely more cases than the three we’re talking about,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security who specializes in infectious diseases and pandemic preparedness.

He added that it was more reason to follow public-health guidance, such as wearing masks and social distancing.

“It adds more urgency to the fact if you couple the discovery of the strain with a really lagging vaccination program,” he said in a phone interview.

 

Slow vaccine rollout

By the end of the year, officials with Operation Warp Speed had hoped 20 million people would receive their first dose of the vaccine. But just 2.79 million people have received their first shot of 12.4 million distributed doses, according to data from the Centers for Disease Control and Prevention.

In long-term care facilities, just 167,149 people have received vaccines of a total of 2.17 million distributed doses, according to the CDC. Retail pharmacies, such as CVS and Walgreens, have been tasked with going into nursing homes and assisted living facilities to distribute the vaccine.

CVS said it expects to vaccinate 4 million residents and Walgreens expects to vaccinate 3 million residents through the program, which began last week. Some facilities, such as Grace Manor Care Center, near Colorado’s border with Kansas, won’t receive their first doses until January 9.

“The individuals who are responsible for the vaccinations right now need more federal support. You need to be able to get our state and local health departments to be able to have the bandwidth to do this,” Adalja said. “These are the same people who have been tasked with responding to increasing numbers of cases, including at the hospital level.”

California is still in the process of vaccinating healthcare workers, as well as paramedics, and workers and residents at long-term care facilities. The state has allocated 1.76 million doses of the vaccine so far.

Colorado has also prioritized healthcare workers and long-term care facilities in its first round of vaccinations. It has administered more than 84,000 doses so far, Gov. Jared Polis said on Thursday.

But this is still the easy part, Adalja said. And healthcare workers that aren’t affiliated with a hospital, such as community mental health workers or private practice physicians, are facing challenges in getting their shot.

“It’s going to be a lot harder when you go to phase 1B, and you’re starting to vaccinate front-line essential workers that are not healthcare workers as well as people who are high risk in the community,” he said. “It’s just much more complicated logistically when you’re talking about a vaccine — suppose you’re using the Pfizer vaccine — that you can’t keep it close to patients because it has such cold storage needs. The Moderna vaccine makes it easier to do that.

“In general, we need to figure out how is this going to happen. Is it going to be drug stores, is it going to be doctor’s offices, are there going to be mass vaccination sites at high schools or stadiums?” Adalja added. “That kind of thing we need to start thinking about because there are a lot of people who need to be vaccinated.”

With the discovery of the new strain, Polis said he had asked the Centers for Medicare and Medicaid Services for permission to pause visits in nursing homes so residents could be vaccinated quickly.

Separately, the state also decided to make the vaccine available to people ages 70 and up in its next round of doses, through local hospitals or community health clinics.

Polis said he expects this process to take four to five weeks, based on projections for how many vaccines Colorado will get in the future. That could be subject to delays, or happen faster, depending on what takes place at the federal level, he said.