Florida emerges as US ground zero for UK variant of COVID virus

"This isn't just a Florida problem right now — it's potentially an everywhere problem"


Ben Conarck
The Miami Herald
        
Even with two vaccines and COVID cases waning from a winter peak, Florida's pandemic future has been obscured in recent weeks by the rapid spread of a new and more contagious variant of the virus.

The state has become ground zero in the U.S. for the B.1.1.7 variant of the COVID virus, or the '"U.K. variant" — one of several spin-offs that have raised alarm in the scientific community. The more infectious version of the virus, scientists worry, could accelerate severe disease and deaths before public health officials get enough people vaccinated.

The B.1.1.7 variant — which recent studies by private researchers and federal officials predict will be the predominant strain of the COVID virus in Florida by March — is establishing a foothold at a time when COVID cases and hospitalizations are trending down across the state from a  peak in early January.

Scientists worry that the more infectious version of the virus could accelerate severe disease and deaths before public health officials get enough people vaccinated.
Scientists worry that the more infectious version of the virus could accelerate severe disease and deaths before public health officials get enough people vaccinated. (Photo/Miranda Cyr, Las Cruces Sun-News)

Since then, cases have come down about 50% from an average of about 16,000 per day. The number of people being treated for COVID in Florida hospitals has declined by about 30%, from a mid-January peak of about 7,770.

COVID variant introduced to Florida late last year

It's still eerily unclear what happens next, public health experts interviewed by the Miami Herald agreed.

But the acceleration of the variant — which was likely introduced to Florida late last year and could already account for about 15% of cases — has emerged as a decisive factor in that equation.

The diminishing surge of the COVID virus in Florida and the U.S. at large mirrors the seasonal patterns of other coronaviruses, said Michael Mina, an infectious disease expert at Harvard University's T.H. Chan School of Public Health.

That seasonal effect, combined with large pockets of immunity in the population from earlier outbreaks, are the most likely factors  in explaining why cases and hospitalizations have begun to fall across the country all at once, Mina said.

But "the writing is on the wall" for the B1.1.7 variant overtaking other strains of the virus in Florida and the U.S., Mina added, as it has already done in several other countries.

"I think B.1.1.7 is the wild card here," Mina said. "As it starts to take off, is it as a strain going to have a different seasonal pattern?"

That takeoff is already well underway, according to researchers who are tracking the variant in Florida. In fact, it's following the same pattern first observed in southern England, where the variant was discovered.

Florida leads nation in 'U.K. variant' cases

Florida has the most confirmed cases of the variant in the country by far, with 343, up from 201 earlier this week. But the true number of variant cases is undoubtedly far greater. Researchers are only examining a small fraction of the cases because genomic  sequencing, or the process of examining a virus for mutations, is expensive and time-consuming.

"The most recent estimates that we have suggest that it is somewhere between 10-15 percent of new cases in Florida now," said William Lee, vice president of science at Helix, a testing company that has helped health officials track the variant. "That's up from like half a percent in the beginning of January. ...That's a big increase."

Lee is the co-author of a not-yet-peer-reviewed study measuring the variant's growth in the U.S. that found Florida has become the epicenter of the B.1.1.7 strain.

His team estimates the variant is 35% to 45% more transmissible than the original COVID virus and appears to double every week or so.

'A dozen different factors'

It's still unclear whether the variant will be supercharged enough to spike COVID cases and hospitalizations as it takes over South Florida.

What has become increasingly clear, scientists say, is that the fate of Florida's epidemic has grown intertwined with the variant as it establishes itself in the region that has largely continued to function as the beating heart of Florida's tourist economy since the fall.

There is mounting evidence that the B.1.1.7 variant of the COVID virus is much more contagious than the original strain, but it seems unlikely to affect the potency of vaccines, scientists have said.

Mary Jo Trepka, an epidemiologist at Florida International University, stressed that while cases and hospitalizations are certainly falling, they are still high — descending from a large winter peak that appeared to be fueled by tourism and holiday gatherings beginning around Thanksgiving.

It's also become more apparent that large pockets of South Florida have developed immunity to the virus, Trepka said, likely blunting the force of the last surge. She estimated that as much as 40% of the county could have already been infected, which would be about four times the number of documented cases, in line with estimates from federal health officials at the U.S. Centers for Disease Control and Prevention.

That is well below the level of population immunity needed to halt the virus, scientists agree, though it may be enough to slow it down.

"What you end up with is a dozen different factors and no way to predict what's going to happen," Trepka said. "But I think the message is the same: We have to get people vaccinated and we have to stick to the physical distancing and the masks and so forth."

Another complicating factor raised by Trepka is that the seasonal patterns of viruses play out slightly differently in Florida compared to elsewhere in the U.S.

For example, flu season typically extends longer in Florida, Trepka said, though most respiratory illnesses peak in January. She added that a big part of seasonal patterns is how often people gather inside, which happens more often in the summer than the winter in Florida.

"[Florida's pattern] doesn't follow the country quite as well," Trepka said. "We're almost the reverse."
Nonetheless, public health experts agreed on one thing: that the B.1.17 variant is almost certain to become the predominant U.S. strain of the COVID virus within about a month.

Will Florida become a hub for variant spread in the U.S.?

One explanation for the falling cases coinciding with the emergence of the new variant in Florida is that we're simply not yet seeing its effects. Florida health officials first announced the discovery of the variant on New Year's Day, and it has since accelerated to make up an unknown but ever-increasing proportion of cases here.

Robert Bednarczyk, a public health expert and assistant professor at Emory University's Rollins School of Public Health, said there is certainly a lag between when the variant starts spreading and when it starts to drive new infections.

"My biggest concern is that if there's a sense of complacency or a sense of success in seeing case numbers falling after the holiday peaks we experienced, that's a perfect opportunity for this new variant to really take hold and cause a lot of spread and transmission," Bednarczyk said. "That's what I worry about: a perfect storm."

Even if existing population immunity in Florida dampens the effect of the new variant, Bednarczyk said the state's position in the U.S. as a tourism hub is especially concerning, given the potential for Florida tourists to spread mutated versions of the virus that were incubating here to other parts of the country as they return home from their vacations.

"This isn't just a Florida problem right now — it's potentially an everywhere problem," Bednarczyk said. "Just because we may not be seeing those increases in Florida, it does open up the possibility for some of those increases nationally as well."

Lee, the researcher who tracked the spread of the new variant, said that his team is expecting just that. Tourism patterns, and the recent Super Bowl, have placed Florida squarely on the radar of scientists watching the variant.

"The question is, two weeks from now, if we look and we see B.1.1.7 everywhere, does the genetic information suggest that it radiated from Florida?" Lee said. "We won't know that quickly ... but it is a distinct concern, and I think it's highly likely to happen that way."

Read more: COVID-19 variants: What first responders need to know

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