COVID-19 variant found in UK spreads 'like wildfire.' British experts fear what will happen if US won't lock down

LONDON – On Jan. 4, British Prime Minister Boris Johnson made yet another somber coronavirus-related address to the nation: A variant first identified in Kent, England, was thought to be 50%-70% more infectious. In little more than a week, hospital admissions had increased by nearly a third. Deaths had risen by 20%. Johnson ordered the country's third full lockdown since the start of the pandemic.

"That means," Johnson said, "the government is once again instructing you to stay at home. You may only leave home for limited reasons permitted in law, such as to shop for essentials, to work if you absolutely cannot work from home, to exercise, to seek medical assistance such as getting a COVID test or to escape domestic abuse."

Monday, amid a dramatic drop in coronavirus infections, Britain's leader will unveil his plan for unwinding one of the world's strictest COVID-19 lockdowns. Only Cuba has tougher restrictions in place, according to an index of government measures compiled by Our World in Data, a research unit attached to Oxford University. 

The COVID-19 Government Stringency Index looks at nine different national coronavirus response indicators, including school and workplace closures, travel bans and limits on public and family gatherings. Thomas Hale, one of the researchers behind the index, said it conceals some local and regional variations – particularly in places such as the USA, where city, state and federal authorities rely on a patchwork of coronavirus measures – but overall, it is instructive.

Out of a possible score of 100, Britain hit 86.11 on the index Feb. 18.

The U.S. figure was 68.06.

In Cuba, where even road access to the Caribbean nation's capital, Havana, is restricted, the number is 90.74. 

'Like wildfire': B.1.1.7 may soon dominate across the US 

American public health officials will watch what Johnson says closely, not least because the Centers for Disease Control and Prevention (CDC) said that as early as the end of next month, B.1.1.7, the more transmissible coronavirus variant originally identified in Britain in September, is likely to be the dominant one circulating within U.S. borders. 

The USA has seen peaks and declines of COVID-19 cases since the first infections were reported in North America in January 2020, but there are concerns that the B.1.1.7 variation is among a number of different variants that could help  precipitate a so-called fourth wave of American coronavirus infections. 

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Trevor Bedford, an epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle, said in a Twitter thread Thursday that a steady decline in U.S. coronavirus cases that has brought levels back to where they were in late October could be threatened by the "rapid take-off of B.1.1.7." He said there is evidence that the B.1.1.7 variant "will reach 50% frequency in the U.S. perhaps by late March."

In the USA, there were 1,523  cases of B.1.1.7 reported across 42 states as of Feb. 18, according to CDC data. To put that in perspective, though new coronavirus infections in the USA have been falling broadly for about a month, the daily new case count for February still averages about 95,000, according to a USA TODAY analysis of Johns Hopkins University data. In February, U.S. coronavirus deaths have averaged about 2,520 per day.

In Britain, new daily coronavirus case counts have hovered around 12,000 for the past week. Christina Pagel, who leads a team of researchers at University College London who apply mathematics to problems in health care, said the B.1.1.7 variant makes up about 90% of new cases in Britain.

Variants also emerged from Brazil, South Africa and California. Researchers said the United States is almost certainly undercounting cases of the B.1.1.7 variant. The case count has more than quadrupled since Jan. 27.

"It (B.1.1.7) spreads so easily, like wildfire. It's really caught us by surprise," Carl Waldmann, the director of an intensive care unit at a hospital in Reading in southeast England, told German state broadcaster Deutsche Welle. 

'We are sinking'

As the more contagious variant tore through Britain in January, the government warned that hospitals were on the verge of being overwhelmed. There was a steady stream of pleas from doctors, nurses and other health care workers for the public to abide by Johnson's lockdown. 

"It’s brutal, and we are sinking," said Sarah Addis, an emergency room doctor at a hospital in York in northern England on Jan. 8. "Quite simply, we are being overrun. And we are starting to see younger and sicker COVID patients."

On Jan. 20, about 1,820 people died in Britain from coronavirus, the largest number of fatalities reported in a single day since the pandemic began – and almost double the peak from a wave of infections in April, according to Public Health England.

Amid the soaring death toll, British hospitals canceled all elective surgeries. Appointments for cancer diagnoses were halted. Health care staffers were redeployed to coronavirus intensive care units even though they lacked specialized training. Ambulances full of coronavirus patients queued up outside hospitals waiting for beds.

Johnson is likely to announce a phased return for some schools starting March 8. It's not clear if rules around gatherings, nonessential retail and hospitality will be relaxed. He clamped down on international travel, adding mandatory hotel quarantine for travelers arriving from some countries.

Britain has administered more vaccines per 100 people than any other advanced economy except for Israel, according to Our World in Data. There is little data to show how well the vaccines affect new U.K. infections. 

'We can't control this thing with half-measures'

Simon Clarke, a professor in cellular microbiology at the University of Reading, said there is an emerging body of evidence suggesting that the B.1.1.7 variant is not only more contagious but also more lethal, a possibility initially raised by British scientists. He said there is anecdotal evidence from hospitals, not confirmed by studies, that the B.1.1.7 variant could harm more younger people. He cautioned it was too early to drawn firm conclusions. 

He expressed concern about how the United States would deal with B.1.1.7 if, as expected, it becomes entrenched as the dominant variant by the spring. 

"U.S. coronavirus waves have been based on slower-moving variants," Clarke said. 

"If a faster-moving one such as B.1.1.7 starts to take off, then you are going to have yourself a problem if you're not prepared to do a strict, broad-based national lockdown," Clarke said, noting that the United States doesn't seem willing to do this. 

Unlike Britain's nationwide orders, not all U.S. states have restrictions on travel for leisure, many states offer exemptions that allow restaurants to stay open and many have resisted calls for entertainment venues, gyms and personal care businesses such as hair salons and tattoo parlors to be closed. It is largely up to local officials to decide whether and how to impose U.S. coronavirus restrictions. 

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Other countries in Europe that have not imposed lockdowns as strict as Britain's have struggled to keep rising cases of the B.1.1.7 variant in check. 

"If you want to get B.1.1.7 under control, lockdowns just have to be that much tougher," said Kit Yates, a professor of mathematical biology at the University of Bath, England. 

Yates said he believes that when schools in Britain reopen, coronavirus cases are likely to rise again despite new evidence that the B.1.1.7 variant's transmissibility may not be as high as originally thought. It may be closer to 30% to 40%, he said, more contagious than that of the more commonly found variants in the USA. 

Pagel, the University College London researcher, said Britain's latest lockdown has reduced new cases of coronavirus by about 60%. "That's the good news," she said. "The bad news is that we can't control this thing with half-measures."

She said that if the United States can't or won't order a national lockdown similar to Britain's to deal with the B.1.1.7  variant, its best hope may be to "vaccinate its way out."

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Pagel cautioned that if the variant first detected in Britain is allowed to circulate too freely in the USA, it could lead to an even more aggressive variation that could evade vaccines or better target younger people.

She said that  cases of an older variant could fall  rapidly enough that it might look like everything was OK even while a new variant spread.

"Effectively, you have two epidemics going on at the same time where one is shrinking, and one is growing," she said. "That's exactly what happened in the U.K. and seems likely for the U.S."

Contributing: Chloe Laversuch, The York Press; Mike Stucka, USA TODAY