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The COVID-19 variants that have emerged in the United Kingdom, Brazil, South Africa, and now Southern California are receiving two particularly different responses from U.S. public health officials.
First, widespread concern. Variations that have caused damage in the UK, leading to a spike in cases and hospitals, are appearing in a growing number of places in the US. This week, another worrying variation seen in Brazil came in Minnesota. If these or other sequences change dramatically as the virus spreads and attacks the body, as scientists fear they could, they could cause another major increase in the illness and death in the US, even as things have started to go on and vaccines are being dispensed.
On the other hand, there are no novel or even uncommon changes in viral diseases. The viruses that promote common cold and flower grow regularly. Even if a mutated strain of SARS-CoV-2, the virus that causes COVID, makes it more contagious or makes people sicker, the basic public health response remains the same: Keep an eye on it virus, and any mutations, as it spreads across communities. Use masking, testing, body speed, and quarantine to keep the spread.
The problem is that the U.S. has struggled with every step of its public health response in its first year of battle against COVID-19. And that raises the question of whether the country will provide the attention and resources it needs to spread the virus as it grows.
Researchers quickly confirm that a coronavirus mutation in itself is not a cause for warning. In making millions and billions of copies as part of the infectious process, small changes in the virus genome occur all the time as a function of evolutionary biology.
“The word‘ variant ’and the word‘ mutation ’have those scary words, and they’re not scary at all,” said Kelly Wroblewski, director of infectious disease programs for the Association of Public Health Laboratories.
When a mutation hits public health warnings, this is usually because it has merged with other mutations and, together, changed the way the virus behaves. At that point, it may be a variable. A variety of viruses can spread faster, or jump more easily between species. It can make a virus more successful in making people sicker, or altering how our immune systems respond.
SARS-CoV-2 has been suppressed as far as we know; mutations were identified by scientists through 2020. While they are scientifically relevant – mutations can be helpful, acting as fingerprints that allow scientists to track the spread of a virus – there were usually few concern at the designated lines for public health.
Then came the end of the year, when a number of changes began to be investigated. One of the most worrying, first discovered in the UK, appears to be making the virus more susceptible. Emerging evidence suggests it could be more lethal, although scientists are still debating that.
We know more about the UK’s diversity than others not because it’s much worse, but because the British have one of the best virus screening programs in the world, said William Hanage, epidemiologist and senior professor at Harvard University.
In contrast, any country’s richest country has one of the weakest genomic analysis programs, Hanage said. “As it is, people like me chew partnerships with places and try to persuade them” for samples, he said on a recent call with reporters.
Other different varieties have been identified in South Africa and Brazil, and share some solstices with the UK variety. These changes have independently changed in several parts of the world to reflect the evolutionary benefit of the virus. Another strain was recently identified in Southern California and was noted because of its growing popularity in tough cities like Los Angeles.
The Southern California strain was discovered because a team of researchers at Cedars-Sinai, a hospital and research center in Los Angeles, has unequal access to patient samples. They were able to see that the strain made up an ever-growing department of cases at the hospital a few weeks ago, as well as among the limited number of other samples collected hard at a network of laboratories in the area.
Not only is the U.S. doing less genomic classification than most rich countries, but it is also monitoring its occurrence. That means it will take longer to find new series and make decisions about them. It is not yet clear, for example, whether that Southern California strain really deserved a press release.
Many American private and decentralized healthcare systems are not set up to send samples to public health or an academic laboratory. “I am more concerned about the systems for detecting variables than I am with these specific variables,” said Mark Pandori, director of the Nevada public health laboratory and associate professor at the University of Nevada-Reno School of Medicine.
Another side effect is limited genomic analysis of undeveloped and underfunded public health system viruses that struggle to test, monitor connections, and control COVID throughout the entire disease. -discharged, Wroblewski said.
In the country’s public health infrastructure, usually funded by disease, rational systems are in place to control flu, foodborne illnesses, and consumption, but not a national strategy on COVID. “To look for change, it has to be a national picture if it’s going to be done well,” Wroblewski said.
Last week, the Biden administration outlined a strategy for a national response to COVID, which included extended sensitivity to change.
So far, vaccines for COVID appear to protect against the known variables. Moderna has said its vaccine is effective against the UK and South African strains, although it produces fewer antibodies against the latter. The company is working to develop a revised dose of the vaccine that could be added to the standard two-dose regimen as a warning.
But much damage can be done in the time it takes to roll out the routine vaccine, not to mention an update.
Even with limited sampling, the UK variant has been found in more than two dozen U.S. states, and the Centers for Disease Control and Prevention has warned that it could be the biggest strain in the UK. USA by March. When it started in the UK at the end of last year, it caused inflammation in cases, got over hospitals, and led to holiday closures. Whether or not the U.S. opposes the same race may depend on what types they compete against, and how the public behaves in the coming weeks.
Dangerous human interactions can, on average, pose some risk. Many researchers want better masks and better indoor ventilation. But any update to proposals would seem to play at the margins. Even if variables spread more easily, the only suggestions public health experts have been raising for months – humiliation, physical pace and limiting indoor time with others – are best way to keep them away, said Dr. Kirsten Bibbins-Domingo, a physician and professor at the University of California-San Francisco.
“It’s pretty unsexy what the solutions are,” Bibbins-Domingo said. “But we all have to do them.”
That doesn’t make the task simple. Masking remains controversial in many states, and public tolerance for maintaining a physical pace is a thin topic.
Adding to the concerns: While case numbers have stabilized in much of the U.S. in recent weeks, they have settled at rates many times higher than they were at previous times in the pandemic or in the pandemic. other parts of the world. Getting that virus in so many bodies will create more opportunities for new mutations and changes to appear.
“If we keep letting this thing slip around, it goes around every step we take against it, which is the worst thing possible,” Pandori told Nevada.
Compared to less robust strains, a more contagious variation is likely to require more people to be vaccinated before a community can see the broad benefits of immunity. It is a grim prospect for a nation that is already late in the vaccination race enough people to bring the pandemic under control.
“When your best solution is to ask people to do the things they don’t like anyway, that’s awful,” Bibbins-Domingo said.
This story was produced by KHN, which publishes California Healthline, an independent editorial service from the California Health Care Foundation.