Written by Matt Apuzzo, Selam Gebrekidan and Apoorva Mandavilli
Doctors and nurses at a South African hospital group noticed an odd spike in the number of COVID-19 patients in their wards in late October. The government had slackened its lockdown grip, and springtime had brought more parties. But the numbers were growing too quickly to easily explain, prompting a distressing question.
“Is this a different strain?” one hospital official asked in a group email in early November, raising the possibility that the virus had developed a dangerous mutation.
That question touched off a high-stakes genetic investigation that began here in Durban on the Indian Ocean, tipped off researchers in Britain and is now taking place around the world. Scientists have discovered worrisome new variants of the virus, leading to border closures, quarantines and lockdowns, and dousing some of the enthusiasm that arrived with the vaccines.
Britain has been particularly overwhelmed. Infections and hospitalizations have skyrocketed in recent weeks since that country discovered its own variant of the virus, which is more contagious than previous forms. By one estimate, the mutated virus is already responsible for more than 60% of new infections in London and surrounding areas.
The coronavirus has evolved as it made its way across the world, as any virus is expected to do. But experts have been startled by the pace at which significant new variants have emerged, adding new urgency to the race between the world’s best defenses — vaccinations, lockdowns and social distancing — and an aggressive, ever-changing foe.
The new variant pummeling Britain has already been found in about 45 countries, from Singapore to Oman to Jamaica, but many countries are effectively flying blind, with little sense of how bad the problem may be.
Long before the pandemic emerged, public health officials were calling for routine genetic surveillance of outbreaks. But despite years of warnings, many countries — including the United States — are conducting only a fraction of the genomic studies needed to determine how prevalent mutations of the virus are.
Denmark, which has invested in genetic surveillance, discovered the variant afflicting Britain in multiple Danish regions and recently tightened restrictions. The health minister compared it to a storm surge, predicting that it would dominate other variants by mid-February.
And as countries go looking, they are discovering other variants, too.
With the world stumbling in its vaccination rollout and the number of cases steeply rising to peaks that exceed those seen last spring, scientists see a pressing need to immunize as many people as possible before the virus evolves enough to render the vaccines impotent.
“It’s a race against time,” said Marion Koopmans, a Dutch virologist and a member of a World Health Organization working group on coronavirus adaptations.
The vaccine alone will not be enough to get ahead of the virus. It will take years to inoculate enough people to limit its evolution. In the meantime, social distancing, mask-wearing and hand-washing — coupled with aggressive testing, tracking and tracing — might buy some time and avert devastating spikes in hospitalizations and deaths along the way. These strategies could still turn the tide against the virus, experts said.
“We do know how to dial down the transmission of the virus by a lot with our behavior,” said Carl Bergstrom, an evolutionary biologist at the University of Washington in Seattle. “We’ve got a lot of agency there.”
Yet in the course of the pandemic, governments have often proved reluctant or unable to galvanize support for those basic defenses. Many countries have all but given up on tracking and tracing. Mask-wearing remains politically charged in the United States, despite clear evidence of its efficacy. Cities like Los Angeles have been gripped by a spike in cases linked to Christmas festivities, and national public health officials are bracing for surges elsewhere, driven by people who ignored advice and traveled during the holidays.
Much remains unknown about the new variants or even how many are sprouting worldwide. Scientists are racing to sequence enough of the virus to know, but only a handful of countries have the wherewithal or commitment to do so.
The variants’ rapid spread is a reminder of the earlier failings and missteps of major countries in containing the virus. Just as China failed to stop travelers from spreading the virus before the Lunar New Year last year, Britain has failed to move fast enough ahead of the new variant’s spread. Britain lowered its guard during the holidays, despite a rise in cases now known to be linked to a variant. And just as China became a pariah early on, Britain now has the unfortunate distinction of being called Plague Island.
The spread of the variant lashing Britain has left some countries vulnerable at a time when they seemed on the brink of scientific salvation. A case in point: Israel. The country, which had launched a remarkably successful vaccine rollout, tightened its lockdown Friday after having discovered cases of the variant. About 8,000 new infections a day have been detected in recent days, and the rate of spread in ultra-Orthodox communities has increased drastically.