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The increase in coronavirus variants will determine the next phase of the pandemic in the United States

The bottom line of all three remains positive. In laboratory tests, vaccines are just as effective against the variant identified in the United Kingdom as against the original strain of the virus. And there is only a moderate decline in their effectiveness against the other two.

“These variants came about because we continued to give the virus a better chance of spreading,” said David D. Ho, whose lab at Columbia University is leading the study of variant P. 1, first discovered in Brazil. “The sooner we all vaccinate, the sooner we will limit the spread of the virus and reduce the chance of new variants appearing.”

But the overall picture is problematic in some places. One or more of the variants – which also cause more severe disease than the original version of the virus – raced through the Northeast and Midwest. This has led officials in some communities to ask for more vaccines than they would receive under a population-based government formula. Officials in the Northwest are witnessing a major outbreak of variant P. 1 in British Columbia.

“We need more vaccines here, on the nose, now,” said Bruce G. Murphy, health director in Yarmouth, Massachusetts, Cape Cod, which has 82 active cases in its population of just over 23,000.

Mass vaccination centers in the Boston area are not very helpful to Yarmouth residents, especially the elderly who cannot travel, Murphy said.

“If we see 13 [cases]”It could just be the tip of the iceberg coming,” he said.

Michigan also requested another vaccine to control an astonishing jump, during which its average daily volume of coronavirus increased from 1,503 on March 7 to 7,020 on Wednesday, according to CDC data analyzed by The Washington Post.

Asked if the administration would ever change its strategy, Andy Slavitt, a senior adviser to the White House coronavirus response team, said Wednesday that the government was now able to move vaccine supplies from other parts of the state to more affected areas. .

“We get the amount of vaccines that we consider necessary for the population, because that’s fundamental,” Slavit said. “And then we work in a lot of tactical areas. . . how to increase this spread of vaccines so that we get the things we want: efficiency, health equity and the other goals we have. “

In addition to these three options, the CDC is considering two “options of concern” in California and is monitoring them closely. He also observed a variant found in New York.

As most of the rest of the world lags far behind immunizations, the virus will continue to spread and mutate, each copy with the potential to cause variation that current vaccines will not be able to control. The chances of this remain low, experts say, but they are not zero.

“I’m afraid there will be a terrible option that will come out and bring us back to the first place,” Ho said.

But experts say vaccines could be strengthened and new ones developed to address all emerging options.

As of April 6, there were 16,275 cases of B.1.1.7, 386 of B. 1,351, first detected in South Africa, and 356 of P. 1 in the United States. Experts believe that the actual number is much higher, but as US efforts to sequence the virus’s genomes are lagging behind, it is difficult to see how widespread the variants are.

“The landscape is this big explosion in the UK, the alarming outbreak in P. 1, and then other strains,” said Daniel Jones, vice president of molecular pathology at Wexner Medical Center, Ohio State University. Within a few weeks, he said, there would be enough infections in the United States to gather better data on the human immune response instead of through laboratory tests.

Laboratory tests usually involve looking at one mutation at a time; circulating options can have many, said Stephen Kisler, an immunology expert at Harvard School of Public Health TH Chan.

And “the human immune system is much more complex than we can imitate in a Petri dish, so we can only get partial information,” he said.

It is estimated to be up to 2.2 times more contagious and 61 percent more contagious than the original form of the virus in more than 24 states and 25 U.S. states. In other words, it produces a greater viral load, which probably makes people worse.

Some experts question whether competing options have slowed its spread. For example, Northern California is dominated by cases B.1.427 / B.1.429, while Southern California has a higher share than B.1.1.7.

“We see different variants in different parts of the country competing to conquer populations,” said Benjamin Pinsky, medical director of the Stanford Clinical Virology Laboratory.

For now, B.1.1.7 seems dominant. According to the latest figures from Helix, a company that works with CDC to track variants, B.1.1.7 includes about 50 percent of all sequenced cases in the United States.

“My feeling is that if you’ve been in the boxing ring with all the options, the UK option will have won in terms of transmission,” said Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco.

The P. 1 type immune response will be better than the South African variant, but probably not as good as the British variant, Ho said.

The options found in California look potentially better than the others. Several states with outbreaks of B.1.1.7 have reported unusual outbreaks among school-age children that are spreading in their communities, but this is not the case with the options in California.

“We have reduced hospitalizations very low” in areas where B.1.427 / B.1.429 is becoming dominant, Chin-Hong said. “You would expect to see more cases among children and spring breakers, but we haven’t seen that. He suggests that he does not mark his territories, making younger people sicker. “

In Canada, public health officials are struggling with the biggest jump in the P. 1 option outside Brazil. As of Tuesday, there were more than 787 cases in British Columbia and a small but growing number in the neighboring province of Alberta. This makes young skiers in the Whistler Blackcomb resort and workers in an energy company ill. Twenty-one players and four employees of the Vancouver Canucks hockey team were infected with a variant of the virus, although the team did not determine who.

Alberta’s chief medical officer, Diena Hinshaw, tweeted Monday that her team was investigating a P. 1 outbreak linked to a “big employer” that began with a passenger returning from a trip outside the countryside. She said there was a separate outbreak in the workplace in different parts of the state.

Hinshaw said the province had identified 887 new cases in the previous 24 hours and that 39 percent of active cases were already options.

In Connecticut, the option, first discovered in the United Kingdom, has helped 20- to 29-year-olds have the highest incidence rate of any age group in the state. Whether this reflects the properties of the variant, the calm precautions among young people or the vaccinations that protect the elderly – or some combination of the three – is not clear.

Another variant, originally discovered in India, makes headlines in California this week as a “double mutant” because it features features from variants first discovered in California and Brazil / South Africa.

Described by Indian researchers on March 24, it was first identified in the United States on March 25 in a patient in the San Francisco Bay Area.

Pinski said “it is too early to say how this option will work. We know how these individual mutations change the virus, but we have not been able to see how they behave in combination. “

Brazil, which is now fully in control of option P. 1, shows how quickly it can take control when not taken seriously. In the Amazon rainforest, it quickly devastated the city that spawned it, then invaded the south. It soon became widespread throughout the country – and its attack on Brazil, now in the midst of a national medical failure, has been relentless ever since.

Nearly 67,000 Brazilians died of covid-19, a disease caused by the virus, in March, more than twice every other month during the pandemic. The highest death toll – 4,195 – was registered on Tuesday. Scientists have not proven that the option is more deadly. But doctors and health officials in Brazil say it is a signal of a darker and deadlier phase of the pandemic.

The level of vaccination in Brazil lags far behind that in the United States.

Patients arrive much sicker – and much younger.

“The P. 1 option across the country is clearly contributing to the increase,” Sylvain Aldigieri, a senior official at the Pan American Health Organization, told reporters last week. “We also receive signals and reports in various states that young people are hospitalized in greater numbers.”

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