New variant, new restrictions?

BOSTON — It came as less of a surprise than a surrender to the inevitable. Sunday, the Massachusetts Department of Public Health announced detection of the state’s first case of the so-called British COVID-19 variant, known scientifically as B.1.1.7.

The infected individual, a Boston woman in her 20s, traveled to the United Kingdom and fell ill the day after getting back.

B.1.1.7 has now been detected in 14 states, according to the Centers for Disease Control and Prevention -- but a new study found in the agency’s publication Morbidity and Mortality Weekly Report (MMWR) suggests it won’t be long before the variant will be found in many more places.

“Emergence of SARS-CoV-2 B.1.1.7 Lineage - United States, December 29, 2020-January 12, 2021,” predicts the strain will become predominant in the United States in March.

“There’s now a higher risk that someone could get COVID-19,” said Richard Ellison, MD, hospital epidemiologist at UMass Memorial Medical Center in Worcester. “This variant does seem to be more contagious and I think we need to take even extra cautions.”

The British variant was first discovered in the UK last September. It is notable -- as are several other variants -- for a mutation on the spike protein portion of the virus. Specifically, a switch of amino acids at position 501 from asparagine to tyrosine. Shorthand, this mutation is known as N501Y.

“You never know when a virus mutates what we are hitting up against,” said Sowmya Viswanathan, MD, MBA, Chief Medical Officer for St. Vincent Hospital and Metrowest Medical Center. “Sometimes they are more sinister, more deadly than the previous mutation. Sometimes it’s just like what this time around has happened. It’s more contagious.”

While not intrinsically more deadly, more contagious variants can lead to more deaths, simply because more people get sick.

“It’s going to spread so easily that we all have to be on guard and on our toes for a much longer period of time,” Viswanathan said. “Because this variant is going to continue to spread. It’s just going to jump from one group to another, one community to another, one state to another more easily than before.”

The state is advising that with the British variant now in circulation the ‘public health risk reduction measures remain the same.’

That is largely true, but Ellison said the contagiousness of B.1.1.7 merits tightening some self-protection measures.

“You have to figure that before if you had to be with someone for 15 minutes you may only need to be with someone for 4 or 5 minutes now to be at high risk of getting this infection,” Ellison said.

Avoiding crowds and non-household gatherings will become increasingly important from this point forward, Ellison said -- as well as wearing a mask that actually offers protection.

“We do know that these very simple single layers of cloth that someone can sort of pull up -- they do not appear to be adequate,” he said. “You want to wear something which is at least equivalent to a standard hospital procedure mask -- a surgical mask. The blue mask you see us doctors and nurses wearing in the hospital.”

Ellison said he sees no reason to go to heavier N-95 masks at this time.

In some respects, the British variant could not be hitting at a less opportune time. COVID-19 fatigue set in many months ago. And the arrival of effective vaccines has taken some of the urgency out of self-protection.

That would be a mistake, said Dr. Viswanathan.

“When the vaccine came out, and the vaccine rollout was starting to happen, people felt they could sigh with relief that the vaccine is going to give them that little bit of freedom,” she said. “The problem is with the more infective or contagious or transmissible type of variant, we have to continue to exercise all precautions and probably be even more stringent.”

And it may be that way for many months.

“We’re going to actually need to have more than 70 percent of the population vaccinated to have protection,” Ellison said. “How much more than 70 percent is not clear. Whether we’ll need to go to 80 or 90 percent to really stop it, we’ll have to find out.”

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New variant, new restrictions?

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