Taking variants seriously

Each one should be treated as if it is a new virus

Welcome to Plugging the Gap (my email newsletter about Covid-19 and its economics). In case you don’t know me, I’m an economist and professor at the University of Toronto. I have written lots of books including, most recently, on Covid-19. You can follow me on Twitter (@joshgans) or subscribe to this email newsletter here. (I am also part of the CDL Rapid Screening Consortium. The views expressed here are my own and should not be taken as representing organisations I work for.)

Variants. We knew that if we let the pandemic run rampant, this would provide a breeding ground for viral mutants. Moreover, those mutants are only successful if they outcompete other variants as well as Classic Covid, which, until recently, had “market share” advantages.

The variants have basic reproduction numbers that are about double last year’s coronavirus. What is more, in competition amongst them, the variants that will be successful will not only be those that are able to bind to cells more effectively but also ones that will be able to get into people in the environments we have created — that is, environments of social distancing and mask-wearing. Thusfar, it appears that B.1.1.7 or the UK/Kent variant, is more effective in spreading indoors. That is why it runs through workplaces where there are essential workers and more easily travels with them home. It was responsible for the Christmas outbreaks in the UK and is responsible for the outbreaks now in Canada.

By contrast, P1 (the Brazil variant) is taken hold in Brazil, Mexico and Sweden. From the NYT:

While B.1.351 (the South African variant) has been confined to Southern Africa and appears to be brought under control there.

The worrying new variant is B.1.617 which is now dominant in India.

Here’s my concern about these variants that are arising in certain places: they are all spreading in places where there is warmer weather and where, for various reasons, there is a more ventilated set of environments compared to our more sealed work and living environments in the west. Indeed, while those variants have appeared elsewhere, they have not gained traction. Here are the recent Ontario numbers:

Those variants have not, thusfar, been able to compete successfully in Canada. The question is whether that will change when things become warmer. This is what I worry about.

Treating variants as new viruses

While we monitor variants, we do, to a certain extent, treat them as “same old same old.” We do the same measures to combat them.

But what if we changed the frame? What if we believed that a new variant was a completely new viral threat — albeit one we know lots more about, have the ability to test for quickly and have vaccines that potentially work against. In other words, they are a new threat but we are armed.

In that case, we would immediately want to put a ring around them. The UK should have been isolated when the variant started spreading. Same with Brazil, South Africa and India — or in each case, certain regions. We would then direct testing and vaccine resources to those areas with a view to wiping the variants out. In other words, while we can no longer eradicate SARS-CoV-2, we still have an opportunity to eradicate variants that appear to be successful.

While we have more tools to fight new variants, what we face is an information problem on steroids. This is because it is hard to distinguish the variant at the heart of a Covid case or outbreak. We need rapid genomic testing to do that. The UK actually had that so that opportunity to use that information was a big missed one for the world. We have that now in Canada. But we need to move that testing to where the variants are being seeded.

This is particularly so when it comes to variants that may evade vaccines.

My point is that we cannot let our guard down on the information challenge right now. It is more critical than ever. We need international resources and some teeth to get those resources to where they are needed.