Everyone Needs to Pay Attention to the British COVID Mutation.
If the claims are true and it spreads, this pandemic is about to get a whole lot worse.
Yesterday, U.K. Prime Minister Boris Johnson announced that a new strain of COVID-19 had emerged in the country late September which “might be as much as 70% more transmissible.” Today, the U.K. Health Minister called the new strain “out of control.”
This new strain has accounted for more than 60% of new cases in the past week in London (which are up 40% week-over-week), and “20% of viruses sequenced in Norfolk, 10% in Essex, and 3% in Suffolk.”
There is a lot we still do not know about this new strain and the data is still early and subject to review. Therefore, it is possible the new strain is not actually 70% more transmissible. And for context, the U.K. (and in particular England) recently relaxed their COVID restrictions.
However, given the rapid increase of this strain’s share of COVID cases in London and South East England, I believe it is highly unlikely that this new strain is not, to some substantial degree, more transmissible. And early analysis from NERVTAG — the British new virus advisory group — indicates as much.
Hopefully, scientists will be soon be able to determine the true threat of this new strain. But if true — if this new mutation of COVID-19 is 70% more transmissible — then the pandemic’s home-stretch will be a lot worse.
70% Higher R0 = Disaster
The most obvious way in which a higher transmission rate would make the pandemic worse is by increasing the number of total cases which would thereby increase the total number of deaths.
Death by Transmission Alone
Using a Susceptible, Exposed, Infected and Resistant Model created during the early months of the pandemic by Gabriel Goh and others —designed to determine the effectiveness of lockdown durations — we can get a crude estimation of what a 70% increase of the R0 for COVID-19 mean.
Note: The model was used because it was the only interactive one I could find and was useful enough for illustrative purposes.
(Full disclosure: I am not an epidemiologist, virologist, public health expert, or master statistician. The following numbers and the analysis in this article should be taken as a rough estimation — an illustration. However, I have read a dozens of journal articles, government and intergovernmental reports and playbooks, and a few books on public health crises and SARS-COV-2. I also wrote my master’s thesis proposal on COVID-19 pandemic.)
A 70% increase in the base assumption of the model’s R0 (the number of people who will be infected from a single infected person) from 2.5 to 4.25 would increase the total number of projected deaths by 70%.
If this British strain of COVID-19 were the original one, then the United States would’ve reached 549,782 deaths yesterday instead of 323,401.
When Hospitals Break
The real concern is not the increase of total cases, however. The real concern is the damage this new strain would cause if the health care system were to collapse due to the increased number and rate of new cases.
And the if is more like a when should the new strain spread to a country. This is particularly the case for the United States, given I.C.U. beds across the country are already reaching capacity while cases continue to grow.
A 5% Death Rate
We know that as hospital capacity increases, the death rate of COVID-19 increases. (Although this trend has been offset by introduction of new therapeutics and better care techniques during the past few months of the pandemic.)
The increase in lethality is most drastic when the hospital system collapses. We saw this in Italy, Sweden, Spain, and Iran. In comparison to a current global average 2.2% case-fatality-ratio (CFR), these countries witnessed a CFR of 14.5%, 14.3%, 12.2%, and 7.8% respectively (12.2% average).
Given that a) 20% of COVID-cases are asymptomatic, b) in the initial months of the pandemic only symptomatic people got tested, c) therapeutics have gotten better, and d) hospitals will not always be past capacity, let us consider a COVID death rate of 4.88% if hospitals reach capacity — or 40% of the average.
(This number is to some degree subjective and might well be on the low-side, but it was chosen to account for the issues with early data, testing, care and therapeutics.)
Using the same model as before, a 4.88% death ratio with a 70% increase in R0 would mean an 8.25X increase in deaths (10.736M deaths vs 1.3M deaths in the model).
If Nate Silver is right and the United States will have an additional 460,000 deaths over the next six months, then should this new strain spread and takeover within the U.S. that additional number would soar to 3,800,000 deaths.
If you were to half the new strain’s death toll, there would still be +1.4 million deaths over the next sixth months over the current strains of COVID-19.
What’s Comes Next
All of this, of course, assumes that the new strain of the coronavirus will spread outside of the United Kingdom and that is 70% more transmissible. Currently there is no evidence the strain has spread to the United States, but we know it reached the Netherlands in early December, it is now in Australia and Denmark, a growing number of European countries have banned all flights from the Britain, and a similar strain has independently emerged in South Africa. And we know that this new strain spreads fast once it arrives: In only a month and a half, it managed to account for 60% of new weekly COVID cases in London. In South Africa, it accounts for 90% of sequenced viruses.
At the same time, experts seem relatively confident that the current vaccines for COVID-19 will work on the new strain.
In the United States, Dr. Anthony Fauci says the United States might be able to reach herd immunity through vaccination by the end of summer 2021. According to the editor of the Lancet, global herd immunity will take 2–3 years.
We can only hope the news from Britain is wrong, that my analysis is somehow super wrong, or that — somehow — the new strain stays confined to a select few, unfortunate countries. Otherwise, much stricter restrictions will need to be implemented to limit as much of the new strain’s destruction as possible.
If not, President-elect Biden’s “darkest winter” will be paradise in comparison to what’s to come.