If you’re not following the COVID news out of Brazil and are under the impression that cases must be down there since they’re down everywhere, let me shatter your illusion. Not only are things bad, they’re worse than they’ve ever been:
Six days ago Brazil recorded 1,840 deaths in a single day, its worst of the pandemic. Its seven-day daily average of deaths stands at 1,540, also its worst since COVID arrived. Why are cases exploding there when they’re receding in most of the rest of the world? Reporters have been wrestling with that question lately but one prime suspect is the rise of the P.1 variant inside the country, which has proved itself capable of reinfecting people who have already contracted and recovered from common COVID. P.1 has already reached the U.S. too: A case of it was detected recently in Oregon. Needless to say, a strain capable of overcoming natural immunity is a severe threat to herd immunity, potentially putting the U.S. back at square one in defeating COVID until a vaccine can be developed and distributed that’s able to defeat the Brazilian variant.
Results from a new study suggest that that vaccine already exists, though. If you’ve gotten the Pfizer shots, you should be safe.
Blood taken from people who had been given the vaccine neutralized an engineered version of the virus that contained the same mutations carried on the spike portion of the highly contagious P.1 variant first identified in Brazil, the study conducted by scientists from the companies and the University of Texas Medical Branch found.
The scientists said the neutralizing ability was roughly equivalent the vaccine’s effect on a previous less contagious version of the virus from last year.
The results when Pfizer was tested against South Africa’s variant weren’t as strong but it’s “highly likely” that the vaccine will protect against that strain too. Plus, eyeball South Africa’s epidemic curve and you’ll see a much more familiar bell shape to it, quite different from the ordeal Brazil is suffering. Is P.1 really that devastating relative to other variants?
It’s more complicated than that. Pieces in Bloomberg and WaPo this week paint a picture of total administrative chaos there, with vaccines in short supply and COVID-skeptic President Jair Bolsonaro disengaged from efforts to control the spread despite the threat from the variant. Some cities are open for business while others nearby are in total lockdown; others have been forced to try to acquire supplies of the vaccine themselves because the national government has been so inattentive to it.
Under the chaotic leadership of President Jair Bolsonaro, Latin America’s largest country long ago succumbed to denialism, disorganization, apathy, hedonism and medical quackery — and buried more than 265,000 people along the way…
Scientists across Brazil expressed deep pessimism for the coming weeks. The ICU occupation rate is at least 80 percent in most states, much higher in some. Patients are being transferred from state to state — sometimes traveling hundreds of miles — in a nationwide hunt for hospital resources. Without ventilators, nurses have pumped infected patients’ lungs manually. Cemeteries are running out of space to put the bodies. Refrigerated containers wait outside hospitals to take the overflow. People all over the country are dying at home, unable to get treatment…
There’s little national coordination. The vaccine rollout has been bogged down in delays, vaccine shortages and political infighting. It has left the country in disarray: Every city, every state, every Brazilian has taken their own direction. As things stand now, few scientists think the country will be able to stop the carnage.
To make matters worse, there’s early evidence that the Chinese vaccines being rolled out to some Brazilians are ineffective against P.1. And even if their vaccines worked, they’re not being administered quickly enough: According to the latest data, Brazil is immunizing people at a daily rate about a quarter of ours. If you’re tempted to dismiss all of that by saying, “Sucks to be them,” bear in mind that any place where the virus is spreading unchecked is a human laboratory for new, potentially vaccine-resistant variants to arise. Brazil has already gifted us with P.1. What will the next variant there look like after another million opportunities to mutate?
Like all viruses, sars-CoV-2 will continue to evolve. But McLellan believes that it has a limited number of moves available. “There’s just not a lot of space for the spike to continue to change in ways that allow it to evade antibodies but still bind to its receptor,” he said. “Substitutions that allow the virus to resist antibodies will probably also decrease its affinity for ace-2”—the receptor that the virus uses to enter cells. Recently, researchers have mapped the universe of useful mutations available to the spike’s receptor-binding area. They’ve found that most of the changes that would weaken the binding ability of our antibodies occur at just a few sites; the E484K substitution seems to be the most important. “The fact that different variants have independently hit on the same mutations suggests we’re already seeing the limits of where the virus can go,” McLellan told me. “It has a finite number of options.”
Over time, sars-CoV-2 is likely to become less lethal, not more. When people are exposed to a virus, they often develop “cross-reactive” immunity that protects them against future infection, not just for that virus, but also for related strains; with time, the virus also exhausts the mutational possibilities that might allow it to infect cells while eluding the immune system’s memory.
Amid all the talk of Brazilian variants and British variants and New York variants and the booster shots each may require, what if we don’t end up needing any boosters? What if the worst the virus can throw at us is the variants we’ve already seen and Pfizer, Moderna, and Johnson & Johnson are each already equal to the task of defeating them?
To put that another way, the challenge with the variants likely has less to do with developing a product to defeat them — we already have those, it seems — than with winning a horse race to distribute that product to people before the variants reach them. Florida recently overtook New York in terms of daily percentage of ER visits related to COVID-like illness, which may be due to the fact that the British variant is more common there than it is in other states. That’s why experts like Fauci and Walensky are wringing their hands about states reopening too early: They’re not worried that B.1.1.7, the UK strain, will overcome the vaccines, they’re worried about losing the horse race to it in March and April, before we get anywhere near to herd immunity via vaccinations.