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Covid-19 cases and hospitalizations fell 77% and 44% over the past month, respectively, LA County health officials said on Monday. This is great news for the hardest hit region of the country. The question remains, however, whether new variants of the virus will create another wave.
Los Angeles County Director of Public Health Barbara Ferrer said Monday that “we will report later today that we now have 5 cases associated with the UK variant.” It’s not a lot, but the amount of genomic testing in the county to identify new variants is extremely low compared to the number of Covid tests delivered.
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“It is impossible that we do not have [that] variant circulating here, ”Ferrer said. The UK mutant strain is believed to be 30-50% more transmissible. The UK variant doubles its prevalence among identified cases every 9-10 days, according to a new report.
As for the South African variant, also more transmissible and possibly also vaccine resistant, “Let’s assume it’s here,” Ferrer said. Then she dropped the real bomb.
“At least 50% of our samples showed the West Coast variant,” Ferrer said, before covering that “more research needs to be done.”
Last week, California’s top health official revealed that more than 1,000 cases of the West Coast variant have been discovered in the state. California Governor Gavin Newsom said Monday that number had risen to 1,200. That’s a 20% increase in less than a week.
Such increases could make the effort to vaccinate Los Angeles residents even more critical. The region has dramatically stepped up its immunization infrastructure in recent weeks, but a bottleneck in vaccine supply is hampering the effort.
Newsom revealed on Monday that 1.2 million doses of the vaccine are expected to arrive in the state this week. But only 540,000 of them will be first doses. “We need to see more doses entering the state to keep these sites operational,” Newsom said.
Ferrer said the situation in Los Angeles was even more desperate. For the remainder of this week, at county vaccination sites, she said, “All we can offer is second dose appointments.” In a county of 10 million people with new variants in circulation, that’s a problem.
Nicknamed variously B.1.429 and B.1.427, the West Coast Variant or sometimes referred to as CAL.20C, the new strains are still a mystery.
Dr Charles Chiu, virologist and professor of laboratory medicine at UCSF who, together with state authorities, genetically sequenced test samples to identify new variants, said the first indications are CAL .20C may be less sensitive to currently approved vaccines, but further investigation is needed.
“This variant carries three mutations, including L452R, in the spike protein, which the virus uses to bind and enter cells, and is the target of the two vaccines currently available in the United States,” said Dr. Chiu. A spike protein mutation could then interfere with the effectiveness of the vaccine. Given the importance of this spike protein, L452R is another name sometimes used for West Coast variants.
When asked about vaccine resistance, Ghaly was more circumspect, saying, “He doesn’t know exactly what its exact role is in making people sicker or its impact on things like vaccines.”
West Coast variants have also been detected in Los Angeles, Mono, Monterey, Orange, Riverside, San Francisco, San Bernardino, San Diego, San Luis Obispo, Humboldt, and Lake counties. Since genomic sequencing is rare, it is currently unclear exactly what the prevalence of L452 is statewide, nationally, or globally.
Dr Chiu said L452R has grown from around 3.8% of the samples it tested from late November 2020 to early December to over 25.2% from late December to early January 2021.
Eric Vail, director of molecular pathology at Cedars-Sinai, said The New York Times that CAL.20C may have played a role in the spike in cases that overwhelmed Southern California hospitals earlier this month. “I have no doubts that this is a more contagious strain of the virus,” said Dr. Vail.
Scientists are concerned about L452R because it may help coronaviruses adhere to and infect human cells more easily.
Dr Vail and other state researchers say the L452 mutations they found were still alongside four other specific mutations. This invariable arrangement was a strong sign of a single line “native” to California.
Cedars researchers discovered CAL.20C in July. As far as limited genetic testing was able to detect, the variant did not reappear in Southern California until October. At the time, this did not seem to be widespread.
As of December, however, 36% of virus samples from Cedars-Sinai patients were identified as CAL2.0C. The variant also accounted for nearly a quarter of all samples from Southern California. But again, the number of samples tested is tiny next to the total number of daily Covid tests.
By early January, the state had administered more than 30 million Covid-19 tests. Of those tens of millions, only about 7,000 had been genomically analyzed, according to the San Jose Mercury News. It must be said that the nation as a whole is terribly behind in such analyzes. But California – and Los Angeles in particular – is the global epicenter of the pandemic. The need here is more acute. But these tests are expensive.
Los Angeles County only genomically analyzes a few dozen samples per day, so it’s hard to know. That’s on an average of 81,000 tests per day. (Health officials say they are flagging the most suspicious samples for genomic examination, which appears to increase the likelihood of finding mutations.)
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