How the More Infectious South African COVID-19 Strain Will Affect Our Future

by Wei-Shin Lai, MD, Co-Founder and CEO of SleepPhones®, background in epidemiology
January 6, 2021

The new South African strain is more infectious than current strains, similar to the UK strain, though we don’t know exactly how much more infectious yet. What’s more concerning to scientists is that the vaccine may not work against it as well. The new variant (dubbed 501Y.V2) has a particular mutation that reduces the ability of antibodies produced against existing strains to neutralize the virus.

It is more infectious.

It is summer in South Africa. Despite this, they are having a huge surge in cases. According to media reports, the new variant is out-competing other variants, which means it’s more infectious. We don’t know by how much yet. The UK variant is at least 50% more infectious, which is a huge number. The South Africa variant might be a bit less infectious than the UK variant.

The current vaccines may not work as well.

Scientists posted some preliminary results from about a dozen people. Basically, they drew blood from people previously infected with various “old” strains of the coronavirus. Then they checked to see if the antibodies in the blood would be able to neutralize the types of mutations seen in the new variant. They showed that the antibodies were 10 times less effective at neutralizing the virus. Note that this is in a laboratory setting, not with the actual new virus, and not with vaccinated people. So this is extrapolated information.

The real test will have to look at blood from vaccinated people against the actual virus, which will take a few weeks. Still, the new strain is disturbing, and I estimate that the vaccine may have reduced efficacy from 95% to something like 80%. This difference means that more of us will need to be vaccinated to achieve herd immunity.

Here is the good news. Some vaccine manufacturers may be able to add this new strain pretty quickly, without having to go through all of the clinical trials again to prove safety and efficacy. The two vaccines currently approved in the US — the Pfizer and Moderna vaccines — can both accommodate quick and simple changes like this within weeks. (Distribution is another matter.) And the news vaccine will have fantastic efficacy again, likely over 90%. Because we can rapidly change the vaccine, I’m less concerned about the fact that the current vaccine may not work as well. Not enough of us will be vaccinated when these new strains exert their dominance to make vaccine evasion a primary concern.

Increased infectiousness is a huge problem for our hospitals and overall healthcare system.

How much more infectious is this new South African strain should be the more important concern. If the virus spreads more quickly, more people will be sick and require medical care. Los Angelos is currently running so low on oxygen that some hospitals can’t keep the pressure up through their oxygen pipes. Their ambulances are told to not start oxygen unless the patient’s oxygen levels are less than 90%. Most of us feel short of breath at 93% or lower. They are also not transporting people they can’t revive in the field to the hospital, since the wait time is 12 hours for the ER. The hospitals are swamped. That means people who have a heart attack or a car accident can’t get standard care either.

Hospital strain has been the real reason we do everything we do through this entire epidemic. Of course deaths are the ultimate tragedy, but the severe impacts of mass illness is what overwhelms our social fabric. A more infectious strain will further exhaust every level of our healthcare system. We cannot let things degrade to the level of rationing care. Doctors and every moral person will struggle with and suffer from having to make choices on human life. It’s an untenable predicament.

That’s why the more infectious strains in the UK and South Africa are such a big problem. England is in their third lockdown. Schools are closed. They are considering mixing and matching vaccines, delaying doses, laying out pretty much anything and everything on the table. They are desperate to curb spread.

This chart compares how quickly the virus variants spread. Our current virus on the left roughly doubles every week in an uncontrolled environment (people gathering, not wearing masks). The new UK strain variant roughly triples every week in an uncontrolled environment. It’s not even close. In two months, the caseload is 2878 compared with 98. This is the real problem with both new strains right now. More infections mean overwhelming our healthcare system.

Chart comparing a number doubling versus a number at 56% more than doubling. In eight weeks, the difference is staggering — 98 versus 2878.

Each of us can continue to do our utmost to avoid the disease or passing it on. You already know what the experts recommend. Just follow the recommendations. If you are in a position of power, use it to prevent illness.

Here at AcousticSheep™, we have revamped our office, warehouse, and procedures so that no one can be a close contact to anyone else. We have had employees go home for various reasons, and we’ve been generous with paying for downtime. No one will get sick from work. First, do no harm.

Written by Wei-Shin Lai, MD, Co-Founder and CEO of SleepPhones®, family doctor with special interest in epidemiology.