Shelby County may not be vaccinating fast enough to stop a surge if UK strain becomes dominant
Medical and public health personnel are concerned if the UK COVID-19 variant B.1.1.7 becomes the dominant virus strain in Shelby County, cases, hospitalizations and deaths will rise quickly and the county won’t be able to stem the tide fast enough.
And while the first case of the mutated strain may have recently been detected locally, experts say the variant could have been present in the community before now and could be more prevalent than known.
Dr. Steve Threlkeld, co-chair of the infection control program at Baptist Memorial Hospital-Memphis, said “by the time we see it, you’re already behind the eight-ball.”
“There’s no way we’re going to vaccinate people fast enough to keep up with the likely spread of this variant," he said. "It is likely if it does the same thing here as it’s done in so many places around the world, it’s likely going to take over a substantial portion of the variants here."
Dr. Jon McCullers, the senior associate dean for clinical affairs within the College of Medicine at the University of Tennessee Health Science Center, said earlier this week rapid spread of B.1.1.7 could lead to another surge, just as Shelby County recovers from the last wave.
"I think it's likely that it will spread over the next 4 to 12 weeks and probably become the dominant strain in Memphis," he said. "Which will probably mean, we'll have a surge of COVID, unfortunately."
Doctors and public health experts said the new strain increased the importance of tried and true infection control measures — masking, social distancing and hand washing. It also highlights the importance of getting the vaccine distributed as quickly as possible.
“We want to ramp up vaccinations regardless of whether we have the UK strain here or not,” said Alisa Haushalter, director of the Shelby County Health Department. “But it’s not just ramping up by getting increased doses locally. We have to get those doses widely distributed.”
Mutant strain detected
Vaccine rollout in Shelby County has been rocky. Some days, vaccination sites have been so busy, people with appointments have been turned away. Other days, hundreds of vaccine appointments went unfilled. Many Shelby County residents continue to report difficulty scheduling appointments, particularly through the vaccine hotline.
As of Thursday, 67,061 total vaccine doses have been distributed in Shelby County, according to the health department.
Haushalter said she hopes COVID-19 vaccinations will eventually be like flu vaccinations, where pharmacies and doctors' offices are the main distributors, rather than the health department.
“Widening that distribution will help us scale up more quickly so we can prevent surges whether it’s the UK strain or any other variant strain,” she said.
Threlkeld said the variant increases the stakes, locally.
“If you have an effective vaccine but you’re not giving it, that doesn’t really help us,” he said.
Shelby County Health Department officials first announced on Tuesday a suspected case of the variant had been identified locally.
Although the virus was sequenced at the biocontainment lab at UTHSC, the health department has to wait for confirmation from the Centers for Disease Control and Prevention before it can officially say the specimen is the UK variant.
Nationally, the strain remains relatively rare. The CDC reported 541 cases across 33 states as of Tuesday. California and Florida host a plurality of those cases while two are confirmed in Tennessee. The South African strain B.1.351 and Brazilian strain P.1 are even rarer with three and two cases confirmed domestically, respectively.
On Wednesday, Haushalter told the Shelby County Commission the health department, in conjunction with UTHSC and local healthcare systems, was “doing what we can to contain that particular case."
"We are treating it as a variant, which means we launched a very intensive case investigation with that individual and very intensive contact tracing with that individual," she said. "We may increase some testing in the community, just really encouraging more people to get tested.”
‘More hospitalizations, and potentially more deaths’
The B.1.1.7 variant, first detected in the U.S. in December, is one of multiple COVID-19 mutations identified in the U.S. since the pandemic began, according to the CDC.
The strain is known to be more contagious than others prevalent in the U.S., and preliminary reports show it could be associated with an increased risk of severe illness and death. However, more research needs to be done before those reports can be definitively confirmed.
Even if the mutant strain is not more lethal, its rapid spread could lead to an increase in deaths. The variants can also re-infect people who already had COVID-19.
“These variants seem to spread more easily and quickly than other variants, which may lead to more cases of COVID-19. An increase in the number of cases will put more strain on health care resources, lead to more hospitalizations, and potentially more deaths,” according to the CDC.
That worries Morgan Jones, inpatient critical care clinical pharmacy specialist at Methodist University Hospital.
“The problem though is obviously the more we spread this variant, the more people may become infected. And living in Shelby County where we have a lot of at-risk patients with multiple comorbidities that will undoubtedly increase the strain on healthcare providers to care for these patients,” he said.
There were 332 people confirmed to have COVID-19 in Memphis-area hospitals as of 5 p.m. Wednesday, the most recent data available. That’s down from an all-time high of 661 on Jan. 6.
“The ability to spread this strain may result in more people being infected. The more people who are infected may potentially mean more people in the hospital,” Jones said. “We really all have to do our part right now to make sure we’re socially distancing, washing our hands, wearing a mask and, again, getting a vaccine when we’re able to.”
At this point, he said, it appears the vaccines available are still effective against the known mutant strains at preventing hospitalizations and death. However the more the virus spreads, the more chance there is that it will mutate and it’s possible a future mutation could be resistant to the available vaccines.
“This is a reminder that we’re really not out of the woods yet and this pandemic is a marathon, not a sprint,” Jones said.
Commercial Appeal reporter Laura Testino contributed to this report.
Corinne Kennedy covers economic development, soccer and COVID-19’s impact on hospitals for The Commercial Appeal. She can be reached via email at Corinne.Kennedy@CommercialAppeal.com or at 901-297-3245.