Dr. Ashish K. Jha, dean of the Brown University School of Public Health and a leading expert on infectious diseases, is warning that progress against the pandemic might be faltering as worrisome coronavirus variants take hold.
“Over past week, number of infections in U.S. has stopped declining,” Jha, whose threads on the pandemic have taken on the status of required reading among public health observers, tweeted Wednesday night. “At about 50K infections every day. About where we were at height of summer surge. Why the stall?”
He cited the B.1.1.7. variant, which first emerged in Britain, as a possible factor.
“Suspect B.1.1.7 is now starting to really have an effect,” Jha wrote. “And states are opening up. This is a problem.”
Over past week, number of infections in U.S. has stopped declining— Ashish K. Jha, MD, MPH (@ashishkjha) March 18, 2021
At about 50K infections every day
About where we were at height of summer surge
Why the stall?
Suspect B.1.1.7 is now starting to really have an effect
And states are opening up
This is a problem
Nicholas Reich, a professor at the University of Massachusetts whose lab creates a pandemic ensemble model in collaboration with the US Centers for Disease Control and Prevention, sounded a similar note. “For the first time in a while, I am actively concerned about the new trends, and perhaps more concerned that this isn’t getting the attention that I think it deserves,” he said.
It increasingly seems, he said in an e-mail, that plateauing cases “aren’t just data aberrations but rather the variant actually taking hold and starting to do in some parts of the US what it’s already done in much of Europe.” He noted that, in some states, plateaus have turned into increases, pointing to Michigan and New Jersey as examples.
He tweeted Wednesday that the case and hospitalization trends in Michigan were “not good,” saying his lab’s forecast saw the uptick continuing for at least two weeks.
In Massachusetts, the seven-day average of cases reported peaked in the first half of January, then dropped precipitously until the last week in February. Since then, it has hit a plateau, ticking up and down, with a slight uptick in the past week or so. The levels remain higher than the lows reached last summer.
“There is only limited data available on the prevalence of the variants, but the data that is available seems to suggest that in many places, one or more variants are on the cusp of out-competing the predominant strains,” Reich said in the e-mail. “This is a concerning trend. To me it suggests that these next 4-6 weeks are a very critical phase for staying very vigilant, and not letting our guard down while we continue to get shots into arms.”
“Yes, we should be worried,” he said.
Dr. Eric Topol, a professor of molecular medicine at the Scripps Research Institute in San Diego, suggested in tweets on Wednesday that Minnesota and Georgia were two other states to watch.
Some upticks to watch in states where B.1.1.7 -> dominant cause of infections— Eric Topol (@EricTopol) March 18, 2021
The other question is whether we'll see rise in cases but without proportional increase in hospitalizations and deaths due to building immunity, especially >65% vaccination in age ≥ 65 pic.twitter.com/WmTSRuCavL
Dr. Thomas Frieden, a former director of the US Centers for Disease Control and Prevention, said Thursday in a tweet he was worried about a fourth surge in the United States. (For Massachusetts, it would be the third surge since the state kept the virus under control last summer.)
I look at cases increasing in Europe with high levels of masking and closed restaurants, and I worry.— Dr. Tom Frieden (@DrTomFrieden) March 18, 2021
Worry variants will drive a 4th surge here.
Worry more dangerous variants may emerge with more uncontrolled spread.
Worry we won't have patience needed to keep the upper hand.
Public health officials at the national level have been warning about variants because of concerns that they may spread faster, cause more severe disease, not be responsive to treatments or vaccines, or have a combination of those attributes. The B.1.1.7 variant is believed to spread more easily and quickly, and some studies have suggested it causes more severe disease, the CDC says.
Dr. Anthony Fauci, President Biden’s lead medical adviser on the pandemic, warned Wednesday that the variants continue to threaten progress made in reducing cases and immunizing the population. “While we are cautiously optimistic about the future, we know that many challenges remain,” Fauci said in prepared remarks ahead of a congressional hearing on Wednesday. CDC Director Rochelle Walensky said in her remarks, “An increase in viral transmission could reverse the progress we’ve made.”
Jha said in his tweets that a month ago every US state had seen declining cases, but now, 15 have more cases than they did two weeks ago, and 19 states have posted higher positivity rates over the same period.
Even hospitalizations, Jha said, are creeping back up in spots.
“Not a surprise B.1.1.7 -- probably represents about 40% of infections in US today,” Jha tweeted. “Means about 20,000 infections identified today were likely from B.1.1.7. It will become the dominant variant in next couple of weeks. So what’s the problem?”
He suggested the public look across the pond to Europe for insights on what the variant could do here.
As the variant became dominant in European nations, Jha continued, they tended to “see large spikes in cases, hospitalizations, and deaths So are we in big trouble?”
Not necessarily, Jha tweeted.
He said the US has two options for avoiding a similar fate: continue to vaccinate people “and fast,” and maintain pandemic-related restrictions for a few more weeks.
“We are doing the first, not the second,” Jha tweeted. “Every high risk person should be able to get a vaccine by mid to late April. That’s so close. Every infection that kills someone today is a person who would get vaccinated in the [next] few weeks. So we have to keep public health restrictions in place for a tiny bit longer.”
That means, Jha said, maintaining indoor mask requirements, not yet returning to full restaurants and bars, and not cutting back on testing.
“And it definitely adds an urgency to vaccinate every high risk person -- older folks, those with chronic diseases, as quickly as possible,” Jha tweeted.
The bottom line, Jha said, is that the nation remains at a high level of infection.
“Am I sure we’ll see cases rise? No, but worried,” Jha tweeted. “Lets finish vaccinating high risk folks. Then smartly relax public health measures. That will allow us to enjoy what should be a great summer.”
Massachusetts Governor Charlie Baker told the Globe Wednesday in a wide-ranging interview that with the state on the cusp of fully immunizing 1 million people and federal officials projecting a big boost in vaccine supplies, he’s increasingly confident he can meet his goal of vaccinating more than 4 million adults by July 4th.
“We ran a pretty decent [vaccination] program so far, despite the bumps along the way,” Baker said. “We’ll continue to work as aggressively as we can to get as many people vaccinated as soon as we can between now . . . and the summer.”
Ryan Huddle of the Globe staff contributed to this report. Material from prior Globe stories and Globe wire services was used.
Travis Andersen can be reached at email@example.com. Martin Finucane can be reached at firstname.lastname@example.org.