After Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said it could become the United States’ dominant variant sometime this summer, the delta variant of the new coronavirus has been getting increased attention.
When it comes to tracking the spread of SARS-CoV-2 variants, Washington is better equipped than most states, with greater capacity to identify variants through genotyping. The state runs genotype tests on 17% of cases, with the goal of increasing to 100%, said acting state health officer Dr. Scott Lindquist.
We’ve been getting a lot of questions about what the delta variant’s emergence nationally means for Washington. We delve into that question and others for this week’s FAQ Friday.
In a previous FAQ Friday, we explained the World Health Organization’s new nomenclature for variants and what constitutes a variant, which describes a number of mutations that occur within a virus. The accumulation of mutations doesn’t always make the virus more dangerous, but it can make it more transmissible and more lethal.
Which variant is dominating in Washington?
It isn’t delta, first identified in India. The most prevalent variant in Washington is alpha, which received significant media coverage in 2020 and into early 2021 after first being identified in the United Kingdom.
The CDC’s COVID Data Tracker shows that as of June 5, the alpha variant accounted for 60% of positive results sequenced, down from 69.5% the previous two-week reporting period ending May 22. During those same periods, cases linked to the delta variant increased from 2.8% to 9.5%; those linked to gamma grew from 8.7% to 11.2%.
While the rest of the country is experiencing a rapid increase of cases involving the delta variant, the dominant variant in Washington is alpha, Lindquist said during this week’s state Department of Health press briefing.
“What we are seeing now is this alpha variant is slowly being outcompeted by two main variants,” Lindquist said. “One of them is indeed the delta variant. But more important … is the gamma variant.”
Alpha still accounts for almost half of identified variants in the state, but according to DOH’s latest sequencing and variants report, instances of the delta variant increased from 4.7% in the previous report to 9% of variants identified. Gamma, which first emerged in Brazil, makes up 24% of variants, an increase from 13.9% in the previous report.
King County’s variant numbers are in line with the state’s. According to Public Health – Seattle & King County, as of Wednesday, alpha is the variant most widely circulating, accounting for 62% of all variants of concern (VOCs), followed by gamma at 12%. Delta registered at nearly 4% of variants sequenced.
Why is gamma growing here?
Lindquist likened the competition among variants to a battle in a Roman coliseum.
“The best way to think about this is it’s like a gladiators’ game out there. Right now these viruses are competing for people that are unvaccinated, essentially,” he said. Variants are more transmissible if they have spike protein substitutions, he said. Both delta and gamma have these.
Why is gamma doing better here? That isn’t clear yet, Lindquist said.
“The rest of the country is looking at delta but I’m raising the flag about the gamma variant here in Washington state,” he said.
Are delta and gamma more dangerous than other variants?
The gamma variant has local public health officials worried. That’s a contrast with some Mountain West and many Southern states, where the delta variant — which is more transmissible compared to alpha by as much as 60% — is driving up cases and putting pressure on hospitals.
“While everyone is concerned that delta is going to have more deaths and hospitalizations, we are just not seeing that here in Washington, we are seeing more breakthrough cases proportionately, and hospitalizations with the gamma variant,” Lindquist said.
Any surge driven by variants is going to bifurcate the pandemic. Regions with high vaccination rates will have fewer infections and fewer restrictions, while those lagging behind in vaccinations will bear the brunt of the surge.
“I think a rise in cases is certainly going to happen,” William Hanage, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health, told The Washington Post. The question “is how large a rise and how consequential it’s going to be.”
“Those under-vaccinated communities are more likely to be severely” affected, he said.
Could emerging variants force a reopening rollback or return to remote learning in the fall?
Dr. Umair Shah, the state secretary of health, doesn’t think this is likely, but he wouldn’t rule it out when asked during DOH’s briefing.
“This pandemic has taught that you don’t let your guard down. And you don’t say absolutely never, because you just don’t know,” he said.
People should continue to wear masks, especially those younger than 12 and not yet eligible for a COVID-19 vaccine or who otherwise can’t be vaccinated, Lindquist said.
“There’s one strategy that still works very effectively against any of these variants. And that’s mask-wearing,” he said. “So this will play into any recommendations for continued mask requirements into the school system as we go back into the next year.”
We can expect variants that are more transmissible and cause more severe illness to emerge, and the best defense is to get vaccinated, Dr. Jeff Duchin, Public Health – Seattle & King County’s health officer, said in an email.
“It’s an important reminder that COVID-19 is not over and we need to continue to be prepared and use a range of COVID-19 prevention measures, of which vaccination currently is the most important,” he said.