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Home US ‘Everything Seems So Tenuous’: Variants Threaten N.Y.C.’s Progress on Virus

‘Everything Seems So Tenuous’: Variants Threaten N.Y.C.’s Progress on Virus

Since the peak of the holiday surge in early January, New York City has seen a steep decline in the number of people testing positive for the coronavirus each day, as have the state and the nation.

But the drop has not been as dramatic as it has been nationally, and community transmission in the city remains high, with about 3,200 probable and confirmed new cases reported daily. As more contagious variants spread, the city’s positive test rate has only dropped slowly, to over 7.1 percent this week from 8 percent two weeks ago, according to city data.

“Everything seems so tenuous and fragile in many ways,” said Dr. Wafaa El-Sadr, an epidemiologist at Columbia University’s Mailman School of Public Health. “While overall there is a decrease, it is moving incredibly slow, in some ways slower than the decrease that has been noted in the rest of the country.”

Two studies that were published online this week — but have yet to be peer reviewed — said that a new variant in New York City, first detected in samples collected in November, was beginning to spread. This variant, called B.1.526, shared similar characteristics to variants found in South Africa and Brazil that have been shown to weaken the effectiveness of vaccines.

At this point it’s unclear what the new variant means in the long-term, since officials don’t know yet the real-world impact it will have.

“Right now, we need to just consider this a variant of interest — something that’s interesting, that we need to follow and track,” Dr. Jay Varma, a senior adviser to the mayor’s office, said at a Thursday news conference. “But it doesn’t change anything about our public health concern.”

The existence of variants may require people who have been fully vaccinated to receive a third booster shot by the end of the year. But most importantly, it underscores the need to get more people vaccinated as soon as possible.

As of Wednesday, officials were publicly tracking only the more contagious B.1.1.7 variant — first discovered in Britain — which they said made up about 6.2 percent of cases in the second week of February.

That variant was first detected in New York in early January, and has been spreading. Between Jan. 11 and Jan. 31, it was detected in 2.7 percent of the cases sequenced in New York City, according to data released weekly by the city. In the first week of February, that number shot up to 7 percent.

But the two studies published online this week, by researchers at Caltech and Columbia University, suggest more variants have been spreading in the city. Aside from the discovery of the new variant, these researchers found a case of the variant that first emerged in South Africa and two cases of the variant originating in Brazil that had not yet been publicly reported by the city or state.

City officials said that this new research had not been shared with the city before its release.

Nationwide, researchers have mostly focused on the variant first discovered in Britain, because it is spreading widely. One study found that B.1.1.7 cases are doubling about every 10 days. The Centers for Disease Control and Prevention has predicted that the B.1.1.7 variant, which is estimated to be 35 to 45 percent more transmissible, could become the dominant source of infection across the country in March.

One encouraging sign about the rollout is that there has been a steeper drop in the positive test rate among New Yorkers over 75 than in New Yorkers as a whole, likely because of vaccinations. Also, emergency room admissions for people over 65 have stabilized and are falling gradually.

Epidemiologists say that these numbers underscore the importance of targeting vaccinations to those most likely to be hospitalized and die from the virus, particularly as the variant first detected in Britain becomes more common in the city.

As of Tuesday, the city had partially or fully vaccinated about 1 million people, in a major milestone for the rollout. Of those, about half a million people had received both of their shots.

But the vaccine rollout has been uneven across racial groups, with those hit hardest by the virus being vaccinated at lower rates. Though nearly one-quarter of New Yorkers identify as Black, for example, Black people have received only 12 percent of the vaccinations, according to city statistics.

In addition, about a quarter of the people who have been fully vaccinated in New York City do not live in the city, but outside it, according to the data. It is unknown how many qualified because they work in the city or were vaccinated at state sites, and how many broke the rules.

The pace of vaccination in recent days has also been slower than the city would like, as shortages in supply were compounded by delivery delays caused by bad weather. In the past week, the city has administered about 30,000 vaccines a day, down from a peak of 60,000 doses per day the prior week.

New York state ranks toward the bottom in terms of the percentage of people in a state who have received at least one shot, according to a New York Times vaccine tracker.

As the number of cases and positivity rate have trended downward to pre-holiday levels, Gov. Andrew M. Cuomo has reopened a spigot of activity: indoor dining in New York City, major sports stadiums and arenas with a capacity of 10,000 or more people, movie theaters in the city and wedding venues, all at reduced capacities and with other safety measures in place.

Mr. Cuomo said he did not want to keep things closed just because the variants were here.

“On a daily basis we are looking at the data and calibrating this,” said Gareth Rhodes, a member of Mr. Cuomo’s coronavirus state task force. “You have to be very, very careful, but also recognize that you cannot keep the economy indefinitely closed.”

But experts are concerned. They note that with the arrival of the variants, keeping community transmission at bay is more important than ever.

“It does not make epidemiologic sense to me,” said Dr. Denis Nash, an epidemiologist at the City University of New York. “I see how it makes economic sense, on the one hand. In the short term, it will help the bottom line of restaurant workers and employ people. But it also puts employees at risk, and it is at cross purposes with the larger goal, which is to get the vaccine into as many arms as possible before the virus gets them.”

Dr. El-Sadr added: “I don’t think now is the time to reopen more. I think it is time to hunker down and focus on the expansion of vaccination.”

Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, argued in a new paper that vaccinations needed to be sped up and more targeted to people over 65 who are at highest risk of death as the variant that originated in Britain takes hold.

The race, disease experts argue, is now between the variants and the vaccine, and the surest way to win is to tamp down transmission as much as possible while vaccinating as quickly as possible.

“A major peak in cases, hospitalizations, and deaths in the near future remains a strong possibility,” the paper states.

Joseph Goldstein contributed reporting.

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