Last Wednesday, as California Governor Gavin Newsom gave one of his regular Covid-19 updates, he expressed surprise at “something not a lot of folks are paying attention to.” That “something” is the growth of the so-called West Coast variant of Covid-19.
Newsom and his surrogates have, to their credit, regularly given updates on the growth of the variant. Deadline reported that CA Health and Human Services Director Dr. Mark Ghaly reported in early February that the state had discovered 1,000 instances of the West Coast variant, which is actually two similar variants referred to as B.1.427/B.1.429 or CAL2.0C.
The following week, Newsom reported the number of B.1.427/B.1.429 cases identified had risen 20% to 1,200. Last week, when he expressed surprise at the lack of coverage, the governor noted a further 50% jump to 1,834 cases. But those numbers were just a fraction of the actual numbers. Genomic testing is required to identify new variants from samples, and it is expensive.
At the beginning of January, the state had administered over 30 million Covid-19 tests. Of those tens of millions, only about 7,000 had been analyzed genomically, according to the San Jose Mercury News. Los Angeles County, for its part, is only genomically analyzing a few dozen test specimens each day.
According to Dr. Charles Chiu, a virologist and professor of laboratory medicine at UCSF, who authored a new study analyzed by the Los Angeles Times, CAL2.0C has surged to account for more than half the cases in the state and could be the source of 90% of the state’s cases by the end of March.
What’s worse, Dr. Chiu told the New York Times on Tuesday infections from the variant produce a viral load double that of other variants. CAL2.0C also seems more wily at evading the immune system. As a result, said Chiu, cases caused by the variant are doubling each 18 days.
While the more contagious UK variant of the virus is also spreading in the state, it seems to be doing so more slowly. But the two variants could merge.
The U.K. and California variants are each armed with enhanced capabilities, and the likelihood that they could circulate in the same population raises the specter of a return to spiking infections and deaths, Chiu said. It also opens the door to a “nightmare scenario”: That the two viruses will meet in a single person, swap their mutations, and create an even more dangerous strain of the SARS-CoV-2 virus.
Eric Vail, the director of molecular pathology at Cedars-Sinai, told The New York Times in early February that CAL.20C may have played a part in the surge in cases that overwhelmed Southern California’s hospitals earlier this month. “I’m decently confident that this is a more infectious strain of the virus,” said Dr. Vail.
“At least 50% of our samples have shown the West Coast variant,” said LA County Director of Public health Barbara Ferrer last week, before hedging that “more research needs to be done.”
That research may confirm what one small sample seems to indicate: The West Coast variant may not only be more transmissible, but more virulent.
Dr. Chiu studied the medical history of 324 people hospitalized at UCSF and found that those infected with CAL2.0C were more likely to have been admitted to the ICU and 11 times more likely to die.
That is, again, a very small sample and requires more research. But if nothing else, the indications from Chiu’s research call for vastly increased geonmic testing of Covid-19 sames and increased caution as the state proceeds to reopen.