As the pandemic continues to worsen around the world, scientists are grappling to better understand spin-off versions of the COVID-19 virus — and one of the latest strains poses a particular threat to South Florida.
The little-understood “P1” strain of the COVID-19 virus, known as the Brazilian variant, contains two of the mutations that have researchers worried: one that is thought to increase the infectiousness of the virus — with mounting evidence coming from the U.K. to support the conclusion — and one that is thought to aid the virus in escaping a potential target’s immune system, which would have implications for vaccines.
“It could be a double whammy,” said Dr. David Andrews, a pathologist who helps run the Jackson Health System’s laboratory at Miami-Dade’s public hospital.
Andrews is leading the charge locally to collect samples of the virus from patients at Jackson who test positive and search for signs of the mutations known to be circulating in Brazil, the U.K, and South Africa. State and federal health officials also say they are monitoring for mutated versions of the virus, though the Florida Department of Health has shared little information about its efforts and did not respond to several requests for comment.
The variant was first discovered in the U.S. on Monday after Minnesota health officials traced it to a recent traveler from Brazil. Two direct flights arrive daily at Miami International Airport, serving a large Brazilian community. The consulate estimates that as many as 400,000 Brazilians live in Florida, traveling back and forth between Miami and Fort Lauderdale and major cities like Sao Paulo and Rio de Janeiro.
Felipe Naveca, a researcher at the Oswaldo Cruz Foundation, a major public health institute in Brazil, sequenced the genome of the new strain earlier this month and is now tracking the spread of the new variant spread in Manaus, a city of 2 million people in the Amazon rainforest. The P1 strain is now the most prevalent variant in the city, responsible for more than 80% of cases.
“We observed that this variant has more mutations than other new strains, and a higher transmissibility may be one factor that led to the sharp increase in case numbers here in Manaus,” he said.
The emergence of the variant is concerning for several reasons, said Bill Hanage, an infectious disease expert at the Harvard T.H. Chan School of Public Health.
“It is common in Manaus, which is experiencing a surge that has severely compromised healthcare,” Hanage said. “This has happened despite Manaus having already been severely affected in the early stages of the pandemic, with estimates that as many as 75% of the population could have already been infected by October of last year.”
The high estimates of infection rates led some researchers to believe that the city had achieved herd immunity. By November, the start of the rainy season and the Amazonian winter, Manaus residents let down their guard and resumed life as usual, giving the virus free rein, Naveca said.
“This variant is the consequence of the freedom that we gave the virus to evolve,” he said.
Manaus’ health system collapsed earlier this month as hospitals struggled to tend to patients after a surge in infections after the holidays. Oxygen supplies ran out and the local government admitted it didn’t plan for the magnitude of the disaster.
There’s concern that the Brazilian strain will spread to other large metropolitan areas that are only now starting to see cases go down. And the country’s patchy vaccine rollout won’t likely be enough to immunize people to stay ahead of the new variant.
Brazil kicked off its vaccination program last week, but political infighting and President Jair Bolsonaro’s slow response left the nation of 200 million people with less than six million doses on hand and no real plan on how to obtain more doses soon.
Bolsonaro, who downplayed the seriousness of the virus and spent his time promoting miracle cures based on Chloroquine and Ivermectin, drugs used to treat lice and other parasites, has criticized the COVID-19 vaccines, saying there is no scientific proof that they work. He consistently rejected calls for national mask mandates and mocked governors and mayors who implemented lockdowns. Last month the Brazilian president waned supporters at a rally that the Pfizer-BioNTech vaccine could turn people into alligators or Super-Man.
Given travel patterns to South Florida, and the potential that the Brazilian variant could be more infectious and also more easily evade the immune system, Andrews said that if there were to be a sudden surge in cases, it would raise the possibility that the strain is spreading locally.
Andrews said the biggest source of uncertainty around the new strain would be how it responds to people who have been vaccinated for the old strain.
The Brazilian strain contains the same mutation as a South African variant that was studied by vaccine manufacturer Moderna, which concluded that its vaccine would still be effective, though perhaps less potent.
“Clearly the Brazilian strain is a concern,” he said. “And look, we live in Miami, for goodness sake.”
Brazilians in South Florida and those in Brazil with ties to the U.S. worry that the new variant will complicate their lives even more. President Joe Biden reinstated a ban on travel for non-citizens from Brazil shortly after taking office, and said Monday a team of health experts will decide when it is lifted.
“What I’m worried about is what if this new variant is very serious and creates total chaos here in the US? Will President Biden ever lift the ban?” said Liz Gonçalves, a Brazilian who is studying to be a financial adviser in Miami. “I want my family to be allowed to come visit me.”
“What I’m worried about is, what if this new variant is very serious and creates total chaos here in the U.S.? Will President Biden ever lift the ban?” said Liz Gonçalves, a Brazilian who is studying to be a financial adviser in Miami. “I want my family to be allowed to come visit me.”
Like many places in the U.S., the Florida Department of Health has done relatively little to track the variants, though they have still turned up plenty of examples of the strain from the U.K. There are now 92 known cases of that version of the virus documented in Florida, which leads the country.
The strain appears to have begun spreading outside Brazil in mid-January, when it was found in Japan. Four Brazilians arriving from Manaus tested positive for the variant. British officials quickly suspended travel to Latin America and Portugal to reduce ties with Brazil as much as possible.
Mutations are to be expected during outbreaks. The more a virus circulates, the more opportunities it has to mutate and adapt to different circumstances, said Marco Salemi, a University of Florida professor and molecular biologist.
“That doesn’t mean the mutant strains will be necessarily more deadly or more contagious, but it’s important to monitor what is happening with these mutations,” he said.
It’s also important to be prepared for spikes in case numbers if the Brazilian strain starts to circulate in Florida.
Dr. Tanira Ferreira, a chief medical officer at the University of Miami Health System, said hospitals and staff are prepared to handle infections caused by new strains. But she warned that the new strain is yet another reminder that the three weapons to fight the virus -- face coverings, social distancing and hand washing -- are more important than ever.
“We are constantly preparing for new challenges of how to deal with this virus,” she said. “We already expected mutations so it doesn’t change our strategy.”