UK variant of COVID is overtaking Florida. Can vaccines stymie it or is surge coming?

The more-infectious “U.K. variant” continues to out-compete other strains of the COVID virus in Florida, causing about 15% to 20% of infections, according to estimates from one major private diagnostic and research lab, leading the rest of the country by far in confirmed and estimated cases.

The variant has so far matched the rate in other countries where it had caused an explosion in cases, such as England and Ireland. But the strain is facing a tougher fight as it cements its foothold in Florida, where nearly half of the state’s residents 65 and older have received at least one dose of a COVID vaccine and nearly a third of the population may have already been infected by the virus, according to estimates.

Researchers and scientists interviewed by the Miami Herald said the U.K. variant remains poised to spike infections and prolong vaccination efforts, but expressed some optimism that large swaths of Florida protected from natural or vaccine-induced immunity could blunt the impact of the more-contagious strain.

“There is a general sense that Florida is going to be the canary in the coal mine,” said William Lee, vice president of science at Helix, a testing company that has helped state officials track the variant.

Concerns that COVID cases could rise in Florida

COVID cases and hospitalizations have declined steadily in Florida, but there is still significant concern that cases could start to flatten, then rise again in the coming weeks. Lee said that would be a “warning sign” for other parts of the country where the U.K. variant was still growing exponentially.

But there’s also the possibility that the variant could cause a rise in cases without a coinciding rise in hospitalizations and deaths if enough of the people most at risk for developing severe outcomes have already been vaccinated or infected.

“If it turns out that Florida is fine even with an increase in cases resulting from [the U.K. variant] because of the vaccines and everything else, I think it will be a good sign for the rest of the country,” Lee said.

COVID cases declining among Florida seniors

Especially encouraging is that COVID cases are declining rapidly among senior citizens in Florida — the primary recipients of the state’s vaccine supply.

Jason Salemi, a University of South Florida epidemiologist who tracks COVID data, emphasized earlier this week that cases in the 65-and-older age bracket have gone down 56% in the last four weeks, and have dropped from about 2,500 daily cases to 800 daily cases over the last week — a bigger decrease than seen in other age groups.

What do the next three months hold for Florida?

Even given the rapid spread of the more-infectious variant in Florida, cases could continue to decline until the virus reaches a low baseline level of circulation in the population, or what scientists call an “endemic state.”

Ira Longini, a disease modeler and biostatistics professor at the University of Florida’s Emerging Pathogens Institute, said that gradual decline would continue to deepen over time as natural infection and immunity from vaccines build up.

“We should see a gradual decline to some kind of endemic state over the next six months or so, going into the fall,” Longini said.

The “big caveat” to that gradual decline would be a reversal and a rise in cases, driven by the U.K. variant, that would begin in March and continue through April and May, followed by a decline, Longini said.

Longini added that he was more concerned with other variants that have shown an ability to trick the immune system, potentially reducing vaccine efficacy. Those variants include the Brazilian strain, which has been discovered in Miami-Dade County, and the South African variant, which derailed a vaccine trial in that country due to the persistence of mild cases cases in the vaccinated group.

The UF institute’s modeling, which assumes that people will continue to socially distance and wear masks into the fall, shows that the virus will fall off considerably, but it is unlikely to disappear completely. That’s in part because the researchers are assuming there will be vaccine holdouts that would prevent total elimination of the virus.

“Even if we did [eliminate it], we’d constantly be invaded by other states or other parts of the world,” Longini said.

Front line healthcare workers still face COVID daily

Miami-Dade hospitalizations due to COVID have decreased slower than the rest of the state, with the weekly average of daily hospitalized patients at about 665 as of Wednesday, about 39% lower than the winter surge’s mid-January peak of 1,085.

Statewide, hospitalizations have dropped to an average of 4,221 COVID patients, about 44% less than the mid-January peak of 7,574.

Dr. David De La Zerda, a critical care physician and the head of Jackson Memorial Hospital’s intensive care unit, said he is still seeing a lot of admissions, but the hospital is doing a better job of discharging patients more quickly.

“The reason we’re not seeing a bigger decrease is because we still see a lot of people coming in with COVID,” De La Zerda said. “I think the difference is the discharge time.”

De La Zerda said the nursing and staffing situation in the intensive care unit of Miami’s public hospital has improved considerably, and he said patients are staying for shorter periods of time and having generally better outcomes.

Typical ICU stays used to be six to eight weeks, De La Zerda said, but have shortened to two to three weeks, with more than half of the patients eventually recovering.

“In the last few weeks, we’re seeing a change,” he said. “We have 30% or 40% of patients that stay longer, that might not get better, and half or more of the patients getting better, getting extubated.”

Though much of the state is eager to move beyond the pandemic, De La Zerda said the healthcare workers in his critical care unit are even more tired of the disease. But he said the county is still too far away from vaccination — fewer than 13% of people 16 and older have received a dose — for anyone there to breathe any easier.

“I’m worried about another surge,” De La Zerda said. “I think people are relaxing, and the mode is now, ‘We are over this.’ But I’m worried about the situation, to be honest with you.”