Tomas Pueyo is warning that the new variant discovered in the UK will cause a spike in Covid cases and deaths that is far larger than anything we’ve seen so far. I’m afraid he is probably right.
Who is Tomas Pueyo? Those of you who have been following my blog for a while know that I have been impressed by the Covid-related writing of Tomas Pueyo. Pueyo’s background isn’t in science or medicine: he’s head of marketing for a Silicon Valley software company. But he has two great gifts: the ability to assimilate and analyze huge amounts of data, and the ability to explain it clearly, often using graphs and other data-visualization techniques.
My first post about Pueyo’s work was back in April, when I wrote about his concept of “The Hammer and the Dance”. He proposed that, until a vaccine was ready, the only way to control Covid was through very strict lockdowns and contact-tracing (“the hammer”) to reduce infections to a tolerable level, followed by intermittent local lockdowns (“the dance”) wherever there were signs of a resurgence. This, he said, had to be done by the federal government because states had very inconsistent policies. Of course, very little of that actually happened. (Links to three of Pueyo’s articles are in that post.)
I mentioned Pueyo again in a June post. That one summarized several articles (including one by Pueyo) that argued there was no possibility of a quick solution for Covid. I concluded that post by writing: “I have had to lower my expectations. I fear we may be just at the beginning a very long period before we return to anything that resembles the life we enjoyed just six months ago.”
The difference that virus transmission rate makes. Pueyo’s new analysis is based on data out of the UK that shows the main variant there, called B117, spreads 50-70% faster than other forms of the virus. He doesn’t suggest that it will make you sicker or more likely to die. But he shows how the faster transmission rate leads to far greater numbers of infections, and how it makes herd immunity harder to achieve. I’ll spare you the details. You can read the article for yourself here. Pueyo thinks B117 will outcompete other forms of the virus and will soon account for most cases of Covid everywhere in the world, just as it has done in the UK. He predicts that the US peak will occur in mid-March.
Will it evolve to become less deadly? Pueyo also debunks the widely-held idea that more successful variants are likely to be less deadly. That’s based on an analysis of viruses that kill quickly, while their victims are still contagious (unlike Covid). Early death means the virus has less time to be spread to others. If such a virus becomes less deadly, its victims will have longer to spread it and it may become more successful at infecting a larger population.
Covid has a different disease progression, however. Those who die from this virus are mostly well past the contagious stage, and the disease is often caught from people who have not even shown any symptoms yet (or who never will show any). Becoming less deadly would not provide a significant transmission advantage for a Covid variant, in Pueyo’s view.
What about the other new variants? Pueyo’s article does not address the new virus variants from South Africa and Brazil. When he was writing the article, there was too little known about them. The concerns I have seen raised in news reports are that some vaccines may be less effective against the South African version, and that the Brazilian version (known as “P1”) may not be stopped by herd immunity.
In response to comments from readers, Pueyo discusses the lack of data concerning P1 and herd immunity. He is not certain how much credence to put into the Brazilian reports.
There are other signs of disturbing mutations in the virus. One virus mutation (confirmed too recently to make it into Pueyo’s analysis) causes a change in the shape of the virus’ “spike”, which is the element of the virus that the vaccines attack. This mutation, called “E484K”, is present in both the South African and Brazilian variants and may be causing lowered vaccine effectiveness.
Mutations such as this one may enable the virus to avoid full control via either vaccination or herd immunity. This possibility is discussed in an excellent article in The Atlantic by Sarah Zhang. Her interviews with immunologists and vaccine experts suggest that we may be facing a future of persistent, worldwide, low-level Covid infection for the foreseeable future. Vaccines will help, but they will have to be periodically updated (as they are for the flu) in order to provide a reasonable level of protection.
How will Kendal be affected? If Pueyo is right in his transmission rate analysis, there will soon be a huge surge in Covid infections in the general US population. However, the Pfizer vaccine (administered here) has been found to be almost as effective against B117 as it is against earlier versions. That means those of us who were vaccinated will probably be fine. (It is not yet clear whether the new E484K mutation will affect that assessment.)
But our surrounding counties are a different matter. There, vaccination is still the exception. If Covid surges again (as Pueyo thinks), we may have to become even more vigilant in terms of deliveries, contractors, staff testing, and so on. Even though the Pfizer vaccine is effective, it is not 100% effective even against the virus currently circulating, and we don’t have much information yet about the new mutations. That means we cannot let down our guard. The gradual re-opening process we have been awaiting may have to be delayed, perhaps by months.
I hope Pueyo is wrong about the coming spike, but his logic seems correct to me. Read his article and see what you think. I welcome comments in the box below.