The state quietly passed a milestone this week, recording its 7 millionth COVID-19 test, but even as the pace of testing has slowed, laboratory data suggest that the number of cases that could be caused by the B.1.1.7 variant is rising sharply.
The new data released late Thursday by Dr. Nathan Grubaugh, an associate professor of epidemiology at Yale’s School of Public Health, show there were at least 152 confirmed cases of the B.1.1.7 variant as of the end of February.
For the week of Feb. 13, nearly 15% of the samples Yale tested had characteristics that indicated they could be of the B.1.1.7 strain, although they weren’t confirmed. By the week of Feb. 27, that percentage increased to nearly 28%, although the increase from Feb. 20 to Feb. 27 was only about 2.5 percentage points.
Some Yale epidemiologists, including Grubaugh, have questioned whether the state should push back its date for reopening because of the increasing appearance of the variant, but Gov. Ned Lamont reiterated Thursday that he has no plans to change his timetable. The governor announced last week that he was lifting capacity restrictions on restaurants, houses of worship, retailers and most other businesses on March 19. Mandates for social distancing and masks will continue, however.
“While the variant may be expanding and is a bigger piece of the infected community here in the state of Connecticut, it’s not reflected in higher infection rates, and that’s very important,” Lamont said.
[Restaurants and other business can go back to full capacity on March 19 as Lamont rolls back COVID restrictions in CT]
While acknowledging they are monitoring the variants closely, state officials have said they aren’t particularly worried because hospitalizations continue to fall even as the percentage of positive COVID tests has hovered between 2% and 3%.
20% to 40% of cases could be B.1.1.7
The number of cases of B.1.1.7., commonly referred to as the U.K. variant, have been steadily increasing to the point where the two laboratories doing specific genomic testing to isolate the variant believe it is present in up to 40% of the cases in the state now.
The two labs doing the genomic sequencing for the variant, other than the state Department of Public Health’s own laboratory, are Jackson Laboratories and the Yale School of Public Health. Both have said the variant is more prevalent now in the state than even a few weeks ago.
Mark Adams, director of microbial genomic services and deputy director of JAX Genomic Medicine, said there is no question the number of cases of the variant are higher than what the testing data show.
For example, B.1.1.7 shares a common genome with “regular” COVID-19, and in January, Jackson lab technicians were finding about 1 in 25 random positive test samples had the common genome, Adams said.
The number is now roughly 21 out of every 25 samples, although Adams cautioned that doesn’t mean every one of those 21 cases is B.1.1.7.
“So we have a reduction in overall cases while at the same time an increase in the proportion of those cases that have U.K. lineage,” Adams said. “It’s hard to say — maybe about 20%, to as much as 40%, of all positive cases now are the variant.”
Adams said they have been watching the state’s case positivity rates closely.
“There’s a fair amount of noise, that it is hard to get an idea of the trends, but it is worth keeping an eye on,” Adams said. “There’s a lot of scientific concern about the U.K. strain and other variants, but I think we’re now getting the epidemiological picture about what it means for the trajectory of the pandemic. And I think it’s still difficult to predict that.”
Not an overwhelming concern
Some Yale officials have been critical of Lamont’s decision to expand the reopening.
Grubaugh called it a “terrible” decision in a recent WNPR radio interview.
But Keith Grant, director of infection prevention at Hartford HealthCare, said Thursday that “Connecticut right now is in a very good place to start having discussions” about reopening more.
Grant said hospital admissions are down about 80% in some areas, and the mortality rate from the virus has shifted significantly because of the vaccine — particularly in nursing homes and other areas that have had higher mortality rates.
Also, he said, the state has consistently ranked high in the number of vaccinations administered. Take all that data together, and Grant believes B.1.1.7 isn’t the threat some fear it is.
“So I think we have enough data to be comfortable with where the epidemiology is, and I don’t think it’s significant at this point in time,” Grant said. “I do think we’re making good progress on our vaccinations. At this point, I don’t think it’s a concern. We need to watch it, but I don’t think it is the overwhelming concern that has been reported at this time.”
Lamont and other state officials have acknowledged they are tracking the variants, not only here but in other areas such as Florida and San Diego — but the increasing number of cases hasn’t swayed them from delaying the planned relaxing of restrictions on March 19.
They believe the number of people that have already been vaccinated, coupled with people who have already had COVID, makes it less likely for B.1.1.7 to cause a major outbreak, even though it is considered much more transmissible than standard COVID-19.
“I’ve seen that it is increasing — it could be the dominant strain — but at least it is not increasing exponentially … and if we did find things were changing, we have the ability to change course,” Lamont said at a press conference earlier this week.
“But right now I think the vaccine is staying ahead of the variant, and that’s slowing its increase. And by the way, the vaccine works against the variant.”
Small town shock
Earlier this week, Lamont announced the first COVID death from B.1.1.7 and said the state’s cases of that variant had increased to 81, with 15 additional cases through Feb. 17.
Unlike the early variant cases, which were focused mostly in New Haven County, the newest 15 cases were spread out across the state from East Canaan to Bridgeport to Rocky Hill, suggesting that this version of the virus has spread across the state more than officials have been able to quantify.
The state reported two cases of B.1.1.7 in East Canaan, a village in North Canaan, which has been relatively unscathed by the virus except for a major outbreak at a nursing home facility in town last spring.
North Canaan First Selectman Charles Perrotti said no one had informed him that his small town had cases of the variant until he saw the town’s name listed during the governor’s press conference. Perrotti said he called Torrington Health District officials to see if they had any more information, but as of Thursday, he was still in the dark.
“It would be nice to know how or where we got the variant in our town and perhaps possibly get more vaccine available up this way, because right now, other than Walgreens, we don’t have much in this corner of the state,” Perrotti said.
Lamont also announced the state’s second case of the B.1.351 variant of COVID-19, commonly known as the South African variant. That new case is an individual who is between 15 and 25 years old and a resident of Greenwich. The patient was tested in early February and reported having traveled to Massachusetts.
Testing demand is down
The Jackson Laboratory and Hartford HealthCare have conducted about 1.2 million tests and more than 900,000 tests respectively, and both agencies said testing is starting to dwindle.
Dr. James Cardon, Hartford HealthCare’s chief clinical integration officer, said Thursday they are doing about half the tests that they were just a few months ago.
“Certainly the demand at our testing sites has reduced significantly,” Cardon said. “We have scaled back the double lanes, the multiple cars at once, because there’s no real wait.”
Hartford has closed down testing sites in Newington and Westport and is running reduced hours on the weekend at several sites across the state because “there wasn’t anybody coming through.”
“We watch the volumes very closely to make sure we’re not starting to see real lines and other things forming,” Cardon said.
For Jackson labs, the demand has lessened mostly because nursing home testing has slowed. The state is still testing staff at every nursing home each week but is now testing residents only when they have a positive case in the building.
“We are getting fewer tests to perform, and I would say that there’s probably a complicated set of reasons for that, but one of our main testing partners through the state is nursing homes,” Adams said. “The number of cases in nursing homes is dramatically lower as an increased proportion of both residents and staff are vaccinated, and so the intensity of screening in nursing homes has gone down.”
The state has spent more than $284 million on testing, according to documents that Office of Policy and Management Secretary Melissa McCaw recently submitted to legislators. It has contracts with labs all over the state that submit their testing data daily to the DPH.
State officials said earlier this week the DPH database passed 7 million tests, almost exactly a year after Gov. Ned Lamont declared a state of emergency following the state’s first COVID case.
The milestone is a far cry from last March, when testing was so scarce that only people in the hospital could get one, and Lamont announced at press conferences that the state lab had “ramped up” to 30 tests a day.