‘Impending doom’? What scientists say about chances of fourth COVID-19 wave in Santa Cruz, rest of California
Quick Take
A “fourth surge” in Santa Cruz County, and California as a whole, is now unlikely, according to scientists and local health authorities, who also explain why variants aren’t turning out to be as alarming as was feared.
On Monday, the director of the Centers for Disease Control and Prevention, Rochelle Walensky, said she felt a sense of “impending doom” as cases of COVID-19 rose an average of 10% in the previous week — a trend not reflected locally. In fact, her statement came amid myriad reopenings and relaxed restrictions in Santa Cruz County and other California counties where cases have consistently reduced.
Earlier in the pandemic, California celebrated declining cases by lifting lockdowns and other restrictions, only to be faced with a surge of infections soon after. But a local health official, and national infectious disease experts, say it’s highly unlikely to play out the same way this time, despite the proliferation of concerning variants.
“I’m almost marveling that people are talking about a fourth surge in California,” said Dr. Monica Gandhi, an infectious disease expert at the University of California San Francisco and an adviser to the National Institute of Allergies and Infectious Disease.
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“Whenever we released restrictions before, of course we (saw) cases going up, but there’s something huge going on (now), which is we’re laying down the ultimate protection against getting COVID-19,” she said.
That protection, of course, is vaccination.
“The only thing that’s ever going to get you out of a pandemic is immunity,” Gandhi said. “Masks, lockdowns — they’re all tools, but we’re talking about the ultimate end which is immunity.”
Gandhi said that the combination of vaccines — which increasingly appear to provide significant protection against both illness and spread of the virus — and natural immunity from infection, will prevent cases from creeping up again before vaccines can stop the virus in its tracks.
“This is so different than spring, summer, winter,” Gandhi said. “I’m going to go so far as to say I am 99.99% certain we will not see a fourth surge in California.”
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Dr. George Rutherford, a professor of epidemiology and biostatistics, also at UCSF, says he “would not be nearly that confident,” but said that “I think there’s a better than even chance that there won’t be.”
The fourth wave is very real in many parts of the country, he said, but California isn’t seeing it yet. He also added that the current low infection and hospitalization rates in Santa Cruz County are “really quite remarkable.”
Santa Cruz County health officer Dr. Gail Newel agrees. “Right now things for the state of California and also Santa Cruz County look very optimistic,” she said. “None of the modeling at this point indicates a surge in the coming weeks.”
After a slight increase in case averages and other numbers last week, “Our metrics improved a lot over the past week,” Newel said.
What about the variants?
Gandhi said that she believes fears about variants of concern, like the B.1.1.7 variant which originated in the United Kingdom, should be somewhat allayed by new research showing those who have been infected with or vaccinated against the original strain of COVID-19 appear to remain immune to the official variants of concern: B.1.1.7 (the UK variant), B.1.351 (the South African variant), and B.1.1.248 (the Brazilian variant).
Though antibody response in patients who were previously infected or vaccinated might be diminished against the new variants, T-cells, another part of the body’s immune system, appear to respond robustly to the variants of concern and may be able to prevent severe disease.
These variants of concern do appear to spread more readily, and perhaps increase COVID-19 mortality, but the fact that prior infection and vaccination are protective against them means they likely won’t prolong the pandemic indefinitely.
A variant that originated in California, known as B.1.427/B.1.429, so far does not appear to have created the devastating rise in cases some feared. “It supposedly (was) reported as early as September, and despite that, all we’ve been seeing after our winter surge is a decrease in cases,” Gandhi said. UC Santa Cruz surveillance of a batch of COVID-19 tests in Santa Cruz County found that 65% of all cases tested showed the “California variant.”
This variant is “very common,” in Santa Cruz, Newel said. “So much so that the state is tracking it, but we’re not doing intensive case investigation or contact tracing.”
Rutherford said he likes the term “scariants” to describe the way variants have sometimes been discussed in public conversations.
“I’m not at all concerned about this round of mutations,” Rutherford said, “but it’s a matter of time before something comes along that really evades the vaccine.” The fact that previously infected and vaccinated people appear to have T-cell immunity against the new variants is an “ace in the hole,” he said.
Newel and Rutherford both mentioned a new theory that the “California variant” B.1.427/B.1.429 may actually be somewhat protective.
The California variant seems “to be out-competing the UK variant,” Rutherford said. He said the California variant appears to be more susceptible to the vaccine, and though it is possibly more transmissible than the wild type or original virus, it doesn’t seem “as transmissible as the U.K. variant or cause as severe disease,” Rutherford said. “That’s kind of good news.”
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Newel said that Santa Cruz County has identified just three cases of the U.K. variant, and so far, mutations and variants do not appear to be a significant concern. “Our local modeling, as well as the state modeling, shows that even if we had a lot more variants with a lot more transmissibility, we’d still be doing well,” she said. “We’re not expecting a spring surge.”
The race between variants and vaccines isn’t over yet, but Gandhi, Newel, and Rutherford agreed: in Santa Cruz, and much of California, vaccines are winning.
But Newel warned that this lead could be temporary, as more time elapses from the big fall and winter surges when hundreds of county residents were infected and acquired some immunity. Immunity from infection is likely much shorter-lived than from vaccination. So continuing to quickly vaccinate as much of the population as possible remains urgent.