Why Michigan's variants remain dangerous despite falling COVID cases

Troy — After a year of quarantining at home, Tina Catron ventured to an indoor soccer field to watch her two sons play, not knowing that a highly contagious COVID-19 variant was circulating among those in attendance.

The next weekend, the team's coach tested positive. The week after, half of the soccer team, including family members, fell ill. Catron's husband came down with the virus on March 22 and, by March 30, Catron was hospitalized with pneumonia from the B.1.1.7 variant.

"I really felt like this is it, I'm dying and I didn't even get a chance to say goodbye to anybody," said Catron, 44, of Troy. She had no underlying health conditions and, prior to contracting COVID-19, hadn't visited a doctor in three years. 

Once a national hot spot for the virus, Michigan is seeing a dramatic dip in cases, its vaccination rate is climbing and COVID-19 restrictions are being phased out. But highly aggressive COVID-19 variants here have surged in the past two months, and with gatherings anticipated throughout the Memorial Day weekend, local and national public health officials are warning of a heightened risk for the state's unvaccinated population.

Because the B.1.1.7 variant — the most prevalent in Michigan — is more transmissible than the coronavirus, unvaccinated people are 50% more likely to contract the variant, said Dr. Emily Martin, professor of epidemiology at the University of Michigan School of Public Health.

"If you were to have an outbreak this Memorial Day, it would probably be 50% bigger than the same outbreak that would have happened last Memorial Day in unvaccinated people," Martin told The Detroit News. "Because of the way the variant transmits, it's basically 50% better (than coronavirus) at infecting a person."

The state's first known case of B.1.1.7 emerged in January after a University of Michigan student traveled here from the United Kingdom. Variants have since spread rapidly, especially in the past two months as the state relaxes more COVID-19 restrictions. 

There are seven known variants in Michigan. Through Friday, there were 11,569 cases of variants, a nearly 700% increase from the 1,450 known cases on April 1, according to the Michigan Department of Health and Human Services.

"For every outbreak situation we have, they're going to get harder and harder to contain," Martin said. 

The majority of the spread, or 10,957 cases, is with the United Kingdom variant, and most of it was detected before vaccines became widely available.

"What we are concerned about with regard to B.1.1.7 is that it's more infectious in children than the original virus, and the ones who do get sick and recover still have problems for a while," said Jeremy Kamil, professor of microbiology and immunology at Louisiana State University Health Shreveport. "This is important when you have a high prevalence in schools."

Reaching vaccine goal

Through Thursday, 53% of Michigan's residents ages 12 years and older have received at least one vaccine dose. For the state's slightly smaller adult population 16 years and older, the rate is 58.6%. 

Michigan's seven-day average has declined to 800 cases per day and is the lowest it’s been since the end of September.

Gov. Gretchen Whitmer said in the past week that the state's vaccine supply is now outpacing demand but she's "hopeful we'll get to 70%," noting "When more people are vaccinated, it's for the better of everyone."

Whitmer wants to reach the 70% mark of at least one dose by the July 4 holiday. For the Pfizer and Moderna vaccines, two doses are needed for fully vaccination. More than 46% of Michigan adults 16 and older are fully vaccinated.

But even if Michigan achieves a 70% vaccination rate, Martin contends there still won't be a balance in communities and public settings across the state between those who have had the vaccine and those who have not.

"Should the variant make its way into an unvaccinated cluster of people, it has a lot of opportunities to spread," she said.

Dr. Mouhanad Hammami, director of the Wayne County Health Department, said Michigan is seeing a large increase in variants because "we are actively looking for them."

"We saw the spread of the U.K. variant in the early stages of the vaccination process. It was spreading so fast, but with specifically P.1 and the B.1.617, which came during a very robust vaccination plan, it limited the spread," he said, referring to the Brazil and India variants, respectively. 

Variants a low risk for vaccinated

Variants have a low risk of infecting those who are vaccinated, scientists say. Less than 1% of those fully vaccinated in Michigan have contracted a virus, according to the state health department.

"You can be infected and have very mild to no symptoms, but still transmit the virus," Kamil said. "That's more likely to happen with P.1 and B.1351 than it would with B.1.1.7. Imagine, B.1.1.7 as a Ferrari that doesn't have off-road tires. Whereas P.1 and B.1.351 have off-road tires, they can cruise around your antibodies without getting a flat."

To identify variant cases, each COVID-19 testing sample is sent to a laboratory to be examined by a process called genomic sequencing, which allows scientists to monitor how SARS-CoV-2 changes over time and its characteristics.

But one of the challenges in Michigan and nationally is that the testing is capturing a fairly small slice of the pie, said Dr. Nick Gilpin, director of infection prevention at Beaumont Health.

"We're not sending every sample that tests positive for COVID for sequencing. We're really just sending a small sample to the state and the state is the one who's really doing all the sequencing for us," Gilpin said. "So, we're probably underestimating, in some regards, these numbers, but we know the general trends."

The Centers for Disease Control and Prevention has said there's a greater need for more labs and has awarded $14.5 million over two years to seven universities to conduct genomic surveillance research with public health agencies.

"With the increase in sequencing through contracts that CDC has put into place, sequencing has increased as a whole for Michigan; however, we do not have a definitive count or list of labs that are performing sequencing," said Chelsea Wuth, a state health department spokesperson.

"Variants threaten our ability to contain COVID-19," Wuth added. "We are encouraging all Michiganders to get one of the safe and effective COVID-19 vaccines."

Where's the major spread?

Wayne County has the largest spread of the B.1.1.7 variant with more than 1,200 cases and an additional 546 in Detroit. Wayne, Washtenaw, Macomb, Livingston and Genesee counties have six of the seven variants. Oakland and Clinton counties have all the reported variants.

The first case of the South African variant B.1.351 was confirmed in March by the state Bureau of Laboratories in a boy living in Jackson County. There are a total of 67 cases of the variant, the most being in Washtenaw County.

The first case of the P.1 variant from Brazil was identified in a Bay County resident last month. There are now 217 confirmed cases of P.1, with both Macomb and Oakland counties each having 32 known cases.

There are also 296 confirmed cases of B.1.427 and B.1.429, two variants formed in California, the most in Macomb County.

The first case of B.1.617 was identified in Clinton County in early May. The variant was initially detected in India in October. There are now 23 cases in the state.

"We know the U.K. variant B.1.1.7 is the big one in play, the B.1.351 variant from South Africa, P.1 from Brazil and B.1.617 from India are all of great concern," Beaumont's Gilpin said.

Those who aren't vaccinated, who are pregnant or have health risks are more likely to end up in intensive care units from the variants and there's typically nothing to indicate someone has a variant versus the coronavirus, Gilpin said.

Doctors are treating some COVID-19 patients with monoclonal antibodies to block the virus from attaching to human cells, making it more difficult for the virus to reproduce. However, the P.1 variant from Brazil and B.1.617 from India are resistant to the treatment, Gilpin said.

"So we are in the process of making some changes to our monoclonal antibody protocols to basically switch over to the Regeneron treatment, which is more effective, per recommendations of the FDA," Gilpin said, referring to the Food and Drug Administration.

Some researchers, tired of what they've deemed variant hysteria, recently noted Michigan formed its own variant in a cluster during the fall.

A University of Michigan medical student was analyzing sequences from 2020 while working with Dr. Adam Lauring's Lab, a sequencing lab for Michigan Medicine, which tests genetics and evolution of RNA viruses in Ann Arbor, and discovered a cluster of 87 cases found nowhere else.

Dubbed the "Wolverine Variant," the cluster was sourced in Washtenaw County, but Lauring said there's no indication the variant is currently circulating "and is of absolutely no consequence."

'Didn't think much of it'

When the Catron family contracted B.1.1.7, they had been on wait lists to get vaccines. 

Catron said her two boys, ages 7 and 9, both came down with severe fevers but after resting and Tylenol for a day, they returned to normal.

She and her husband, however, have lingering effects including brain fog and fatigue.

"It hit my husband 10 times harder than it did me, but then mine turned into pneumonia," Tina Catron said. 

She was hospitalized at Beaumont Hospital in Royal Oak for six days, and doctors instantly believed she had a variant "because it took a hold of me so quickly," she said. Her husband's bout with the virus did not require hospitalization.

The experience, she said, brought her "face-to-face with mortality."

"Kids are bringing this home and even if a lot of adults are getting vaccinated, we need to be careful for the kids who are not of age yet," she said. "It's not over yet. We heard about variants beforehand and we didn't really think much of it."

srahal@detroitnews.com

Twitter: @SarahRahal_