Yale News

Gov. Ned Lamont plans to loosen COVID-19 restrictions in the coming weeks, drawing criticism from some Yale public health experts who say that the state is locked in a race between variants and vaccines.

On Mar. 4, Lamont announced that Connecticut would ease certain COVID-19 restrictions. Though mask-wearing, social distancing and disinfection procedures will remain in place, beginning Mar. 19, capacity limits on restaurants, libraries, retail, gyms, offices and houses of worship will be lifted. Additionally, private social gatherings of up to 25 people indoors and gatherings at indoor commercial venus of up to 100 people will be permitted. Some Yale professors shared their concerns about the changes with the News, noting that data from the Yale Grubaugh Lab and Yale New Haven Health shows that the number of coronavirus cases caused by variants have surged in recent weeks.

“We’re still in a precarious place,” Chaney Kalinich, who heads variant reporting for the Grubaugh Lab, told the News. “We can respond to the success we’ve had in controlling the virus by loosening up on some things, but increasing capacity all at once in many non-essential indoor establishments in the way that’s planned entails a lot of risk that I don’t believe is worth it … I would rather see every K-12 student have the option to return to in-person school before we increase capacity in bars and restaurants.”

In Connecticut, the statewide test positivity rate was 2.47 percent as of Friday, down from more than 6 percent earlier this winter. There is not yet clear data on why the caseload recently decreased, said Luke Davis, associate professor of epidemiology. Looking to the coming weeks, epidemiologists are concerned about a growing risk of COVID-19 variants that could contribute to a spike in cases as Connecticut eases its restrictions.

The Grubaugh Lab tracks two types of variants. The first, which are called “Variants of Concern,” are variants with evidence that they spread more quickly or are likely to cause more severe disease than the original SARS-CoV-2. This category includes the B.1.1.7 variant, a more transmissible coronavirus variant first identified in the United Kingdom, the B.1.351 variant and the P.1 variant.

The Lab also tracks “Variants of Interest,” which are variants that might be increasing in frequency or have mutations that may affect vaccine efficacy. It is conducting research on two variants that have the same spike gene mutation that the B.1.351 and P.1 variants do and an additional variant that has a different mutation in the spike gene.

A large proportion of the current number of cases are from the B.1.1.7 variant. According to the Grubaugh Lab’s website, about 25 percent of new weekly cases were caused by the B.1.1.7 variant at the end of February. Assistant Professor of Epidemiology Nate Grubaugh estimated in an early March tweet that by Mar. 28, this variant would account for 75 percent of new cases.

“We are seeing exponential growth of B.1.1.7 in some populations from New Haven and Hartford Counties,” Kalinich wrote in an email to the News. “We expect it to be the dominant SARS-CoV-2 lineage by the end of the month.”

The Grubaugh Lab does not have sufficient data from outside of these counties, so the researchers cannot know the prevalence of the variant beyond these populations, Kalinich explained.

Another website run by the Grubaugh Lab that shares weekly reports on coronavirus epidemiology has information on a specific test called the TaqPath SARS-CoV-2 test that can detect the B.1.1.7 variant. The test is currently being used by many facilities, including Yale New Haven Hospital, to screen for positive cases of COVID-19.

Jordan Peccia, a professor of chemical and environmental engineering, explained that TaqPath uses a technique called a “spike gene failure test” that is able to detect one of the 17 mutations characteristic of the B.1.1.7 variant. Further sequencing of the results that trigger a spike gene failure can confirm the case is a B.1.1.7 case or one from another variant.

Initial TaqPath tests conducted at YNHH from December to early February found many of the viruses causing spike gene target failure belonged to a new viral lineage, B.1.375 — which the Grubaugh lab deemed was “not of concern.” However, in the past three weeks, more than 90 percent of spike gene target failure results have been caused by the UK variant, demonstrating a marked rise in cases due to the highly infectious variant.

“Now that the B.1.1.7 is taking over, I’m not surprised that 90% of the spike gene target failure[s] are the B.1.1.7.,” Peccia wrote in an email to the News. 

Kalinich explained that with only a portion of the population vaccinated against the coronavirus, it is the ideal time for variants that are more transmissible or resistant to the vaccine to emerge. The more often a vaccinated person is exposed to the virus, the more likely it is that a variant will emerge that can infect people who have been vaccinated, she wrote.

“It’s tempting to see how cases are falling and want to return to pre-COVID life, but for this reason it’s so important to keep the community spread under control,” Kalinich told the News. “The true light at the end of the tunnel is when we surpass herd immunity, so there is little or no spread and no chance for the variants to arise.”

Connecticut has seen success in rolling out the vaccine, with 54 percent of the population over the age of 55 inoculated thus far. Vaccines will likely be available to all Connecticut residents sometime before the end of the summer, Kalinich noted.

As Davis sees it, the best-case scenario is that Connecticut could see a gradual and safe reopening in late spring or summer. The FDA-approved vaccines seem to protect against the B.1.1.7 variant as well as they do the original coronavirus. If enough people can get vaccinated before the B.1.1.7 variant becomes dominant in the area, reopening could be possible. But if the variant becomes dominant, many more people will likely become infected due to its higher transmissibility, making it harder to reach herd immunity without excess deaths.

A worse possibility is that another variant, either the B.1.351 or the P.1 variant, overtakes B.1.1.7 as the dominant variant, and people who have received vaccinations become infected. Or if the number of people who choose to be vaccinated is not high enough to reach herd immunity, the state could see a resurgence of the virus.

“I am a little concerned about the rapid plans to reopen given all these things that are going to be hitting Connecticut at once,” Davis said, pointing specifically to the spread of the B.1.1.7 variant and the fact that many high schools are starting to reopen in the state.

As of now, the hospital can manage the number of patients it is seeing. But Davis said it is important to keep case counts below the overwhelming numbers of last spring, particularly as hospital staff are exhausted from a year of long hours and caring for severely ill patients.

Lamont did not reply to requests for comment.

The Connecticut Department of Public Health reports 290,577 total cases of COVID-19 since the start of the pandemic.

Sydney Gray | sydney.gray@yale.edu 

Rose Horowitch | rose.horowitch@yale.edu