{"id":28583,"date":"2021-02-06T10:00:00","date_gmt":"2021-02-06T10:00:00","guid":{"rendered":"https:\/\/www.propublica.org\/article\/why-opening-restaurants-is-exactly-what-the-coronavirus-wants-us-to-do#1049947"},"modified":"2021-02-06T10:00:00","modified_gmt":"2021-02-06T10:00:00","slug":"why-opening-restaurants-is-exactly-what-the-coronavirus-wants-us-to-do","status":"publish","type":"post","link":"https:\/\/radiofree.asia\/2021\/02\/06\/why-opening-restaurants-is-exactly-what-the-coronavirus-wants-us-to-do\/","title":{"rendered":"Why Opening Restaurants Is Exactly What the Coronavirus Wants Us to Do"},"content":{"rendered":"\n

\n Caroline Chen<\/a> <\/p>\n \n \n

\n

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories<\/a> as soon as they\u2019re published.<\/p>\n\n<\/div>\n\n \n\n \n\n \n

On Jan. 29, New York Gov. Andrew Cuomo was promoting \u201cmarital bliss\u201d at a coronavirus news conference.<\/p>\n \n

Announcing that indoor dining would reopen at 25% capacity in New York City on Valentine\u2019s Day, and wedding receptions could also resume with up to 150 people a month after, Cuomo suggested<\/a>: \u201cYou propose on Valentine\u2019s Day and then you can have the wedding ceremony March 15, up to 150 people. People will actually come to your wedding because you can tell them, with the testing, it will be safe. \u2026 No pressure, but it\u2019s just an idea.\u201d<\/p>\n \n \n\n

Never miss the most important reporting from ProPublica\u2019s newsroom. Subscribe to the Big Story newsletter.<\/a><\/p>\n\n \n \n

Cuomo isn\u2019t alone in taking measures to loosen pandemic-related restrictions. Michigan Gov. Gretchen Whitmer allowed indoor dining to resume<\/a> at 25% capacity starting Feb. 1. Idaho Gov. Brad Little increased<\/a> limits on indoor gatherings from 10 to 50 people. Massachusetts Gov. Charlie Baker is raising<\/a> business capacity from 25% to 40%, including at restaurants and gyms. California Gov. Gavin Newsom lifted<\/a> stay-at-home orders on Jan. 25.<\/p>\n \n

To justify their reopening decisions, governors point to falling case counts. \u201cWe make decisions based on facts,\u201d Cuomo said. \u201cNew York City numbers are down.\u201d<\/p>\n \n

But epidemiologists and public health experts say a crucial factor is missing from these calculations: the threat of new viral variants. One coronavirus variant, which originated in the United Kingdom and is now spreading in the U.S., is believed to be 50% more transmissible. The more cases there are, the faster new variants can spread. Because the baseline of case counts in the U.S. is already so high \u2014 we\u2019re still averaging about 130,000 new cases a day \u2014 and because the spread of the virus grows exponentially, cases could easily climb past the 300,000-per-day peak we reached in early January if we underestimate the variants, experts said.<\/p>\n \n

Furthermore, study<\/a> after study<\/a> has identified indoor spaces \u2014 particularly restaurants, where consistent masking is not possible \u2014 as some of the highest-risk locations for transmission to occur. Even with distanced tables, case studies<\/a> have shown that droplets can travel long distances within dining establishments, sometimes helped along by air conditioning.<\/p>\n \n

We\u2019re just in the opening stage of the new variants\u2019 arrival in the United States. Experts say we could speed viruses\u2019 spread by providing them with superspreading playgrounds or slow them down by starving them of opportunities to replicate.<\/p>\n \n

\u201cWe\u2019re standing at an inflection point,\u201d said Sam Scarpino, assistant professor at Northeastern University and director of the school\u2019s Emergent Epidemics Lab.\nThanks to the arrival of vaccines, he said, \u201cwe finally have the chance right now to bring this back under control, but if we ease up now, we may end up wasting all the effort we put in.\u201d<\/p>\n \n

Dr. Luciana Borio, an infectious disease physician who was a member of the Biden-Harris transition team\u2019s COVID-19 advisory board, put it more bluntly at a\ncongressional hearing<\/a> on Feb. 3. \u201cOur worst days could be ahead of us,\u201d she said.<\/p>\n \n

I interviewed 10 scientists for this story and was surprised by the vehemence of some of their language. \u201cAre you sure<\/em> it could be that bad?\u201d I asked, over and over.<\/p>\n \n

They unanimously said they expected B.1.1.7, the variant first discovered in the U.K., to eventually become the dominant version of coronavirus in the U.S. The Centers for Disease Control and Prevention has estimated<\/a> that B.1.1.7 will become dominant in March, using a model that presumes it\u2019s 50% more transmissible than the original \u201cwildtype\u201d coronavirus. The model\u2019s transmission rate was based on experience in the U.K., which first detected B.1.1.7 in September and saw an increase in cases that became apparent in December, straining hospitals<\/a> despite stringent closures and stay-at-home orders. So while our country appears relatively B.1.1.7-free right now, the situation could look drastically different in a matter of months.<\/p>\n \n

Experts are particularly concerned because we don\u2019t have a handle on exactly how far B.1.1.7 has spread. Our current surveillance system sequences less than 1% of cases to see whether they are a variant.<\/p>\n \n

Throwing an even more troubling wrench into the mix is that B.1.1.7 is continuing to morph. Just this week, scientists discovered that some B.1.1.7 coronaviruses in Britain had picked up a key change, known as the E484K mutation<\/a>. That mutation had previously been found in the B.1.351 variant, which was first discovered in South Africa. Scientists have hypothesized<\/a> that it\u2019s the E484K mutation that has reduced the efficacy of some vaccines in South African trials, so this is incredibly worrying news.<\/p>\n \n

\u201cIt\u2019s really hard to thread this needle without sounding like a prophet of doom,\u201d said Angela Rasmussen, a virologist at Georgetown University\u2019s Center for Global Health Science and Security. While vaccines bring hope, she said, governors who are moving to expand indoor dining are \u201ccompletely reckless\u201d; if they don\u2019t course correct, \u201cI don\u2019t think it\u2019s hyperbolic to say the worst could be yet to come.\u201d<\/p>\n \n

The choices that our federal and state leaders make right at this moment will determine if we can bend the curve once and for all and start ending the pandemic, or if we ride the rollercoaster into yet another surge, this one fueled by a viral enemy harder to fight than ever before.<\/p>\n \n

All of us have agency in deciding this narrative, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, stressed. \u201cCertainly you need to be prepared for the possibility that things might get worse in the light of the variants, but that is not inevitable because there are things that we can do to mitigate against it,\u201d he said in an interview. \u201cWe're not helpless observers of our own fate.\"<\/p>\n \n

Fauci urged states to \u201cdouble down on your public health measures \u2026 to have virtually everybody wear masks, to have everyone maintain social distance, to have everybody avoid congregate settings, and to have everybody wash their hands very frequently.\u201d<\/p>\n \n

And don\u2019t wait until it\u2019s too late, warned Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.<\/p>\n \n

\u201cWe are so good at pumping the brakes after<\/em> we\u2019ve wrapped the car around the tree,\u201d he said. The new variants aren\u2019t being complacent. \u201cThere\u2019s still a lot of human wood out there for this coronavirus to burn.\u201d<\/p>\n \n

\n

To understand the epidemiologists\u2019 warnings, it helps to understand what variants are, how they have been behaving and our limitations in knowing exactly how far they have spread.<\/p>\n \n

People have a bad habit of anthropomorphizing the coronavirus: ascribing human-like intentions to it, as if a microbe can discern that we finally have a vaccine and try to evade it. But viruses don\u2019t really have any schemes; they just reproduce. \u201cCoronaviruses are a single strand of RNA in a sac of fat,\u201d epidemiologist Larry Brilliant reminded me. \u201cThey\u2019re preprogrammed to replicate and continue replicating. That\u2019s their job.\u201d<\/p>\n \n

Once in a while, when a virus replicates, a mistake occurs, and a letter in the strand of RNA is copied inaccurately. That\u2019s called a mutation. Many times, those mutations are neutral. Sometimes they are detrimental to the virus, and that lineage will quickly die off. Other times, they\u2019re beneficial to the virus in some way, such as by making it more transmissible. When a version of the virus becomes functionally different, that\u2019s when scientists consider it a variant.<\/p>\n \n

As of Feb. 4, according<\/a> to the CDC, the U.S. has found 611 cases of B.1.1.7, the variant first discovered in the United Kingdom, five cases of B.1.351, first identified in South Africa, and two cases of P.1., first identified in Brazil. But that\u2019s almost certainly an undercount.<\/p>\n \n

Part of the reason why epidemiologists are advocating for us to stay hunkered down is because the U.S. doesn\u2019t know exactly where all the variant cases are.<\/p>\n \n

The term that public health uses is \u201csurveillance.\u201d I like to think of it as having eyes on the virus. In order to have good eyes on where coronavirus infections are in general, all you need is the regular swab tests that we\u2019re all familiar with. But in order to tell whether a positive case is the wildtype coronavirus or one of the more nasty variants, an additional step is needed: genomic sequencing. For that, the sample needs to be sent on to a lab that has specialized machinery capable of conducting sequencing.<\/p>\n \n

Until recently, sequencing in the U.S. was a patchwork effort, conducted by a mix of academic and public health agency labs keen to track the evolution of the coronavirus. Though the CDC hosted a\nweekly call<\/a> where those scientists already conducting sequencing could compare notes, there was no dedicated federal funding or coordination to ensure that samples were routinely gathered from across the country.<\/p>\n \n

Today, the U.S. sequences less than 1% of its total cases. This is a pittance compared to the U.K., which sequences around 8-10% of its positive test results. But volume alone isn\u2019t the only thing that matters. Representation, meaning where the samples come from, is another crucial factor. Since most of the sequencing so far has come from voluntary efforts, the U.S. has suffered from uneven visibility, with a whole bunch of eyeballs in parts of the country that are biotechnology and academic hubs, like Boston, San Francisco and San Diego, and less in \u201csurveillance deserts\u201d like North and South Dakota. There, barely any samples have been sequenced at all, even when those states had explosions of COVID-19 cases.<\/p>\n \n

Dr. Phil Febbo is chief medical officer at Illumina, one of the world\u2019s biggest sequencing technology companies. Like so many parts of the coronavirus response, keeping a lookout for variants has suffered from a lack of federal leadership, Febbo said. As early as March of last year, Illumina representatives began meeting with federal agencies, advocating for a national genomic surveillance system.<\/p>\n \n

\u201cWe talked to any three-lettered agency we could,\u201d Febbo said. \u201cThose conversations were cordial: They said they heard what we were saying, but then they\u2019d say, \u2018But we need more tests, but can you do it in five minutes, can it be point-of-care?\u2019\u201d It wasn\u2019t until Dec. 18, when B.1.1.7 was taking off in the United Kingdom, that Illumina finally got a call from the CDC offering to sign a contract with the company. (Since December, CDC has engaged Illumina to do surveillance work by signing two<\/a> contracts<\/a> potentially worth up to $4.6 million.)<\/p>\n \n

Today, Illumina sequences positive samples that are passed on from a diagnostic testing company, Helix. Each RNA strand of the SARS-CoV-2 virus has about 30,000 nucleotides, each represented by one of four letters. Illumina\u2019s sequencers read through each sample\u2019s code and compare each letter to a reference sequence, looking for significant changes. The data gets passed back to the CDC, which uses location data stripped of personal identifiers to map the spread of any variants that Illumina has picked up.<\/p>\n \n

The CDC said it has contracted with several large commercial companies with the goal of sequencing up to 6,000 samples a week by mid-February. Through another program, called the National SARS-CoV-2 Strain Surveillance System<\/a>, state public health labs are supposed to send a total of 1,500 samples to the agency every other week. This program went into effect on Jan. 25 and is still ramping up, according to a CDC spokesperson.<\/p>\n \n

Febbo says more can be done to increase surveillance. He notes that the Biden administration, while clearly more invested in variant surveillance than the Trump administration, hasn\u2019t set a public target in the same way it has for vaccinations with its \u201c100 million shots\u201d campaign. Illumina estimates that sequencing 5% of all samples would allow us to be confident that we are catching all variants of concern, and he would like the Biden administration to make that a public goal. It can be done, Febbo says: \u201cIt hasn\u2019t been the lack of capacity, it\u2019s been the lack of will.\u201d<\/p>\n \n

Having clearer information about where variants are would give governors and local officials actual information with which to make decisions. Then they could say with confidence, \u201cWe can open indoor dining because we know<\/em> that the variants aren\u2019t circulating in our community.\u201d Absent that information, the only thing we can do is act like the variants are here.<\/p>\n \n

\n<\/p>\n \n

The good news is that so far, the vaccines that have been made available to the public appear to be reasonably effective<\/a> against the coronavirus variants. They may be slightly less effective against B.1.351, the variant discovered in South Africa, but none of the variants are total \u201cescapes,\u201d so a vaccine should offer you at least partial protection against any form of the coronavirus you encounter.<\/p>\n \n

All of the available shots give your immune system some familiarity with the virus, allowing it to be more prepared to meet the bug in the wild, whether it\u2019s the original strain or a variant. Having a savvier immune system, in turn, means that even if you do get infected, you\u2019re less likely to need to be hospitalized, and less likely to die.<\/p>\n \n

\u201cRegardless of what\u2019s happening with this variant, we\u2019re much better with people seeingSARS-CoV-2 after seeing the vaccine than not,\u201d said Derek Cummings, a biology professor at the University of Florida\u2019s Emerging Pathogens Institute.<\/p>\n \n

However, we\u2019re not very far along with vaccinations yet. As of F\neb. 4, only 2.1%<\/a> of the U.S. population had been reported to have received both doses of the vaccine; 8.5% had received one dose. That means we\u2019re in a precarious moment right now where the vast majority of the U.S. hasn\u2019t had a chance to get protected, and the variants have a window to multiply. (Of course, those who have already gotten sick with COVID-19 have natural immunity, but some scientists are concerned that those who develop only mild symptoms may not gain as much innate immunity as those who receive a vaccine.)<\/p>\n \n

Of the scientists I talked to, Caitlin Rivers, a computational epidemiologist at Johns Hopkins Center for Health Security, was the most optimistic about a potential variant-fueled surge. \u201cI do think that B.1.1.7 has the possibility to precipitate a wave, but it probably won\u2019t be as bad as the last wave, because we have a lot of preexisting immunity and we are rolling out the vaccines,\u201d she said. Thanks to the vaccines, the U.S. will have more population immunity by March, when the CDC predicts B.1.1.7 will become dominant, than the U.K. did when the variant hit there late last year. \u201cIt\u2019s a low likelihood that we will have a gigantic fourth wave, but not impossible,\u201d she said.<\/p>\n\n

Still, Rivers said, \u201cnow is not the time to relax.\u201d She, too, was critical of state policies to loosen restrictions. \u201cWhen you create the same conditions that allowed the last surge, you should expect the same results,\u201d she said. \u201cOur main move should be to reduce transmission as much as possible while we vaccinate as much as possible.\u201d<\/p>\n \n

Time is not on our side, as the morphing B.1.1.7 variant showed us when it picked up the E484K mutation. While we are lucky that our vaccines still work against the current variants, we have to keep in mind that in this race between vaccines and variants, the variants aren\u2019t staying static.<\/p>\n \n

The big fear is that eventually, a variant will come along that provides the virus with a complete immune escape, preventing our vaccines from working against it. Even though we can update our vaccines, that would take time. The only way to guarantee that the virus won\u2019t mutate into a variant that our current vaccines don\u2019t cover is to lower transmission significantly, said genomic epidemiologist Alli Black: \u201cThe virus will continue to mutate as it continues to spread. We\u2019re not going to stop that biological fact unless transmission stops.\u201d And vaccinating everyone quickly is one key way to make it harder for the coronavirus to get from person to person in the first place.<\/p>\n \n

\u201cWe need to start responding like the variants are going to take over and they are one of the biggest threats,\u201d said Cummings, \u201cor we won\u2019t have vaccinated enough people when this rolls through.\u201d <\/p>\n\n

\n<\/p>\n \n

Throughout this pandemic, the U.S. has often been in the fortunate position of not being first when it comes to novel viral encounters. We weren\u2019t the country where SARS-CoV-2 originated. We weren\u2019t the place where B.1.1.7 was spawned. We\u2019ve had the opportunity to look to other countries and learn from them, if only we\u2019d choose to.<\/p>\n \n

Epidemiologist after epidemiologist pointed out that the U.K., Denmark and Portugal required drastic measures<\/a>\u2014 the dreaded L word, \u201clockdown\u201d \u2014 to get B.1.1.7 under control. \u201cWe\u2019ve seen that multiple different countries in Europe have had toclose schools <\/a>after making it a policy that schools would be the last to close,\u201d Rivers, from Johns Hopkins, noted.<\/p>\n \n

If we don\u2019t want the same fate to befall the U.S., now is the time to act, the scientists urged.<\/p>\n \n

Improving surveillance can help. Utah Public Health Laboratory has a robust state sequencing program, analyzing a random sample of cases sent by the state\u2019s two largest hospital groups. Kelly Oakeson, its chief scientist for next generation sequencing and bioinformatics, has set a goal of sequencing 10% of all cases in the state; his lab is currently doing about 3%. They could do more, he said. The only problem is that they don\u2019t have enough pipette tips due to a national shortage. Oakeson said he\u2019s hoping that the Biden administration will leverage the Defense Production Act to produce more pipette tips so he can increase his state\u2019s surveillance capabilities.<\/p>\n \n

\u201cWe can\u2019t get transmission down through vaccination alone,\u201d said Rasmussen, the Georgetown virologist. \u201cWe need to be encouraging leadership, both at the state and federal levels, to protect people, to have paid sick leave for people if they become symptomatic.\u201d<\/p>\n \n

A restaurant server in New York City, who was laid off early in the pandemic from a high-end steakhouse, told me he understood what the epidemiologists were saying from a scientific point of view. But, he asked, \u201cif you want to shut everything down, who\u2019s going to pay the bills?\u201d<\/p>\n \n

He continued, \u201cIn order to do what the epidemiologists want to get done, you can only do that with policies to support the people and make it worth their while to do it.\u201d He\u2019s job hunting, and he said that if he was offered a position that put him indoors on Valentine\u2019s Day, \u201cI would have to take it.\u201d He\u2019d put on a double mask and go to work.<\/p>\n \n

Whenever we have options, though, individual decisions can make a difference. Black, the genomic epidemiologist, encouraged everyone to limit travel as much as possible: \u201cIt just really facilitates introductions of these circulating variants.\u201d<\/p>\n \n

Hang in there, urged Scarpino, the Northeastern professor, painting a hopeful picture: \u201cCases are coming down, vaccines are going up. Let\u2019s pretend that politicians wake up and don\u2019t reopen restaurants and we avoid a big wave in March. Then we\u2019re running downhill on the vaccines because the pipeline gets better and better. Then we can get our lives back.\u201d<\/p>\n \n

That sounded so tantalizing. Dream-worthy. Just a matter of good science-based public policy and collective compliance driving down the case counts until those little mindless RNA-filled fat sacs have nowhere to go, no one to infect, no way to replicate, no chances to mutate. I imagine them bumping around, lost without crowded indoor spaces to breed in, thwarted by vaccine-boosted immune cells, unable to find a host, dwindling, going, gone.<\/p>\n \n

This post was originally published on Articles and Investigations - ProPublica<\/a>. <\/p>","protected":false},"excerpt":{"rendered":"

Caroline Chen <\/p>\n

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign u…<\/p>\n","protected":false},"author":1862,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[338],"tags":[],"_links":{"self":[{"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/posts\/28583"}],"collection":[{"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/users\/1862"}],"replies":[{"embeddable":true,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/comments?post=28583"}],"version-history":[{"count":4,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/posts\/28583\/revisions"}],"predecessor-version":[{"id":29445,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/posts\/28583\/revisions\/29445"}],"wp:attachment":[{"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/media?parent=28583"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/categories?post=28583"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/radiofree.asia\/wp-json\/wp\/v2\/tags?post=28583"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}