NORTH CHARLESTON, S.C. — South Carolina was already experiencing one of the worst coronavirus outbreaks in the nation when officials got word this week of an alarming development: A new, more concerning variant of the virus, originally identified in South Africa, had been detected in the state.
Not long after, a second case was discovered with no known connection to the first, state officials announced on Thursday.
Neither patient had a history of travel, officials said, suggesting that what many public health experts had feared had come to pass: The new variant of the virus had taken root in the United States.
The arrival of the variant — believed to be highly contagious and less responsive to vaccines — underscores the shaky progress the country has made in its battle against the virus. Even as millions of people have gotten vaccinated, and the country teeters on a downward slope of more than 150,000 new coronavirus cases a day, new mutations of the virus are threatening to undermine what little headway the country has made.
“It is a pivotal moment,” said Shane Crotty, a virologist at the La Jolla Institute for Immunology in California, who studies immunity against infectious diseases. “It is a race with the new variants to get a large number of people vaccinated before those variants spread.”
Pat Kearns, 87, sat in her car in a jammed parking lot clinic in North Charleston on Friday, after receiving her own coronavirus vaccine amid the news that the new variant had appeared.
“This virus is a lot faster than we are,” said her daughter Teresa. Pat Kearns, a retired radiology nurse, said that even after she received both of her shots, she had few plans to immediately venture out. “I’ll stay where I am,” she said. “Staying safe.”
The variant from South Africa, known as B.1.351, is one of several mutations that have emerged as the pandemic has dragged on. Others include a variant from Brazil, which was detected in Minnesota this week, and one from Britain, which is spreading more widely in the United States.
The variants are believed to be more contagious, and the one from South Africa is among the most worrisome because preliminary research suggests that vaccines may be less effective against it.
Both Moderna and Pfizer-BioNTech — the companies manufacturing the two vaccines currently on the U.S. market — have said their shots are slightly less protective against the variant from South Africa, and the companies are considering creating either a booster shot or new version to head off the variant.
Similarly, Johnson & Johnson, the only major drugmaker developing a single-dose coronavirus vaccine, announced on Friday that its shot would provide strong protection against Covid-19 if approved, with an efficacy rate of 72 percent in the United States. But it is less effective against the new variant — dropping to 57 percent in South Africa.
Though that variant appears to partially escape antibodies built up against Covid-19, experts said that vaccines, by and large, should still be effective. Research suggests that even when a vaccinated person does become ill, vaccines can help reduce the severity of Covid-19.
“Vaccines aren’t an all-or-nothing thing,” said Dr. Crotty, who likened getting a shot against the virus to hitting the brakes during a car crash, in that even partial braking — or vaccine efficacy — is far better than none.
But in one troubling development, the variant may also follow a less clear-cut pattern than the traditional version of Covid-19, which is believed to have offered at least short-term immunity to people who got sick. Novavax, a fourth company developing a vaccine, reported that in a small trial in South Africa, about one-third of the participants had previously been infected with Covid-19, but the results suggested that their previous illnesses did not protect them against the new variant.
Even though President Biden banned travel from South Africa beginning on Saturday, the variant could spread significantly in the United States, potentially making up a large portion of its infections by April.
The developments landed with a thud in South Carolina, which is experiencing one of the worst outbreaks in the country, behind only Arizona. “The fight against this deadly virus is far from over,” South Carolina’s interim public health director, Dr. Brannon Traxler, said during a news conference announcing the new cases. “We all must be more vigilant.”
Currently more than 150 million people — almost half the population — are eligible to be vaccinated. But each state makes the final decision about who goes first. The nation’s 21 million health care workers and three million residents of long-term care facilities were the first to qualify. In mid-January, federal officials urged all states to open up eligibility to everyone 65 and older and to adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19. Adults in the general population are at the back of the line. If federal and state health officials can clear up bottlenecks in vaccine distribution, everyone 16 and older will become eligible as early as this spring or early summer. The vaccine hasn’t been approved in children, although studies are underway. It may be months before a vaccine is available for anyone under the age of 16. Go to your state health website for up-to-date information on vaccination policies in your area
You should not have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you don’t have insurance, you should still be given the vaccine at no charge. Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a co-payment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients, including those who are uninsured. Even so, health experts do worry that patients might stumble into loopholes that leave them vulnerable to surprise bills. This could happen to those who are charged a doctor visit fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules. If you get your vaccine from a doctor’s office or urgent care clinic, talk to them about potential hidden charges. To be sure you won’t get a surprise bill, the best bet is to get your vaccine at a health department vaccination site or a local pharmacy once the shots become more widely available.
That is to be determined. It’s possible that Covid-19 vaccinations will become an annual event, just like the flu shot. Or it may be that the benefits of the vaccine last longer than a year. We have to wait to see how durable the protection from the vaccines is. To determine this, researchers are going to be tracking vaccinated people to look for “breakthrough cases” — those people who get sick with Covid-19 despite vaccination. That is a sign of weakening protection and will give researchers clues about how long the vaccine lasts. They will also be monitoring levels of antibodies and T cells in the blood of vaccinated people to determine whether and when a booster shot might be needed. It’s conceivable that people may need boosters every few months, once a year or only every few years. It’s just a matter of waiting for the data.
Though new infections have slowed from a peak this month, South Carolina is now reporting more new cases and has more people in hospitals than at any time last year. It is also reporting the most deaths of the entire pandemic.
It is unclear what role the new variant may be playing in the spread in South Carolina, where officials warned against panic and said contact tracing did not indicate “mass widespread transmission.”
But the new variant only raised the stakes for the state, where Gov. Henry McMaster, a Republican, has taken a largely hands-off approach on virus restrictions, keeping restaurants and bars open and avoiding a statewide mask order in a strategy he has characterized as good for the economy. Unemployment in South Carolina is down to 4.6 percent, lower than the national average.
But experts say controlling the spread of the virus is crucial to stopping any new variants before a potential explosion of cases leads to even more hospitalizations and deaths.
“We need to get the pandemic under control,” said Dr. Krutika Kuppalli, an assistant professor of medicine and infectious-disease physician at the Medical University of South Carolina, who often leaves a shift treating Covid-19 patients at the hospital only to see bars crowded with people on her way home.
“I don’t want to be sitting here next year talking about an even more resistant virus,” she said, adding, “We need to find renewed resolve to come together and make it to the finish line.”
At Roper St. Francis Healthcare, which owns four hospitals in the southeastern part of the state, 17 percent of beds were filled with patients with Covid-19 on Friday, and other people were descending on a drive-through clinic run by the hospital system. Dozens lined up in cars on a blustery Friday morning to receive the first of two Pfizer vaccine shots, filling a vast parking lot at the North Charleston Performing Arts and Convention Center.
“The demand has been off the charts,” said James Bowron, a director of operations for Roper St. Francis. “We’re getting deluged with requests.”
Lynn Bauman was relieved to get her vaccine on Friday but said she had no plans to change her routine. “We still have to wear our masks and wash our hands,” she said. “It’s just going to be this way for a while.”
In a signal of the nation’s fraught progress, many people calling now to get an appointment in South Carolina may have to wait weeks to get vaccinated. At the North Charleston clinic, appointments are not available until mid-March, when new variants of the virus are expected to be much more widespread.
Chris Dixon reported from North Charleston, and Sarah Mervosh from New York.