“The striking thing about these cases that we have is that there is no linkage between the cases that we can identify right now,” said Dr. Janet Memark, director of the Cobb & Douglas Public Health District, which has variant cases in both of its counites. “So it’s not between contacts. It’s not from a traveler or anything like that. And so right now, it’s identified as community transmission.”

Known as B.1.1.7, the new strain is believed to be far more contagious than the common SARS-CoV-2 virus and, according to British researchers, may also be 30% to 40% more deadly.

The proliferation of a potential super-spreader strain raises the stakes for Georgia and the nation, with residents already weary from a crisis that’s lasted 11 months and with a devastating post-holiday surge finally subsiding. On Monday DPH reiterated its broken-record list of mitigation steps that all Georgians ought to be taking — masking, distancing, hand washing, avoiding crowds — advice which anyone who’s ventured out in public knows is still being widely ignored.

Dr. Colin Smith, a social epidemiologist and a clinical assistant professor for Georgia State University’s School of Public Health, said the state must race the clock to get as many people immunized as possible — an effort that has been fraught with frustration and delays over the past month.

The worst-case scenario: If infections continue unabated, Smith said, the strain could mutate further until vaccines become less effective against it, causing the pandemic to extend into the fall or beyond. The Centers for Disease Control and Prevention already expects the U.K. strain to become dominant in the U.S. by March.

“It means that the recommendations that we are starting to see, that people need to be wearing hopefully N95 masks or double masking in some capacity, need to be taken seriously,” Smith said. “And we need to do the things that we were supposed to be doing the whole time — maintain six-feet distancing, do not go outside of your safety bubble if at all possible, and just wash the hands.”

Credit: Ben Gray / Ben@BenGray.com

Credit: Ben Gray / Ben@BenGray.com

19 and counting

Last week, when Georgia had just six confirmed cases of the variant U.K. strain, DPH declined to say which cities or counties had seen infections, telling The Atlanta Journal-Constitution that doing so could identify individual patients. The department’s lead attorney cited the state’s open records law and the the federal Health Insurance Portability and Accountability Act, or HIPAA, which protect patient privacy.

Government transparency advocates, however, called that a misinterpretation of the law and blasted the department for withholding vital information during a health crisis. The AJC filed a formal request under the state Open Records Act, and over the weekend the department reconsidered and released a list of counties, then released additional details on Monday.

According to DPH, the variant has been detected in four residents of Fulton, four residents of Cobb, three residents of Gwinnett, two residents of Paulding, two residents of Carroll, and in one resident each in DeKalb, Cherokee, Douglas and Clayton counties.

DPH said the 19 cases involve eight males and 11 females, ranging in age from 15 to 61. Spokeswoman Nancy Nydam said in an email that state contact tracers are working with the patients to identify close contacts and monitor them for signs of infection. So far no “route to Georgia” has been determined, she said.

The agency also noted that infected individuals could be anywhere in the state. “Just because it has not been identified in a particular city or county does not mean it is not there,” it said in a press release.

Dr. Audrey Arona, director of the East Metro Health District which covers Gwinnett, Newton and Rockdale counties, said that Gwinnett’s three B.1.1.7 cases are being given top priority for contact tracing.

“We do expect more,” she said.

The public doesn’t need to panic, Arona said, but it can’t be complacent either, especially now.

“All we can do is just really hope and pray that our citizens listen to our pleas for them to adhere to all these prevention measures,” she said. “The measures that we ask people to do work against this virus, and any strain of this virus.”

Other researchers echoed that the current low number of infections reported by DPH is misleading.

“The new variant seems to be more contagious,” said Pinar Keskinocak, an engineering professor at Georgia Tech University who develops long-term immunity and mutation models that help governments and hospital systems prepare for pandemics. “And that, combined with people’s general tiredness of physical distancing, it’s not a good combination.”

Credit: Ben Gray / Ben@BenGray.com

Credit: Ben Gray / Ben@BenGray.com

How to stop it

Public health experts told the AJC that to stem the spread of the variant, the state should hire many more contact tracers, but it’s unclear whether the state intends to do so.

Dr. Memark, of Cobb & Douglas Public Health, said people who test positive are becoming less cooperative with contact tracers, and delays in processing COVID tests are also thwarting mitigation efforts. She said when her district found out about the variant cases in Douglas and Cobb, the COVID tests they were based upon were already weeks old.

“That doesn’t help us in our prevention strategies,” Memark said. “You’ve already been out and about, and it just doesn’t help that situation.”

Another strategy could be to conduct more COVID tests to increase surveillance for variants. Currently, the strategy has been to test only those who want to be tested. But a more effective measure would be to conduct random tests of businesses, schools or small communities, experts said.

For example, Georgia Tech has been conducting random tests of 10 percent of its faculty. That makes sense when 40 percent of transmissions are by people who have no symptoms, said Amber Schmidtke, a former associate professor of medical microbiology and immunology at Mercer University in Atlanta.

Like other experts, she cautioned that Georgia needs to act quickly to address the spread of the variant before it fuels another surge.

“Considering that we are starting to slide down this winter peak,” she said, “if this variant takes hold and is as transmissible as is reported to be in other countries, we could very quickly revert and run back into a new surge.”