The state of Michigan was locked down for months, and then in March it started opening up in the midst of a new surge of coronavirus cases.
Michigan’s experience, and other outbreaks across the country involving new foreign strains, once more raise questions and debates about whether we should close our borders to travelers from some countries, impose new restrictions in some areas, or both. But more on those questions in a minute.
Unfortunately, when you suddenly give people their treasured freedom back, they are more likely to take fewer precautions than if you reopened gradually. On top of this, Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky said this week that the United Kingdom’s B.1.1.7 variant of COVID-19 is now the predominant strain in the U.S. — and the U.K. variant is circulating widely in Michigan.
This is concerning because it is more transmissible and more virulent than the original COVID-19 strain. Therefore, it is no surprise that we are seeing younger patients in the hospitals in Michigan, but not as many older patients, many of whom are likely protected by COVID-19 vaccines. In fact, the Pfizer, Moderna and Johnson and Johnson vaccines appear to protect well against the B.1.1.7 variant.
The problem is that only around 35 percent of Michigan adults have received at least one dose of the vaccine. In the United Kingdom, where the B.1.1.7 variant originally surfaced, over 50 percent of people had received at least one dose of a COVID-19 vaccine before the U.K. began to turn the corner on COVID-19 following its latest surge.
Walensky suggested this week that stronger mitigation strategies be brought back in Michigan, including ensuring mask-wearing, pausing indoor dining, and tighter rules around youth sports. But it isn’t clear how well these measures will work. Michigan Gov. Gretchen Whitmer (D), by contrast, is in favor of ramping up vaccinations, mandating the testing of student athletes and temporarily delaying in-person classes. “We recognize the positive impact of mitigation strategies on spread of the infection,” Dr. Chris Carpenter, an infectious diseases specialist and chairman of Internal Medicine at Oakland University William Beaumont School of Medicine, told me. “But there are negative social and psychological consequences as well.”
I think Gov. Whitmer has the better strategy at least in terms of her focus on rapid vaccination and trying to continue school sports. In fact, I believe we should be targeting vaccine distribution right now to the five states that are experiencing surges — Michigan, New York, New Jersey, Pennsylvania and Florida. A million vaccine doses in Michigan would do a lot more to stem the current tide than closing down a restaurant or a football game.
Genetic surveillance for emerging variants is crucial, too, and must be ramped up. We have the testing capacity — we just need to fund it and use it.
At the same time, we should consider completely shutting the border to travelers from Brazil and restricting travel from Canada to essential workers only, the way
Canada has been doing to U.S. travelers throughout the pandemic. The dreaded Brazilian P1 variant is now circulating in Canada, spreading east from British Columbia. The data on whether the vaccines effectively combat the P1 strain is still emerging.
Meanwhile, Dr. Carpenter says that current travel across the U.S.-Canada border is sufficient to spread the P1 variant, which contains the notorious E484K mutation (which the South Africa strain has, too), and may lead to reinfection and/or render the current vaccines less effective.
February and March saw a marked decrease in case numbers across this country. It is clear that the current uptick in these five states correlates directly with the spread of emerging variants. We need to act like England and Israel and continue a high rate of vaccination to overcome them. The best weapon to add to that is a complete temporary travel ban to and from the regions of greatest concern where these variants have done the most damage.
In one 24-hour period late this week, Brazil experienced over 90,000 new cases and close to 4,000 deaths. Meanwhile, only 12 percent of its population has received at least one dose of a COVID-19 vaccine. This is enough of a reason to stiffen the current travel restrictions to a complete ban of travel from Brazil.
By contrast, in Canada, the numbers are much lower, but there are several reasons to be concerned with over 7,000 new cases over one 24-hour period late this week and just 16 percent of the population having received one COVID-19 vaccine dose, only half of what we have accomplished so far in the U.S. And the there is a growing number of cases of the P1 variant in Michigan.
It is far too late to stop travel from the U.K., since the B.1.1.7 variant has already spread and taken root here. But it is not too late to learn the lesson they have taught us: Control the spread of dangerous variants with travel restrictions, bans and vaccinations, not by closing restaurants or by further denying our youth needed sports activities. With all our worry about the southern border, it turns out we need to be concerned about our other borders too.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”