A coronavirus variant first detected in the United Kingdom is now the dominant variant in the United States.
The B.1.1.7 variant of SARS-CoV-2 is present in all 50 US states and is contributing to the surges of coronavirus infection, according to the US Centers for Disease Control and Prevention. Not only does it appear to be more transmissible; some research also suggests it can cause more severe disease, which puts more people at risk for hospitalization and death.
What should people do to protect themselves against this more contagious variant? We asked CNN Medical Analyst Dr. Leana Wen, an emergency physician and visiting professor of health policy and management at the George Washington University Milken Institute School of Public Health. She's also the author of the forthcoming book "Lifelines: A Doctor's Journey in the Fight for Public Health."
CNN: What should we do differently now that the B.1.1.7 variant has become dominant in the United States?
Dr. Leana Wen: The B.1.1.7 variant is more transmissible than the previous strains, which means we need to be even more cautious. Some activities that we previously thought were low risk — such as going to the grocery store and taking public transportation — now have a higher risk for virus transmission. Those that were high risk before—such as going to indoor bars or gathering in large crowds — are now even higher risk.
We need to be even more on guard than before. For example, if you are going to eat outdoors at a restaurant, check to make sure that they are abiding by CDC guidelines and there is at least 6 feet of distancing between tables. Those not yet fully vaccinated should wait until they are vaccinated before dining in close proximity with someone else at their table.
That said, this variant is spread just like other variants. The same measures we used before to prevent coronavirus spread are still effective now. That means wearing a mask in public, practicing physical distancing, and avoiding indoor gatherings with people not in your household.
It's even more critical than ever to be vaccinated as soon as it's your turn.
CNN: Do the vaccines work against this variant?
Wen: Yes — and this is a really important point. All currently authorized vaccines provide a good level of protection against B.1.1.7 (remember that no vaccine is 100% effective, but getting vaccinated against Covid-19 means that you are at far less risk for contracting the illness and becoming severely ill from it). There are other variants against which the vaccines may be a little bit less effective. However, vaccines are still the critical tool to prevent these other variants, too, and still other variants that may develop in the future.
Viruses mutate when they replicate. The best way to prevent viruses from mutating is to stop the spread. We help slow down and stop the spread when we get vaccinated.
CNN: What about this variant makes it particularly dangerous for young people?
Wen: In recent weeks, we are seeing that younger people are being infected in higher proportions. This includes teens as well people in their 20s, 30s and 40s. This likely is due to a combination of factors.
Older people are those who were vaccinated first and so are more protected. Many younger people are not yet vaccinated, and given their increased level of activity, when there is a more contagious variant, they are likely to be infected more. There may also be something about B.1.1.7 that makes it more easily attach to the respiratory system and for people to harbor more virus, thus possibly sickening them more and making them more infectious to others, too.
All this suggests that it's not so much that the virus is somehow attacking younger people preferentially, but younger people are more vulnerable since many have not been vaccinated.
CNN: What should we do to avoid getting infected by this more transmissible variant?
Wen: For people who are not vaccinated, they should try to be vaccinated as soon as possible. That's the best defense against this variant — and others.
Until they can be vaccinated, they should double down on all the precautions. Again, that means wearing a mask in all public places. Studies have shown that it helps to wear two masks — a well-fitting cloth mask on top of a surgical mask. I'd wear two masks like this or an N95 mask in higher-risk settings, such as if you're using public transportation or attending indoor church service with a lot of people around you.
Try to avoid the most high-risk settings where people don't have their masks on, such as indoor dining. Socialize outdoors only, with members of different households separated at least 6 feet apart.
CNN: The CDC has specifically singled out youth sports as a driver of infections. Should these stop?
Wen: It is true that in Michigan and Minnesota, among other places, there have been outbreaks associated with youth sports. With this more transmissible B.1.1.7 variant, and the fact that youth under 16 cannot yet be vaccinated, it is best to use caution.
Sports that can be played outdoors will be a lot safer than those played indoors. Contact sports like wrestling will be much higher risk than, say, soccer or lacrosse. Players should be wearing masks at all times when physical distancing can't be maintained. Regular surveillance testing of all players can help — for example, if everyone is tested twice a week to check for asymptomatic infection.
It's very important for parents to monitor informal settings just as much as formal settings. You wouldn't want all the precautions to be followed during organized sports, only to have transmission happen at the pizza party after the game. Or for the student-athletes to be letting down their guard and transmitting the virus in the locker room if everyone is gathering there, without masks, for long periods of time.
Ideally, these types of social interactions are limited for the time being, with strict precautions followed so as to prevent virus spread and to allow for as much of the actual sport -- and in-person school — as possible.
CNN: What about people who are fully vaccinated — do they still have to be as careful?
Wen: The vaccines we have work very well against the B.1.1.7 variant. People who are fully vaccinated should know that they are very well protected against this strain. "Fully vaccinated" means that it's been at least two weeks after someone has received their vaccines.
Nothing is 100%. What people choose to do once fully vaccinated will depend on their values and their choices. After being vaccinated, activities that were once high risk are going to be lower risk, but there will still be some risk. That needs to be weighed against the benefit of these activities.
The CDC says that fully vaccinated people can see one another and that they can visit one other household with unvaccinated family members, as long as the unvaccinated people are not at high risk for severe outcomes from Covid-19 themselves. It's definitely necessary to wear masks in public places, even after being vaccinated, and to reduce time in high-risk settings like indoor crowded places with unvaccinated people.
I've advocated for thinking about a "coronavirus budget" — essentially, knowing that you can't do everything but should choose the things that are of the highest importance to you.
CNN: Even with a different variant, your bottom-line advice is to follow the same protective measures we're already following?
Wen: That's right. We need to keep in mind that the pandemic is not over. There is absolutely hope and hope is here, but we still need to exercise caution, especially because of this more contagious variant.
Please keep masking, physical distancing, and avoiding indoor gatherings. Aim to get vaccinated as soon as possible. Getting vaccinated is the key to stopping this virus from continuing to spread and potentially sicken many more people.