The reason why December may be the deadliest month in the pandemic yet

Last week, the US surpassed 9 million confirmed coronavirus cases–with John Hopkins reporting a new daily record of 99,321 this past Friday.

Although leading virologists predicted an autumn surge several months back, recent events seem to be compounding initial projections. Among these is a throng of holidays and voting season.

During a segment featured on Face the Nation, former FDA Commissioner Scott Gottlieb theorized about Thanksgiving’s impact on the outbreaks appearing accross the country.

Gottlieb suspects the holiday will be the “inflection point” for a new uptick of coronaviruses cases ahead of winter. This is particularly concerning because the virus’s positivity rate (the percentage of all tests administered that are positive) is currently rising nationwide.

“December is probably going to be our toughest month,” Gottlieb said. “The positivity rate is above 10% in 15 states. And all of the states have an R above one, which means they’re an expanding epidemic right now. This is very worrisome as we head into the winter. I think as we get into the next two or three weeks, it will be unmistakable what’s happening around the country, and we’re going to have to start taking tough steps.”

The four vaccine candidates that are closest to receiving approval from the FDA’s Center for Biologics Evaluation and Research (developed by AstraZeneca, Pfizer jointly with Biotech, Moderna, and Johnson and Johnson) will reportedly be able to prevent the development of symptoms following SARS-CoV-2 transmission but they might not be able to prevent the pathogen from penetrating host cells.

Adding to this, are emerging reports on COVID-19’s evolution. The particular coronvirus responsible for the disease is a fast-acting RNA virus: every time it replicates genetic material it does so uniquely, giving it more opportunities to perfect its tranmittiability.

The latest comes from the peer-reviewed journal, mBIO, In it, the authors posit that a new mutation called D614G, is responsible for a spike protein that makes populations more vulnerable to transmission, which may, in turn, be contributing to the recent surges referenced above.

As is the case with much of the preliminary research on new strains of SARS-CoV-2, it’s important to remember that the following data is susceptible to contradicting analysis, whether it be previously published or provisionally hidden by a fog of yet to be known unknowns.

The principle function of COVID-19 research is to supply clinicians with a long list of variables to anticipate while treating patients and the public with additional reasons to take public health measures seriously during a pandemic.

That being said, the new assessment is the largest peer-reviewed study of SARS-CoV-2 genome sequences associated with a single metropolitan region in the US.

The region happens to be Houston, Texas, where 71% of the positive coronavirus cases recorded during the first wave of infections were linked to the D614G mutation. This figure increased to 99.9% during the second wave of local outbreaks toward the middle of summer.

“We sequenced the genomes of 5,085 SARS-CoV-2 strains causing two COVID-19 disease waves in metropolitan Houston, Texas, an ethnically diverse region with seven million residents,” the authors of the new paper wrote. “Genomes were from viruses recovered in the earliest recognized phase of the pandemic in Houston, and an ongoing massive second wave of infections. The virus was originally introduced into Houston many times independently.

The virus is mutating due to a combination of neutral drift — which just means random genetic changes that don’t help or hurt the virus — and pressure from our immune systems.”

There isn’t really a consensus with respect to the mechanisms just yet. A generic stab at it reasons with the laws of natural selection. If the D614G variant outpaces other strains, cluster infections will favor its sequence.

The variant seems to spread more quickly among communities even if there isn’t any evidence to suggest that it influences disease severity.

SciTechDaily cited the founder’s theory in a recent dissertation. According to the theory, the D614G spike protein may have just arrived earlier than other strains which would explain its prevalence.

From their report:

“The spike protein is also continuing to accumulate additional mutations of unknown significance. The Houston Methodist-UT Austin team also showed in lab experiments that at least one such mutation allows spike to evade a neutralizing antibody that humans naturally produce to fight SARS-CoV-2 infections. This may allow that variant of the virus to more easily slip past our immune systems. Although it is not clear yet whether that translates into it also being more easily transmitted between individuals.”

Still, the mutation is pretty rare in the grand scheme of things. Even if you live in a region disproportionately impacted by it, the countermeasures established by public health experts (masks, social distancing, and contact tracing) will likely keep populations protected from transmission.

“The virus continues to mutate as it rips through the world. Real-time surveillance efforts like our study will ensure that global vaccines and therapeutics are always one step ahead.” Ilya Finkelstein, associate professor of molecular biosciences at The University of Texas at Austin and co-author of the new study concluded.