How COVID-19 Could Be Much Worse In 2021 - Honolulu Civil Beat


About the Authors

Monique Chyba

Monique Chyba is a professor of mathematics at the University of Hawaii at Manoa and a member of the Hawaii Pandemic Applied Modeling work group.

Victoria Fan

Victoria Y. Fan is an associate professor of health policy at the University of Hawaii at Manoa and a member of the Hawaii Pandemic Applied Modeling work group.


Reports of states discovering individuals carrying the new mutated strains of SARS-CoV-2, originally found in the UK, have begun trickling in. States such as Colorado and California have already detected the mutated virus.

Officials in the media have commented that the mutated virus has substantially higher transmissibility (meaning it spreads faster), but that mortality is no worse than the original strain.

Equivalent mortality, however, does not imply this mutation is no less worrying.

On its own, higher transmissibility — even without higher mortality — is very concerning. Faster spread means more people will get the virus more quickly.

With more people infected at any given time, the exponential growth of cases will be larger — with taller spurts and growths of cases from day to day. Imagine case counts growing larger in greater leaps.

With faster growth in cases, we risk our hospitals being more quickly inundated with COVID-19 hospitalizations. The faster spread also means that testing, contact tracing and isolation and quarantine efforts need to be even faster in order to adequately prevent and control the spread.

A faster-spreading uncontrolled virus also means that the current thresholds as defined in the Honolulu tier system will be more quickly crossed and exceeded. The ability to hit requirements for shutdown will be much faster. With the new mutation, the impact and pain to our economy may be sharper.

One of us, Monique, leads a National Science Foundation-funded study and its early research findings confirmed these broad findings. The study developed a model that uses the best available science and data including Hawaii-specific data customized to local conditions and local policy actions.

It found that higher transmissibility of the mutated virus means that it has the potential to replace the original virus. It also has the potential to be overwhelming.

Customers form a social distanced line outside Kahala Whole Foods during COVID-19 pandemic. August 5, 2020
COVID-19 has already upended every aspect of our daily lives. But if the virus changes significantly, there may be worse to come. Cory Lum/Civil Beat/2020

A baseline scenario using the original virus would expect 77 deaths in two months assuming a reproduction rate of about 1.09 and fatality risk of 1.3%.

With a mutated virus that has a 50% higher transmissibility rate, we could see the death toll increasing to 430 from that baseline of 77 deaths. This is an alarming increase of more than 450%.

By contrast, with a mutated virus that has a 50% higher mortality rate, we would see an additional 120 deaths, a much lesser 55% increase from the baseline.

So what should policymakers do? First, we need to study this new mutated virus immediately. Fortunately, the Department of Health has indicated that they are monitoring the situation.

Enhancing genomic surveillance activities of positive cases requires a thoughtful sampling strategy — with a particular focus on cases that are imported and related to travel.

Expanding genomic surveillance can also help to identify new mutations. Resources — both human and financial — are needed to get ahead of this mutated virus.

Policymakers also need to think through how to further enhance the speed of the current public health response. Even as efforts on vaccination are expanded (which will take time to implement throughout 2021), the state must continue to expedite the timeliness and speed of public health control efforts against a mutating COVID-19.

This mutation could be potentially more devastating for the islands, a pandemic far worse than what we saw in 2020. Working faster to fight and control COVID-19 means we need to work smarter. To work smarter, we need to develop a plan to continue to not only detect new mutations but to specifically fight this new mutated virus.

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About the Authors

Monique Chyba

Monique Chyba is a professor of mathematics at the University of Hawaii at Manoa and a member of the Hawaii Pandemic Applied Modeling work group.

Victoria Fan

Victoria Y. Fan is an associate professor of health policy at the University of Hawaii at Manoa and a member of the Hawaii Pandemic Applied Modeling work group.


Latest Comments (0)

Is it likely that the new strain is here already? Is there any reason to doubt that the new strain is coming or that it will dominate in a matter of weeks thereafter? Is it time to suspend Safe Travels until vaccination is more advanced? Would doing so have any impact other than delaying the inevitable? (How many lives could we save with a 6-week pause?)

LarryS · 1 year ago

Thank you for stepping up Victoria and Monique. This warning, coming from institutional experts is long overdue. I hope your voices will have some impact on our policymakers -- our leaders have only been "reactive" since the Oct. 15th "re-opening." 😒

Jray · 1 year ago

Is there any chance that your modeling documentation and/or code will be made public? AFAIK neither HIPAM nor the state have released any info on their models so it'd be refreshing if somebody local finally did.

Laron · 1 year ago

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