Over two millennia ago, the great Greek tragedian Sophocles said “Look and you will find it – what is unsought will go undetected.” This holds true today.
In the Memphis regional area, local laboratory directors looked. We conducted COVID-19 testing with sequencing to identify mutant strains, and we found them.
Since Jan. 1, we sequenced 453 random and selected samples, about 2.3% of the positive cases. We found 12 UK strains, 1 South African strain, 2 Brazilian P2 strain, 7 California strains and 1 New York strain.
When we called our counterparts in sister cities, they had few or no reported mutant strains. They are simply not looking. They are not sequencing for mutant strains. Across America this is the norm.
How the variants evolve
Over a year ago, when life was “normal,” COVID-19 was stealthily penetrating our country. CDC was woefully behind in testing and we did not act with sufficient urgency. The virus epidemiologically evolves through three critical stages: seeding, clustering and community transmission.
Seeding occurs when a few cases from outside enter the region, as from China and Europe to the United States. Then there is clustering. Locally one case leads to others which can be linked with aggressive contact tracing.
Lastly, there is community transmission when cases are occurring in large numbers with no easy identifiable common link. The consequences of letting the original virus evolve were devastating with over a half million Americans dead and trillions in economic losses in one year.
Today, variants are rising in our communities. They will have the same trajectory of evolution from seeding, clustering and community transmission. And once again, we are not looking for them systematically.
The local Memphis regional sequencing data tells us if we have mutations. And, the identification of variants of concern must be conducted not just locally but nationally.
Change is coming
A credit to the federal government, the Centers for Disease Control and Prevention will spend $200 million to sequence 10% of cases and a bill awaiting congressional approval requests over $1 billion in funding for sequencing. Additionally, a new billing code has been created so the laboratories can get paid for conducting sequencing.
We are in a neck-and-neck race as the variants establish themselves, and the vaccine is rolled out. While there are some mutant variants which are less effective against the variant strains, in large part experts agree that the vaccine will confer sufficient protection to prevent severe disease and death even against mutant strains.
In addition to sequencing, we need to be doing greater widespread “blanket” testing. In one local institution, one case of UK Strain B117 was discovered by surveillance sequencing. After testing within days, tens of new cases were found. Tracing, isolation and further aggressive testing led to no new positive cases detected.
This is a success story, made possible by the early detection of the mutant strain and blanket testing of all contacts. All health departments need to collaborate with private laboratories to do sequencing for positive cases to look for the variant and to collaborate in further testing and tracing the positive cases to stall the mutant virus from becoming community transmission.
With the vaccines there is hope, with the variant there is concern. Let us not fly blind. Let us look closely at our circumstances and act in a timely and informed manner.
Source: Commercial Appeal