In contrast, the United States has one of the weakest genomic surveillance programs in any rich country, Hanage said. “As it stands, people like me partner with places and try to beg” for samples, he said in a recent call with reporters.
Other variant strains have been identified in South Africa and Brazil, and share some mutations with the UK variant. The fact that these changes have evolved independently in various parts of the world suggests that they may represent an evolutionary advantage for the virus. Yet another strain was recently identified in Southern California; it was signaled because of its growing presence in hard-hit cities like Los Angeles.
The Southern California strain was detected because researchers at Cedars-Sinai, a hospital and research center in Los Angeles, have unrestricted access to patient samples. They could see that the strain represented an increasing share of cases in the hospital in recent weeks, as well as among the limited number of other samples collected at random from a network of laboratories in the region.
The United States not only does less genomic sequencing than most other rich countries, but it also does its surveillance by chance. This means that it takes more time to detect new strains and draw conclusions about them. It is still unclear, for example, whether the Southern California variety was really worthy of a press release.
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Vast areas of America’s privatized and decentralized health care system are not set up to send samples to public health labs or academics. “I’m more concerned with systems for detecting variants than with these particular variants,” said the director of the Nevada public health laboratory, Mark Pandori, an associate professor at the University of Nevada-Reno School of Medicine.
Limited genomic virus surveillance is another side effect of a fragmented and underfunded public health system that has struggled to test, track contacts and keep Covid-19 under control during the pandemic, Wroblewski said.
The country’s public health infrastructure, usually financed by disease by disease, has decent systems set up to sequence flu, foodborne illness and tuberculosis, but there was no national strategy for Covid-19. “To look for variants, there needs to be a national framework if done well,” said Wroblewski.
Last week, the Biden administration outlined a strategy for a national response to Covid-19, which included expanded surveillance for variants.
So far, vaccines for Covid-19 appear to protect against known variants. Moderna said its vaccine is effective against strains in the UK and South Africa, although it produces less antibodies against the latter. The company is working to develop a revised dose of the vaccine that could be added to the current two-injection regimen as a precaution.
But a lot of damage can be caused in the time it will take to launch the current vaccine, let alone an update.
Even with limited sampling, the UK variant was detected in more than two dozen states, and the Centers for Disease Control and Prevention warned that it could be the predominant strain in the United States in March. When it took off in the UK at the end of last year, it caused an increase in the number of cases, overburdened hospitals and led to a holiday block. Whether the United States faces the same fate will depend on what tensions are competing and how the public will behave in the coming weeks.
Interactions already risky between people can, on average, be a little riskier. Many researchers are asking for better masks and better internal ventilation. But any update to the recommendations would likely affect margins. Even if the variants spread more easily, the same recommendations that public health experts have been advocating for months – masking, physical distance and limiting time at home with others – will be the best way to avoid them, said the doctor Kirsten Bibbins-Domingo and professor at the University of California, San Francisco.
“The solutions are very unattractive,” said Bibbins-Domingo. “But we need everyone to do it.”
This does not make the task simple. Masking remains controversial in many states, and the public’s patience to maintain physical distance has run out.
Raising concerns: Although case numbers have stabilized in many parts of the United States in recent weeks, they have stabilized at rates many times higher than during previous periods of the pandemic or in other parts of the world. Having that virus in so many bodies creates more opportunities for the emergence of new mutations and new variants.
“If we keep letting this thing spread, it will bypass all the measures we take against it, and that is the worst possible thing,” said Pandori, from Nevada.
Compared to less virulent strains, a more contagious strain is likely to require more people to be vaccinated before a community can see the benefits of widespread immunity. It is a bleak prospect for a country that is already lagging behind in the race to vaccinate enough people to control the pandemic.
“When your best solution is to ask people to do things they don’t like to do, that’s very scary,” said Bibbins-Domingo.
KHN (Kaiser Health News) is a non-profit news service that covers health issues. It is an independent KFF (Kaiser Family Foundation) editorial program that is not affiliated with Kaiser Permanente.
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