| Detroit Free Press
Colorado confirms the first known case in the US of a new COVID-19 strain
Colorado confirmed the first known case in the United States of a new coronavirus strain first identified in the United Kingdom.
USA TODAY
They are like the sentinels of the coronavirus pandemic, watching with their eyes fixed on the horizon, looking for invaders.
These infectious disease keepers – scientists from the Michigan Bureau of Laboratories who sequence the entire genome of COVID-19 test samples – rang the warning bells on Saturday.
They alerted state health officials and the public that a new, more transmissible variant of SARS-CoV-2 was detected in a washtenaw County test sample.
Called B.1.1.7 or the UK variant because it was where it was first identified in September, health officials are concerned with what its arrival in Michigan could mean for the number of cases, hospitalizations and deaths.
Although this strain of the virus is no longer deadly and is not known to make people more seriously ill than other previously identified strains, B.1.1.7 spreads more easily.
“It appears to be about 50% more transmissible or able to spread 50% faster,” said Dr. Adam Lauring, associate professor of infectious diseases and microbiology at the University of Michigan. “One way to think about this is if a person usually infects two other people on average with coronavirus, with variant B.1.1.7, that person can infect three other people on average. And so magnified, this can lead to a lot of growth virus faster.
“What I always come back to is this: if it spreads faster, it means that there will be more people who will get infected and it means that there will be more people who will get sick and be hospitalized. And that could mean that more people will die.
“So while it is not really lethal on an individual level, it spreads faster. It will cause more infections and more serious illnesses and more deaths, so I think that’s what concerns,” said Lauring, whose work on sequencing the complete genome in UM it is responsible for about 2.5% of the total surveillance of coronavirus in the country.
Variant B.1.1.7 was detected on Saturday in a COVID-19 test sample from a woman living in Washtenaw County who traveled to the United Kingdom, according to state health officials.
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Two new cases have been identified among the woman’s close contacts, although it remains unclear whether they have the same strain. It takes a minimum of five days to fully sequence a COVID-19 test sample to identify the particular strain, said Heather Blankenship, manager of the bioinformatics and sequencing section of state laboratories.
“Often, this will take up to a week because of holidays and weekends and other tests that are going on for diagnosis,” said Blankenship.
The Washtenaw County woman and her close contacts are now quarantined, state health officials said.
Some states go up, Michigan keeps watch
So far, the British strain of the virus has been identified in at least 16 other states.
The U.S. Centers for Disease Control and Prevention announced on Friday that the trajectory of the variant’s spread suggests that it may become the predominant strain in circulation in the U.S. in March.
If that happens, the CDC has warned that it could “threaten limited health resources, demand an extensive and more rigorous implementation of public health strategies and increase the percentage of population immunity needed to control the pandemic”.
This is already happening in the UK.
England, Northern Ireland, Scotland and Wales are blocked while hospitalizations and deaths from the virus are increasing. And cases of variant B.1.1.7 have been detected in many other European countries, leading to curfews in France and prolonged school closures in Germany.
“We are asked what we should do with this variant,” said state epidemiologist Sarah Lyon-Callo during a news conference with reporters in early January, before being detected in the state. “I think of it as if this virus has improved your game a bit in terms of its ability to transmit between people.
“Therefore, we need to step up our game in terms of wearing masks, maintaining social distance and staying at least two meters away from others, preventing people from ventilating indoor spaces and washing their hands frequently.”
And it places a new urgency on vaccinating as many people as possible, as quickly as possible.
“Obviously, we want the vaccine to be launched as soon as possible to protect people,” said Lauring. “We know what we need to do to control the virus, we are just going to need to do even better just to achieve the same level of control.
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“What worries me,” he said, “is that we haven’t done a good job, and the job just got harder.”
Stricter restrictions were put in place in Michigan in November, closing face-to-face dinners in restaurants and bars, canceling face-to-face classes at high school and college, and taking a break from organized sports.
The measures reduced the increasing rates of new infections and hospitalizations. The seven-day average of new daily cases fell on Saturday to 2,350, its lowest point since the end of October. Since the start of the pandemic, 535,534 michiganders have been infected and 13,804 have died, according to state data.
As rates of cases and hospitalizations dropped and vaccines were placed on the market, high schools were allowed to resume face-to-face classes. Many college campuses are about to reopen to students this week. Indoor entertainment venues and some sports have resumed.
But the emergence of this new, more transmissible strain of the virus puts all of that at risk again.
“We will have to be even more careful with some mitigation strategies,” said Dr. Arnold Monto, professor of epidemiology and global public health at UM who serves as acting chairman of the U.S. Food and Drug Administration, Vaccines and Related Biological Advisory Committee on Products.
He said that state public health leaders will have to watch to see if variant B.1.1.7 gains a foothold here.
“I think what we’re doing is responding by closing or opening based on the observation of the transmission” is working, he said. “Look at Atlanta, where the cases are taking off again. Texas is taking off again. But we’re not. The proof is in the pudding.”
Common mutations, impact of new strains uncertain
All viruses mutate. That’s what they do.
Some mutations help them to spread more easily. Others can cause the virus to cause more serious illnesses. Still other mutations prevent a particular variant of a virus from replicating and it dies.
“Having variants coming up is not unexpected,” said Monto. “In fact, it is expected. And it is a question of where the changes are and what they do to the behavior of the virus. … It is very clear that the UK … has what we call a competitive advantage over the previous ones, and that’s why it spread and took over. “
Researchers can sequence the virus genome to look for these changes or mutations, often tiny, and use them to identify how a virus is spreading within communities or families.
Most mutations are small and relatively irrelevant. But sometimes there can be a significant series of changes that can make a big difference.
Marty Soehnlen, director of infectious diseases at the state laboratories that do most of the viral surveillance in Michigan, said her team is always looking for significant changes, such as those for variant B.1.1.7, and can see how the virus is spreading. spreads from one person to another based on mutations.
“On the public health side, we like transmission patterns very much, figuring out how to investigate our outbreaks,” she said. “We also looked at resistance markers or the way they can alter tests. … Will this make you unable to collect a positive sample? Or, in some cases, you could use it to develop new interventions, and that could be through drug therapy, for vaccination. It can be all of these different things. So, you’re constantly looking at these changes and trying to find out what’s going on. “
Some changes may also make vaccines ineffective, which is why new batches of flu vaccines are launched each year, targeting specific strains that are expected to be in high circulation next season. So far, the research suggests that the current COVID-19 vaccines on the market will still be effective for variant B.1.1.7, said Lauring.
Scientists at the Lansing-based labs ran about 5,700 samples during the complete genome sequencing process in the past 10 months, Blankenship said. This makes them one of the busiest laboratories in the country and their work is responsible for 6% to 7% of all sequencing of the coronavirus genome in the United States.
The samples sent to state laboratories come from all over Michigan to ensure that surveillance has a broad geographic base, Soehnlen said, and there is particular interest in cases with “unusual clinical presentations. So, was it a more serious illness? Was it an unusual combination? There was an age difference associated with that case – all these different things so that we can feed that back into the surveillance data that can be used. “
What they learn about the samples is uploaded to an international database that researchers from around the world can use to learn about the virus.
“We are extremely proud of the numbers we have managed to release and we hope to continue to do even more than that,” said Soehnlen. “Obviously, the whole reason why you want to do big numbers is to be able to do good public health, and we need data to be able to provide our epidemiologists so they can do something for our citizens.”
Eleven known variants of coronavirus, or clades, characterized by a combination of specific mutations, are now spreading around the world, Blankenship said.
Of these, 10 were identified in Michigan. Now that the UK variant has been detected, it means that only the B.1351 variant, also known as the South African variant, has not yet been found in Michigan samples, she said.
“We are beginning to hear possible other variants of concern from Japan and Brazil, and we hope that this type of thing is constantly evolving,” she said.
And as the virus continues to change, Blankenship, Soehnlen, Lauring and other infectious disease watchdogs will remain at their posts, ready to sound the alarm once again.
“If you are working in a public health laboratory, you are choosing to do something because you see the most interesting cases and try to help save lives while doing this,” said Soehnlen.
“People have stepped up. Everyone has done it over time. They do weekends. They do holidays. They do what is necessary, and I think it’s a beautiful statement about how much people care.”
Contact Kristen Shamus: [email protected]. Follow her on Twitter @kristenshamus.