February 16, 2021 COVID-19 bill would scale
up ability to spot virus mutations
By Ricardo Alonso-Zaldivar
The Associated Press
WASHINGTON (AP) — U.S. scientists would gain vastly expanded
capabilities to identify potentially deadlier mutations of the
coronavirus under COVID-19 relief legislation advancing in U.S.
Congress.
The U.S. now maps only the genetic makeup of a minuscule
fraction of positive virus samples, a situation some experts
liken to flying blind. It means the true domestic spread of
problematic mutations first identified in the United Kingdom and
South Africa remains a matter of guesswork.
Such ignorance could prove costly. One worry is that more
transmissible forms such as the U.K. variant could move faster
than the nation’s ability to get the vaccine into Americans’
arms.
"You’ve got a small number of academic and public health labs
that have been basically doing the genomic surveillance," said
David O’Connor, an AIDS researcher at the University of
Wisconsin. "But there is no national coherence to the strategy."
The Centers for Disease Control (CDC) and Prevention is
trying to shepherd those efforts, aligning with the government’s
own advanced detection work, but the COVID-19 legislation would
take the hunt to another level.
A bill cleared for floor debate last week by the House Energy
and Commerce Committee would provide $1.75 billion for genomic
sequencing. It calls for the CDC to organize a national network
to use the technology to track the spread of mutations and guide
public health countermeasures.
In the senate, Wisconsin Democrat Tammy Baldwin has
introduced legislation that would provide $2 billion. Baldwin
says the U.S. should be using gene-mapping technology to analyze
at least 15% of positive virus samples. That might not sound
like much, but the current rate is believed to be 0.3% to 0.5%.
Analyzing 15% of positive samples would expand surveillance by
at least 30 times.
"Variants represent a growing threat," said Baldwin. "At the
start of the COVID-19 pandemic, increasing our testing capacity
was essential to our ability to track and slow the spread of the
virus — the same is true for finding and tracking these
variants."
Genomic sequencing essentially involves mapping the DNA of an
organism, the key to its unique features. It’s done by high-tech
machines that can cost from several hundred thousand dollars to
$1 million or more. Technicians trained to run the machines and
computing capacity to support the whole process add to costs.
In the case of the U.K. variant first detected in England,
the changes in the virus allowed it to spread more easily and
are also believed to cause deadlier COVID-19 disease. The
Institute for Health Metrics and Evaluation in Seattle reports
that transmission of the U.K. variant has been confirmed in at
least 10 U.S. states. CDC director Dr. Rochelle Walensky told
governors on Tuesday that it could become dominant by the end of
March.
Sequencing 0.3% to 0.5% of virus samples, as the U.S. is now
doing, "just doesn’t give us the ability to detect strains as
they develop and become dominant," said Dr. Phil Febbo, chief
medical officer for Illumina, a San Diego-based company that
develops genomic sequencing technologies.
The Biden administration has to "set a very clear goal," he
added. "What’s the hill that we are going to charge?"
"We need that data. Otherwise, in some ways, we’re flying
blind," said Esther Krofah, who directs the FasterCures
initiative of the Milken Institute. "We don’t understand the
prevalence of mutations that we should be worried about in the
U.S."
Even more worrisome than the U.K. variant is a strain first
detected in South Africa that scientists suspect might be at
least partly resistant to some of the coronavirus vaccines. That
variant has also been identified in the U.S. in a limited number
of cases.
White House coronavirus coordinator Jeff Zients has called
U.S. tracking of virus mutations "totally unacceptable," saying
the nation ranks 43rd in the world. But the Biden administration
has not set a target for what level of virus gene mapping the
country should be striving for.
At the University of Wisconsin, AIDS scientist O’Connor said
he and his colleagues started sequencing coronavirus samples
from the Madison area "because that’s where we live."
His colleague, virology expert Thomas Friedrich, said a
national effort will require more than money to purchase new
genomic sequencing machines. The CDC will have to set standards
for state health officials and academic research institutions to
fully share the information they glean from analyzing virus
samples. Currently, there’s a hodgepodge of state regulations
and practices, and some of them restrict access to key details.
"We need to look at this as a Manhattan Project or an Apollo
program," said Friedrich, invoking the government-led scientific
endeavors that developed the atomic bomb and landed men on the
moon.
The United Kingdom was able to identify its variant because
the national health system there has a coordinated gene mapping
program that aims to sequence about 10% of samples, he added.
Since that happened, there’s been greater urgency about genetic
sequencing on this side of the Atlantic Ocean.
"The utility of doing this may not have been as apparent to
as many people until these variants started popping up,"
Friedrich said. |