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Be wary: The highly infectious COVID-19 variant is likely already in Mass

Be wary: The highly infectious COVID-19 variant is likely already in Mass

Governor Charlie Baker on Tuesday urged residents to redouble their efforts to limit the spread of the coronavirus, based on the assumption that a new, more contagious form of virus has arrived in the state, potentially putting in danger dozens of cases and deaths.

Given the contagious nature of this new strain, there's no reason to doubt it'll be discovered, Baker said in Springfield, a day after the first case of the strain was reported in New York. He stressed the importance of masks and social distancing and urged people to be very vigilant and careful and cautious about our physical interaction with other people.

Bakers acknowledgment of the variant possible presence in Massachusetts came less than three weeks after British officials announced the discovery of a potentially deadly new mutation. As the number of cases soared, health authorities around the world scrambled to halt travel to and from the UK as cases increased. Truckers waited in their cabs for Christmas, being barred from entering Europe. Flights were grounded due to the disruption. Nevertheless, the variante spread, across borders and oceans. It has since been found in more than 30 countries, including the United States, where it has been reported in Colorado, California, Florida, and New York.

Baker talks about the highly infectious COVID-19 variant.
Gov. Baker spoke about the new, highly infectious COVID-19 variant, which is likely already in Massachusetts. (CNN) David L Ryan/Globe Staff photo credit: DavidL Ryan )

Massachusetts is already experiencing a rise in COVID-19 cases and hospitalizations, with yearly statewide tests yielding an overall positive test rate of 8.5 percent. Boston Mayor Martin J. Walsh said on Tuesday that he will extend restrictions on gyms, museums, movie theaters and many other businesses for another three weeks, until Jan. 27, saying that we have to do everything possible to get those numbers down.

No case of the variant has been officially announced in Massachusetts, though virologists agree that it is almost certain to exist here. They claim that Massachusetts Labs arent screening the variant sufficiently broad or quickly enough to detect the disease.

There is a good chance that the variant is everywhere and everywhere. But because were not looking for it, we dont find it, said Dr. Dan Barouch, director of the Beth Israel Deaconess Medical Center's Center for Virology and Vaccine Research.

Dr. Lindsey Baden, an infectious diseases specialist at Brigham and Womens Hospital, said he was unaware of any confirmed cases of the new strain in the state. But he too, like him, suspects its here and believes that other strains of the virus will emerge because that is what pathogens do: mutate.

This is a common problem with infectious diseases, he added. Why should SARS CoV-2 be any different? Yes, Im concerned.

While it is highly transmissible, the UK variant is not believed to be more deadly than other variants of the virus, nor does it appear to cause more severe illness. Currently, vaccines are unlikely to be effective against it. However, the variants emergence opens the door to what Harvard epidemiologist Bill Hanage called a surge on top of a rise. If cases rise across the board, then more deaths will inevitably follow.

Several groups in Massachusetts are attempting to develop methods to monitor for the UK variant as well as a similarly alarming strain that appears to be responsible for securing the second wave of COVID in South Africa. Certains experts believe that the vaccines against the latter strain may not be effective.

Current methods of searching for the COVID variant involve a laborious process of identifying virus samples that exhibit an S gene dropout, whose existence could be an indication of the new mutation, and they are then sent off to sifting in specialized labs. Only then can officials be sure which strain the sample belongs to.

A study published in late December reported a recent rise in samples nationwide showing the S gene dropout, suggesting the variant may have entered the United States in the fall.

Dr. Eric Rosenberg, a Massachusetts General Hospital clinical microbiology scientist, is leading scouting efforts for the variant. So far, two samples have been identified as potentially harboring the N501Y mutation, a marker of the British and South African COVID variants, but when they were analyzed by the Broad Institute, the Cambridge research center that has sequenced hundreds of samples since December looking for new and known variant variant identities, they turned out to be false alarms.

The Massachusetts Department of Health is also sequencing samples, but state officials did not respond to requests for comment.

Rosenbergs team intends to screen all positive specimens obtained at Mass. General. It may take days or weeks to link a positive test to the variant, because none of the analysis will be done in real time. Additionally, the screening technique used by Rosenbergs team uses the same desired test reagent as that used for the basic COVID-19 PCR test, which will be prioritized.

We dont sequence as many viruses on a per capita basis as they do in the UK, or as we need to do [to] understand whats going on. Sure, we do some grading, but it isnt always accurate and precise. We examine less than a quarter of the virus, whereas the UK is closer to five to ten percent, said Barouch.

Moreover, the variant underscores the reality that the virus is evolving, sometimes dangerously, even as the world develops methods to limit its spread and treat its disease.

I think youll find a variety of origins all around the world, he added. This isnt a South African or British experience. Its only a matter of time before weve got 'a couple of variants that originate in the United States,' said Dr. Michael Osterholm, an infectious disease expert selected by President-elect Joe Biden's Transition COVID-19 Advisory Board.

We have to understand that were just now entering these very difficult variant situations. Dont expect it to get any better, he cautioned. I think this will only get more complicated as time goes on, as new variants emerge that have these potential aspects of increased transmission or the potential to avoid vaccine-related immunity. This isnt a one-time phenomenon,

Osterholm said the infrastructure exists to sequence more variants and possibly stop them before they become too dispersed. The network isnt there to give us a valid, real-time picture of whats going on out there, according to the author. The virologists who were contacted said they hope the discovery of the two variants will encourage more sequencing investment.

This is a wake-up call. Its clear that were going to have to improve our capabilities and build something more like the United Kingdom has, said Dr. Jacob Lemieux, an infectious disease physician at Mass. General and researcher involved in the Broad Institute's sequencing. Theres been clear indication from the state level as well as national level public health authorities that this is a priority. But we are starting from a position where there is, frankly, 'a lot of work to be done'.

HIV is a prime example of 'the worst-case scenario' when hepatitis b is so quickly mutated that it evades antibodies and thus thwarts adherence to standardized vaccines. Nearly four decades after HIV first emerged in the United States, scientists today rely on a combination of high-cost pre-exposure prophylaxis and an antiretroviral cocktail to prevent and combat the virus. Nevertheless, about 36,400 new infections were identified in 2018. SARS-CoV-2 mutations are much less frequent, though.

But, as we all know, there are always exceptions. The two discovered in the United Kingdom and South Africa have been confirmed to be alarmingly contagious. Given time and space, further mutations may be of even greater concern. Some patients may have more severe disease that doesnt respond well to promising treatments such as remdesivir or monoclonal antibodies. Certains pourraient empcher les tests de diagnostic utiliss to identify cases. Others may try to evade the vaccines, though no official notification has been issued yet.

Hanage asked, Do you know which of the two most important phrases of this epidemic are that people don't typically use?" So far, according to the article.

Jonathan Saltzman of the Globe staff contributed to this report.

Hanna Krueger is available at hanna.krueg@globe.com. Follow her on Twitter @hannaskrueger.

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