Mary Wilson
Well-known member
February 2021
Authors: Kelsey Lane Warmbrod, MS, MPH Senior Analyst, Johns Hopkins Center for Health Security
Rachel West, PhD, Postdoctoral Fellow, Johns Hopkins Center for Health Security
Matthew Frieman, PhD, Associate Professor, University of Maryland School of Medicine
Dylan George, PhD, MS, Vice President, In-Q-Tel
Elena Martin, MPH, Analyst, Johns Hopkins Center for Health Security
Caitlin Rivers, PhD, MPH, Senior Scholar, Johns Hopkins Center for Health Security
Executive Summary
... This document explains the current status of SARS-CoV-2 surveillance, sequencing, and variant characterization and provides recommendations for increasing the United States’ capacity to respond to new variants.
Introduction
As of February 2021, 3 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) with worrisome characteristics have emerged, each on adi erent continent.1 The B.1.1.7 variant, rst identi ed in the United Kingdom, issubstantially more transmissible than previously circulating variants. The B.1.351 andP.1 variants, rst identi ed in South Africa and Brazil, respectively, both exhibit somedegree of immune escape.*2,3 Each of these variants has precipitated resurgences inthe communities where they have become dominant. All 3 have already been identi edat low levels in the United States. If they gain a foothold, the same resurgences can be expected here.
Our dance with the virus will not be limited to these 3 variants. As the coronavirusdisease 2019 (COVID-19) pandemic unfolds, selective pressure and genetic dri will drive additional virus variants that are more t for their survival and spread. Thisinexorable process is accelerated by high levels of community transmission. As more people become infected, the virus has more opportunities to generate mutations.
Although many mutations in the SARS-CoV-2 virus will be inconsequential, some
can be detrimental. During summer 2020, the D614G mutation that is now known to make the virus more transmissible in humans, became the predominant lineage.4 The B.1.1.7 variant is also substantially more transmissible and has prompted lockdown measures in several countries where healthcare systems were overwhelmed. Medicalcountermeasures, speci cally vaccines, have also been challenged by new variants.5Although several authorized and candidate vaccines have shown high levels of e cacy in clinical trials, the target antigens in the vaccine formulation may not re ect emergingvariants.6 To date, preliminary laboratory data suggest that the P zer and Moderna vaccines are still e ective against the B.1.1.7 variant.7,8 However, the Moderna vaccineand some monoclonal antibody therapies may be somewhat less e ective against
the B.1.351 and P.1 variants.9,10 Hypothetical future variants may further degrade the performance of vaccines and therapeutics, require redesign of diagnostic tests, and render naturally acquired immunity less durable.
Although viral mutation is inevitable, it is possible to anticipate, manage, and mitigate the threat to our collective public health. The key to staying ahead of a rapidly evolving virus is to maintain a continuous, systematic genomic surveillance and functional characterization capability that is able to rapidly detect and evaluate new variants
of concern. These data and subsequent analyses can improve risk mitigation e ortsthroughout an outbreak, including decisions to update medical countermeasures and adapt the public health response—before new variants evade existing control measures. The emergence of the novel, more transmissible variants of SARS-CoV-2 underscores the importance of genomic epidemiology for pandemic response. As coverage and consistency of viral sequencing increases, so too will our understanding of emerging variants.
...
https://www.centerforhealthsecurity....9-variants.pdf
Authors: Kelsey Lane Warmbrod, MS, MPH Senior Analyst, Johns Hopkins Center for Health Security
Rachel West, PhD, Postdoctoral Fellow, Johns Hopkins Center for Health Security
Matthew Frieman, PhD, Associate Professor, University of Maryland School of Medicine
Dylan George, PhD, MS, Vice President, In-Q-Tel
Elena Martin, MPH, Analyst, Johns Hopkins Center for Health Security
Caitlin Rivers, PhD, MPH, Senior Scholar, Johns Hopkins Center for Health Security
Executive Summary
... This document explains the current status of SARS-CoV-2 surveillance, sequencing, and variant characterization and provides recommendations for increasing the United States’ capacity to respond to new variants.
Introduction
As of February 2021, 3 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOC) with worrisome characteristics have emerged, each on adi erent continent.1 The B.1.1.7 variant, rst identi ed in the United Kingdom, issubstantially more transmissible than previously circulating variants. The B.1.351 andP.1 variants, rst identi ed in South Africa and Brazil, respectively, both exhibit somedegree of immune escape.*2,3 Each of these variants has precipitated resurgences inthe communities where they have become dominant. All 3 have already been identi edat low levels in the United States. If they gain a foothold, the same resurgences can be expected here.
Our dance with the virus will not be limited to these 3 variants. As the coronavirusdisease 2019 (COVID-19) pandemic unfolds, selective pressure and genetic dri will drive additional virus variants that are more t for their survival and spread. Thisinexorable process is accelerated by high levels of community transmission. As more people become infected, the virus has more opportunities to generate mutations.
Although many mutations in the SARS-CoV-2 virus will be inconsequential, some
can be detrimental. During summer 2020, the D614G mutation that is now known to make the virus more transmissible in humans, became the predominant lineage.4 The B.1.1.7 variant is also substantially more transmissible and has prompted lockdown measures in several countries where healthcare systems were overwhelmed. Medicalcountermeasures, speci cally vaccines, have also been challenged by new variants.5Although several authorized and candidate vaccines have shown high levels of e cacy in clinical trials, the target antigens in the vaccine formulation may not re ect emergingvariants.6 To date, preliminary laboratory data suggest that the P zer and Moderna vaccines are still e ective against the B.1.1.7 variant.7,8 However, the Moderna vaccineand some monoclonal antibody therapies may be somewhat less e ective against
the B.1.351 and P.1 variants.9,10 Hypothetical future variants may further degrade the performance of vaccines and therapeutics, require redesign of diagnostic tests, and render naturally acquired immunity less durable.
Although viral mutation is inevitable, it is possible to anticipate, manage, and mitigate the threat to our collective public health. The key to staying ahead of a rapidly evolving virus is to maintain a continuous, systematic genomic surveillance and functional characterization capability that is able to rapidly detect and evaluate new variants
of concern. These data and subsequent analyses can improve risk mitigation e ortsthroughout an outbreak, including decisions to update medical countermeasures and adapt the public health response—before new variants evade existing control measures. The emergence of the novel, more transmissible variants of SARS-CoV-2 underscores the importance of genomic epidemiology for pandemic response. As coverage and consistency of viral sequencing increases, so too will our understanding of emerging variants.
...
https://www.centerforhealthsecurity....9-variants.pdf