Lack of national oversight is leaving Utah, other states not equipped to handle COVID-19 variants, the U.S. doctor says.
(Rick Egan | The Salt Lake Tribune) Zeanne Timbol administers a test for COVID-19 at the Intermountain Salt Lake Clinic, on January 2, 2021. So far, two cases of the British variant have been detected in Utah.
Health officials were initially unsure how to investigate Utah’s first known case of the more contagious ‘British’ coronavirus variant, according to emails among federal, state and provincial agencies.
But the initial uncertainty may reflect the shortcomings of a nationwide disease surveillance system that relies too heavily on state and private laboratories to detect changes in infectious diseases, one Utah doctor said last week.
“Our knowledge of the variants that originate in the United States and how it spreads is, I hate to say, quite imperfect,” said Dr. Sankar Swaminathan, an infectious disease specialist from the University of Utah, told news conference Thursday.
‘We do not really have a coordinated, integrated national system for detecting high-level, proactive, genetic variation. … That’s why I’ll say we really have a very honest, inadequate knowledge. ‘
Summit County announced Monday that a third Utahn – a woman between the ages of 20 and 44 – has contracted the variant. The second case, in Utah County, was announced by state officials last week.
Without a national genomic surveillance system, Swaminathan said, it is impossible to know how easily the British variant has spread in Utah and in other states since the first Utah patient was confirmed with the variant in mid-January.
On January 14, health officials in the province received the message that the man’s test sample was one that had undergone genetic sequencing by the Utah Public Health Laboratory as part of his oversight of variants of the virus – and he contracted the so-called ‘UK variant’ . . ”
The man has already been identified as a possible contact by another person who tested positive for the coronavirus in late December. But it was two days after the man’s case was confirmed on January 16 that a provincial epidemiologist wrote that she had conducted an interview with the man and the patient who was likely to infect him.
None of them had traveled recently, she reported, and the source patient did not know where he had been exposed to the virus.
Meanwhile, health officials released the case to the public the day after it was identified – but it appears they are unsure how to proceed. Official health officials were not sure if it would be possible to find out if the patient who exposed the man also had the variant, or if the contact detection had to be handled differently for patients with the variant.
‘Is there a specific type of inquiry form that needs to be completed for a change[s]? Wrote one county epidemiologist.
“Should we investigate more thoroughly?” writes Dr. Dagmar Vitek, director of the medical department of the provincial health department. ‘Collect PCR [a genetic COVID-19 test] on him and contacts, order, look at all his contacts? ”
A scientist at the Utah Public Health Laboratory has warned that the variant can only be confirmed in the source patient if he continues to shed the virus, more than two weeks after being diagnosed; his original diagnosis was in an antigen test, with a sample that could not be used for genome sequencing.
“There have been previous discussions about dealing with different cases to quickly identify any trip and identify a potential source,” Salt Lake County Department of Health spokesman Nicholas Rupp wrote Monday when asked about the release. email.
Province officials have decided that for different cases of COVID-19, they will go back to thorough contact detection, where investigators follow up on each contact person individually, Rupp said. In most cases of COVID-19, investigators switched to a ‘shared responsibility model’, where trackers ask patients themselves to pay attention to some of the people they may have had contact with.
The U.S. Centers for Disease Control and Prevention requested details about the man’s case the day after the variant was identified, according to email. But the CDC only requested on January 20 that the sample carry out its own entire genomic sequence.
It is not clear what information the CDC’s sequence provides about the order of the Utah Public Health Lab. State health officials could not be immediately reached for comment.
The British variant, called B117, is significantly more contagious than the tensions that previously dominated the United States – but it is not yet known whether it is more likely to cause serious illness.
‘There is not much evidence for that yet, but there is concern in some of the tribes that are less characterized. And we really do not know how much of a problem it is, ”said Dr Swamainathan.
State epidemiologist Angela Dunn has identified only two cases of the British variant since Thursday, Angela Dunn said at a news conference. “But keep in mind, we only follow ten percent of all our positive results,” said Dr. Dunn said.
This is ‘a lot at the national level compared to other states’, she said. ‘But we still can not follow every person who becomes positive in order. The fact that we found two therefore means that it is here. It has already been distributed by the community. And so it means we have to be extra careful when we take precautionary measures. ”
The more the virus spreads, the greater the chance that it will develop harmful mutations, Swamainathan said.
“It’s not necessary for these things to come in from abroad,” he said. “With the transfer levels we have here, we’re also going to have our own homemade variants.”