by Carolyn Bick
The Washington State Department of Health (DOH) today announced that it, along with Public Health – Seattle & King County and the UW Medicine Virology Lab — have detected yet another novel coronavirus (also known as SARS-CoV-2) variant in the state, in addition to the already-present B.1.1.7 variant. The new variant was detected in King County, the DOH said in a press release. At the same time, the DOH also announced on Tuesday that it has confirmed an additional 19 cases of the B.1.1.7 variant in the state.
The variant health officials and researchers most recently detected in Washington State is known as B.1.351, which was first detected in South Africa, and detected in the U.S. at the end of January. While it doesn’t appear to cause significantly more severe illness, researchers have discovered that it may have an increased resistance to the Pfizer and Moderna vaccines and that it does have an increased resistance to vaccines in the approval process including the AstraZeneca and Novavax vaccines and the soon-to-be-released Johnson & Johnson vaccine. This means that even a person who has the antibodies to fight off the novel coronavirus, SARS-CoV-2, may still develop symptomatic COVID-19, the disease associated with the virus and the new variants thereof. This may also mean that a person who has already had the virus, and associated disease, may become reinfected with a variant of the virus, and therefore may also develop the disease, COVID-19, again or for the first time (some individuals infected with the novel coronavirus have been asymptomatic). This has prompted Moderna to create booster shots for its original vaccine.
Health officials and researchers did not determine that the B.1.351 variant was present in the state until Feb. 22, but the person infected in Washington had tested positive for the novel coronavirus on Jan. 29. In a media briefing on Feb. 23, DOH Acting State Health Officer, Dr. Scott Lindquist, said that “a huge focus” will be attempting to increase the number of cases subjected to genotyping — essentially, looking for changes in a virus’s genetic makeup that can create major differences in how it infects a person — which is how researchers determine with what form of the virus a person is infected with, i.e. SARS-CoV-2 or a variant of the virus. This will help scientists estimate how prevalent a variant is in the state and how long it has been in the state, as well as create a more equitable picture, as health officials’ current focus is specifically on increasing sampling from underrepresented areas of the state and underrepresented populations. Dr. Pavitra Roychoudhury, with the University of Washington Department of Laboratory Medicine, said in the media briefing that the State is working to bring its sample size up to 500–600 samples per week to meet a 5% positive-case sampling target for the state.
“We actually do a lot of sequencing for various studies on any given week, but we want to do more for the purposes of surveillance alone,” Roychoudhury said.
Lindquist said that the DOH expects it will have enough positive samples to estimate variant case rates across the state within the next couple of weeks. He also said that while he hasn’t been genotyping the samples himself, he did notice that the B.1.1.7 variants detected thus far “were not all exactly the same and that they were not all related to each other,” which indicated to him that “we have had multiple introductions [of the variant] into Washington State and that we may have multiple variants of the B.1.1.7.” Still, because the state does not yet have enough samples, it is difficult to determine how far these variant cases may have spread and how long they have been here.
Health officials first detected the B.1.1.7 variant in Washington State in late January. The variant appears to have originated in the United Kingdom, where it was first detected globally. Though confirmed cases of that variant are currently relatively low, they may not remain so for long: the B.1.1.7 variant is much more contagious than the original novel coronavirus, and there is evidence to suggest that it may also be deadlier.
The 19 new cases of the B.1.1.7 variant detected in the state bring Washington State’s B.1.1.7 variant total up to 39 cases. As of Sunday, Feb. 21, there were 19 cases of the variant reported in the state, according to the Center for Disease Control and Prevention (CDC) COVID-19 variant tracker.
Since B.1.1.7’s detection in the state, Public Health — Seattle & King County (PHSKC) Health Officer, Dr. Jeff Duchin, has been reminding listeners at PHSKC’s weekly press conferences that cases of the variant double about every 10 days and that it will likely be the dominant form of the virus within a short timeframe. Duchin’s warnings echo those of other local and national health experts, including the CDC, which said in early February that the B.1.1.7 variant will likely become the predominant version in the United States by March, despite having only had a few short months to fester and spread in the U.S.
A third variant, known as P.1, which can essentially “dodge” antibodies the immune system has created to fight off the virus, has not yet been detected in the state.
The DOH said that it was unable to contact the person infected with the B.1.351 variant in Washington. In the media briefing, Duchin said that it is “impossible” to know if this person has infected others but that it’s also important to remember that the detected cases are just “the tip of the iceberg.” Though this is just one case, and likely doesn’t have a large number of secondary infections — infections in others by the originally infected person — this is not necessarily true of all cases. For every case reported, there may be thousands of others that go unreported.
Duchin said that the best protocol going forward would be to treat every single case as a potential variant and to stick to protocols that work, including tight masking and not gathering. Even though case rates in King County and across the state are decreasing, this won’t necessarily continue to be the case if people ease up on their safety protocols. For example, Duchin said, the B.1.1.7 variant has already caused “a very large outbreak” in several European countries.
“[The B.1.1.7 variant] was introduced at a time when their trajectory [of cases] was going upwards, but nonetheless, it did cause a very large outbreak, before it started to decline. And the decline [was] in response to very rigorous lockdown measures, as well — weeks and weeks of lockdown,” Duchin said. “We don’t want to go there. We think this virus has the potential to do that. We don’t want to give it the opportunity to create circumstances to allow that to happen.”
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