Throughout the COVID-19 epidemic, disease surveillance efforts that rely on testing and alternative sequencing have become important tools in the global effort to fight the virus.
Without these tools, experts say, the spread of COVID-19 could have accelerated further, potentially resulting in many more deaths.
Dr. Rebecca Katz, professor and director of the Center for Global Health Sciences and Security at Georgetown University’s Global Health Sciences and Security, said: “Testing and sequencing is important for understanding where the virus is and how it is evolving. , Told ABC News.
Surveillance tools have helped health officials make important recommendations throughout the epidemic – including the decision to give green light booster doses for extra protection and the decision to withdraw from some monoclonal antibody treatments approved for COVID-19, due to concerns that it was not effective. Specific variant.
However, as the Omicron wave has receded, so has the use of those basic tools called testing – a choice that has become a major concern for health professionals as the more contagious, Omicron subvariant, BA.2, has spread to the United States.
Although some Americans are still receiving PCR tests, which are considered the gold standard of testing, reported test levels are now at their lowest level in eight months, with the number dropping by about 75% since the beginning of the year.
Lab testing is also key to variant detection because genetic sequencing, the primary method of identifying new variants, cannot be conducted.
Even wastewater monitoring, which provides some measure of early warning, does not indicate the variations present or give a clear indication of the number of cases.
“With minimal testing, we have less visibility in the evolution of viruses as well as infections,” Katz said. “Of course, the decline we see in testing in the United States and around the world is alarming. We are losing our situational awareness.”
Last month, the United Kingdom, the global leader in COVID-19 sequencing, reported nearly 200,000 sequences, the highest among any country, GISAID, the international database that tracks virus changes. Across the epidemic, the UK is at the forefront of COVID-19 sequencing.
By comparison, the United States, which ranks third after Denmark for sequencing, has reported about 35,000 sequences in the last 30 days.
The curve is moving forward
Last week, a new study found that the Center for Disease Control and Prevention’s program to detect COVID-19 variants among international air travelers using genetic sequencing revealed that the first BA.2 case actually occurred in the United States just weeks before it happened. First report.
“Early detection of new SARS-CoV-2 forms of interest and concern gives researchers and public health officials the time needed to gather information on infectivity, virulence and vaccine efficacy to be able to adjust treatment and prevention strategies,” the researchers wrote. Can be used as a precautionary measure for future outbreaks.
Worldwide, BA.2 is now responsible for about 86% of the hierarchy in the last four weeks, said Dr. Maria Van Kerkhov reported earlier this month He emphasized that the reduction in surveillance could ultimately put the world at risk because the virus was spreading.
“It’s really important that we have tests and it’s really important that we have sequencing … the systems that are in place at the moment for monitoring, testing, sequencing will be strengthened, which are not isolated, because we will be in the next challenge. We have to move forward, “said Van Kerkhov.
To track new variants, teams are sequencing the virus’s genetic material to identify its strain, lineage, and specific mutations.
“We’ve only realized the value of these practices for our community and our health. Instead of fully recognizing it, we’re considering shutting it down. It’s short-sighted,” said Davida S. Smith, Ph.D. Professor and microbiologist at the University of Texas A&M, who has been tracking COVID-19 in New York City wastewater since the summer of 2020.
Wastewater will continue to be an important tool as a primary indicator of COVID-19 trends in the United States, but adequate genetic sequencing is also needed to identify new forms of water.
“The only way we can track the virus is through a combination of clinical sequencing and wastewater sequencing,” Smith said. “Wastewater can actually act as a precautionary measure. Without sequencing, we cannot identify the form of the virus that is being performed and without testing we cannot know how prevalent it is.”
The test site is being closed
An additional concern for some experts is the decision to close testing sites for in-house testing. From coast to coast, dozens of state shutters have moved to public testing sites.
With out-of-home tests now widely available, most Americans are also not reporting their results to authorities, and thus, experts say the total number of infections is likely to be lower.
“The less data we have, the less insight – even predictive insights – we need to create evidence-based public health policies,” Jessica Malati Rivera, an epidemiologist at the Institute for Epidemic Prevention, told ABC News.
In addition, officials are unable to conduct tests at home, which means no mutations or new variants can be identified, experts say.
“In fact, we’ve never tested enough. And I’m concerned that we’ve fallen into the trap of ‘less testing, less covid.’
What is the fund?
Health officials and experts agree that access to adequate funding will also be essential to the country’s ability to control the virus.
CDC Director Dr. Rochelle Walensky said earlier this month in NPR’s “Morning Edition” that government funding was essential for monitoring the agency’s variants and studying other important COVID-19 issues.
“We need more to be able to sustain all these activities,” Walensky said. “We use these resources to monitor variants, not just here but around the world, and to support a global effort to ensure that we can vaccinate more around the world and ensure that new variants do not arrive.”
It will be important to acknowledge that we do not yet know everything about COVID-19, Smith added, because the virus has often proven itself to be unpredictable and unpredictable.
“I’m concerned that we may not have seen the end of the emerging SARS-CoV-2 variants and we may not have seen the end of what this virus can do in response to vaccines and our immune system,” Smith said. “Without observation and surveillance, we can go blind. We are still not out of the forest.”