By Daniel R. Lucey MD, MPH, FIDSA
On Thursday (Dec. 31), the World Health Organization posted a review on four SARS-CoV-2 variants identified in 2020 and related WHO activities and advice. While in 2020 none of these variants have proven to be more clinically severe, WHO states of the current South African variant: “at this stage, there is no clear evidence of the new variant being associated with more severe disease or worse outcome” even though “preliminary studies suggest the variant is associated with a higher viral load.”
In 2021 there will certainly be more coronavirus variants and some may cause more severe disease, as did the autumn 1918 pandemic influenza virus compared with the milder spring 1918 virus.
Thus, there is an acute need for proactive surveillance in all nations that explicitly focuses on rapid identification of individual patients, or clusters of patients, with unusually severe COVID-19 and provides immediate genomic sequencing of their virus to look for mutations that could explain the increased severity.
Identifying such virus variants would offer the world the best chance to lessen their predictable impacts on patients, public health, economies, and all-of-society.
Actionable steps once such a virus variant is identified are multiple, e.g., determining if new vaccines or antiviral treatments should be made immediately, what policies would be needed across society to slow the spread of the virus, and what measures would be needed to stabilize economies.
Daniel Lucey, MD, MPH, FIDSA, FACP, is a Clinical Professor of Medicine (Teaching) at Dartmouth Geisel School of Medicine, adjunct Professor at Georgetown Medical Center, senior scholar at Georgetown Law, Anthropology Research Associate at the Smithsonian Museum of Natural History and a member of the Infectious Diseases Society of America Global Health Committee. He served as a volunteer to outbreaks overseas including patient care in Sierra Leone and Liberia (MSF) during Ebola 2014, SARS 2003, MERS 2013, Plague 2017 as well as H5N1, Zika, and Yellow Fever. Since Jan. 6 he has contributed more than 50 posts to Science Speaks on COVID-19 and traveled to China Feb. 11. With career experiences, he proposed and helped design the 2018-2022 Smithsonian Exhibition on Epidemics.