CONTINUING EDUCATION :: COVID-19 UPDATE
SARS-CoV-2 sequencing for public health impact
By Noah Kojima, Eugenia Khorosheva, Lauren Lopez, Mikhail Hanewich-Hollatz, J. Cesar Ignacio-Espinoza, Matthew Brobeck, Janet Chen, Matthew Geluz, Victoria Hess, Sophia Quasem, Nabjot Sandhu, Elias Salfati, Maria Shacreaw, George Way, Zhiyi Xie, Vladimir Slepnev, and Jeffrey D. Klausner
L
ike many viruses, coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome corona- virus 2 (SARS-CoV-2), mutates.1
When mutations occur in
key proteins, the virus can become more transmissible, become resistant to certain treatments, and gain the ability to evade antibody-mediated immunity. When that happens, the strain may be classified as a variant of concern.2,3
Earning CEUs
See test on page 16 or online at
www.mlo-online.com under the CE Tests tab. Passing scores of 70 percent or higher are eligible for 1 contact hour of P.A.C.E. credit.
LEARNING OBJECTIVES Upon completion of this article, the reader will be able to:
1. List and describe COVID-19 variants that have swept through the US population.
2. Discuss the study performed in LA County and Riverside County as it relates to: participants, samples transportation, validation and useability.
3. Describe results and finding of the study performed in LA County and Riverside County.
4. Discuss how future variants will be tracked and ways to keep the spread under control.
8 JUNE 2022
MLO-ONLINE.COM Following the initial reports of SARS-CoV-2 infections in China
and Italy, the United States was not prepared for a pandemic of a novel respiratory virus. The initial SARS-CoV-2 detection assay developed by the US Centers for Disease Control and Protec- tion had performance problems,4 diagnostic supplies was inadequate.5
was neither prepared for the volume of SARS-CoV-2 testing nor surveillance for SARS-CoV-2.6
the supply-chain for clinical and the public health system
To have effectively responded to
SARS-CoV-2, the rapid expansion of diagnostic testing and variant surveillance was needed early in the pandemic period.7 Following the initial wave of the wildtype strain of SARS-
CoV-2, the first identified variant of concern was the Alpha variant (UK variant), which spread approximately 50% faster than the wildtype strain.2
the Beta (South Africa), Gamma (Brazilian), Delta and Omicron variants of concern were identified.8,9
actively being identified.12 As evidenced by the Omicron variant,13
variant with its sublineages is the most prevalent SARS-CoV-2 variant of concern in the United States,10,11
ity and ability to evade antibody-mediated immune protec- tion can increase. Due to the major public health concern of SARS-CoV-2 and identified variants, we used a private SARS-CoV-2 clinical laboratory’s infrastructure and newly developed clinical research and sequencing capacity to monitor SARS-CoV-2 variant frequency and distribution in two large counties in California.
Following the Alpha variant of concern, Currently, the Omicron with new variants the transmissibil-
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