Experts call for streamlined lab tests of SARS-CoV-2 variants to spot worrisome features

Rapid genetic sequencing of COVID-19 virus samples isn’t enough; standardized lab assessments are needed to understand potential mutations that may boost infectiousness or enable immune evasion.

March 01, 2021

LA JOLLA, CA—Governments and research organizations around the world must step up their efforts to detect new, potentially dangerous variants of COVID-19—and they must do so in a coordinated way that will enable rapid response from the global health community.

That’s the urgent message from Scripps Research’s Eric Topol, MD, and noted Italian virologist Roberto Burioni, PhD, who together penned an essay that appears in Nature Medicine.

In their article, Topol and Burioni issue a reminder that SARS-CoV-2, which causes COVID-19, only recently became a human virus and continues to evolve for evolutionary advantages. New variants already have emerged that help the virus infect human cells more easily. It’s possible that additional mutations will give it power to dodge immune responses, even among those who are vaccinated.

“This would be a major problem, as such a variant could decrease, and even abolish, the beneficial effects of a wide immunization program,” they write. 

Topol is executive vice president of Scripps Research, as well as the director and founder of Scripps Research Translational Institute. Burioni is a professor of virology and microbiology at Università Vita-Salute San Raffaele in Milan—and earlier in his career, he served as a visiting professor at Scripps Research. Both Topol and Burioni have been forthright advocates of science-based policy to guide pandemic response.

They say the goal of their Nature Medicine essay is not to stoke fear, but to ignite a new era of preparedness. Coronaviruses, which store their genetic material in RNA rather than DNA, may not even be capable of mutating in such a way to evade vaccines, they point out. Other RNA viruses such as measles and rubella still haven’t evolved vaccine-evading features, despite decades of circulating among immunized populations. However, influenza and HIV—also RNA viruses—are notorious for their immune-evading skills, so uncertainty abounds. 

In short, “we can’t rule out the possibility of a SARS-CoV-2 mutant escaping vaccine immunity and retaining its fitness and pathogenicity,” Topol and Burioni write. “This is why genomic surveillance on the new variants is crucial and will be even more important once a large part of the population is vaccinated.”

Coordinated efforts to track new variants and test them in the lab will allow scientists to rapidly modify vaccines to meet the changing nature of the virus. “We will need to be aware of the existence and of the sequence of such variants in the shortest possible time frame in order to mitigate risks and control the consequences,” they write.

Yet, currently, surveillance efforts are limited in most countries and protocols for testing and reporting variants can vary from lab to lab. The authors also urge for innovation in the development of new tools that detect and characterize new strains in a timely and standard manner.

In Burioni’s home country of Italy, the word for expressing “concern” is preoccupazione—a word that combines the Latin “take care” (occupazione) and “in advance” (pre), Topol and Burioni write. “Simply put,” they conclude, "this is what needs to be done.”

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