Advanced planning and a partnership with a world-renowned genetics lab put Maine in an enviable position to quickly detect when new and more contagious COVID-19 variants arrive.
The Maine Center for Disease Control and Prevention reported Wednesday the state’s first case of the B.1.1.7 variant that was first detected in the United Kingdom, making Maine the 35th state to report a positive case of the variant.
But Maine has been actively preparing for months for the likelihood that this COVID-19 mutation, and others, would find their way here.
“We found it because we thought to look for it,” Maine CDC Director Dr. Nirav Shah said Thursday.
The genetic research is important because it helps uncover variants that can be more transmissible – which is the case with B.1.1.7. Additionally, some variants also could lead to more hospitalization or deaths, or evade the approved vaccines.
Detecting the new variant cannot be done through a standard COVID-19 test. Instead, researchers use a process called genomic sequencing, which takes a sample of a positive test and compares it against hundreds of others to look for differences.
Nearly all the work on genomic sequencing has been done at The Jackson Laboratory, the nonprofit biomedical research institute in Bar Harbor. Ryan Tewhey leads a team of eight researchers there and said genomic sequencing has been ongoing since the beginning of the pandemic before variants emerged.
“Maine saw value in it early on and started to do this,” Tewhey said in an interview Thursday. “National efforts are really only starting to ramp up.”
Data released this week from the U.S. CDC suggest that Maine has been particularly aggressive in looking for B.1.1.7 and other variants. As of Tuesday, 952 cases with genomic sequencing completed in Maine had been accepted into public repositories, which ranks 20th among all states, ahead of more heavily populated states like Pennsylvania, Ohio and North Carolina. The number stood at 1,126 as of Thursday, Tewhey said. Nearby New Hampshire had completed just 71 cases for genomic sequencing.
On a percentage basis, Maine has submitted 2.31 percent of positive tests in 2021, which ranks second behind Hawaii’s 2.7 percent, The national rate is well below 1 percent. In fact, researchers believe the reason the U.K. was identified as the origin of the B.1.1.7 is because that country was doing more genomic sequencing than any other country.
Tewhey said the U.S. still has a long way to go. His goal is to move Maine ahead of Hawaii and eventually conduct sequencing on 5-10 percent of all positive tests.
Shah said the state will continue sending as many positive tests for analysis as it can. His office relies largely on field epidemiologists to interview individuals and assess whether their symptoms might be indicative of a variant.
Since the coronavirus strain now known as COVD-19, or sometimes SARS-CoV-2, first arrived, scientists have been prepared for it to mutate because that’s what viruses do. Think of the flu. Many mutations do not affect the virus’s ability to spread or cause disease because they do not alter the major proteins, but some do.
Over the last few months, researchers have identified three emerging variants that they have been watching closely: the B.1.1.7 variant first detected in the U.K., the B.1.351 variant that originated in South Africa, and the P.1 variant discovered in Brazil.
As of Tuesday, there were 932 cases of B.1.1.7 in the United States, nine cases of B.1.351 and three cases of P.1. Of all the cases of B.1.1.7 detected in the U.S. so far, 343 (or 36 percent) have been in Florida.
The U.S. CDC said the variant cases it has identified are based on a sampling of positive specimens, which means they do not represent the total number or match numbers reported by states.
Tewhey outlined how the process works. Jackson Lab gets a positive test sample containing viral RNA, which is then converted to DNA, a more stable molecule. The sample is then put on a sequencing instrument and compared against some 200 other samples to look for differences.
“We know that viruses do mutate, but in most cases the majority of the genome stays the same,” he said. “We’re looking for where it doesn’t match.”
When a sample doesn’t match, researchers can then see if it does match the genetic fingerprint of one of the identified variants. In the case of B.1.1.7, the main difference is that the spike protein, or what Tewhey calls the “mechanism for docking with human cells,” is more pronounced. That’s the reason it’s more contagious, because it more easily binds to receptors in the body.
The B.1.1.7 variant already has become the dominant strain of coronavirus in several European countries and has led to restrictive lockdowns similar to what was seen early last spring. The head of the U.K.’s genetic surveillance program told the BBC’s Newscast podcast this week that the variant is likely to become dominant worldwide.
“The new variant has swept the country and it’s going to sweep the world, in all probability,” said Sharon Peacock, director of the COVID-19 Genomics UK Consortium. “In the future, I think the key is going to be if (a variant) is particularly problematic with the vaccines.”
Indeed, the U.S. CDC has forecast that the B.1.1.7 strain could become dominant here by late March. One of the biggest differences noted in the B.1.1.7 variant is that it is more transmissible, which is concerning because COVID-19 already is highly transmissible through airborne particles from the mouth and nose.
It’s possible, likely even, that there are more cases of B.1.1.7 in Maine. The case announced Wednesday was detected in a resident of Franklin County with a history of recent international travel who developed symptoms in early February. That person has been isolating, as have other members of their household, and close contacts have been asked to quarantine.
“Our (health) recommendations – the bedrock principles – still apply even if we’re talking about these new variants,” Shah said.
As for whether the B.1.1.7 variant or others take hold, he said much still depends on the collective behavior of residents who have grown weary of the pandemic and who are encouraged by the steady but slow vaccination efforts.
“I do have concern that people will let their guard down and let this variant run rampant,” he said.
That’s one of the reasons health officials have been suggesting double masking, which recent studies have shown reduces transmission by nearly 100 percent. Shah said Thursday that double masking is certainly a good option for people, but he said the more important factor is making sure masks fit properly.
The biggest silver lining about the new variants is that the approved vaccines that are being administered in Maine protect against them. The sooner the state and nation can get enough people vaccinated to achieve herd immunity, the less concern there will be about variants.
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