Emergence, Progression and Impact of SARS-CoV-2 Variants in West Virginia

节目概要 新型冠状病毒SARS-CoV-2已经席卷地球仪，导致数百万人死亡。最近的描述 变异引起了人们对COVID-19疗法和预防措施有效性的影响的担忧， 包括单克隆抗体和疫苗。尽管西弗吉尼亚州的COVID疫苗规模扩大， 目前，西弗吉尼亚州是全国最好的，西弗吉尼亚州的人口非常容易受到新出现的变异的影响， 可能影响目前疫苗和治疗性单克隆抗体的有效性。抑制 在新的变异病毒传播并引发一波流感之前，识别、跟踪和隔离它们至关重要。 对现有疫苗有抵抗力的疾病。值得注意的是，我们已经建立了高吞吐量 SARS-CoV-2测序与西弗吉尼亚州马歇尔大学 大学和西弗吉尼亚州卫生和人力资源部。我们有能力提供 快速，有效的信息，关于患病率，变化模式和临床结果， 变异以及变异对接种COVID-19疫苗的人的影响。这个项目 将利用三个现有的测试项目， 包括：1）在服务不足的人群中快速加速诊断（RADx-UP）， 全州1,500多人，2）在养老院居民和工作人员中进行监测检测，3） 大学监测测试通过RADx-UP倡议，目前在37个州进行了测试; 阳性检测结果将被送去测序，以便对西弗吉尼亚州不同地点的变异进行评估 - 一些在40分钟内的地铁华盛顿特区地区和其他偏远的农村地区。而且 WV RADx-UP倡议还在有色人种社区（主要是黑人/非洲人）中进行测试 美国人），从而能够描述该群体与西弗吉尼亚州一般人群相比的变异。 与养老院人群相关，年龄与现代人和老年人的抗体水平较低有关。 辉瑞3期疫苗试验疗养院患者可能更有可能有次优免疫力， 这是一个成熟的情况下出现现有的或新的变种。最后，大学生凭借他们的 流动性和对社会距离措施的不同遵守情况表明，变异现象的出现有着肥沃的土壤。 对西弗吉尼亚大学监测检测项目中的所有分离株进行测序将为以下方面提供极好的机会： 评估随着时间的推移由变异引起的病例。由于该项目将支持SARS-CoV-2测序， 西弗吉尼亚州的人群，我们有信心，这种监测测序将迅速确定变异 出现和分布，以便采取适当的公共卫生措施。

PROGRAM SUMMARY The novel coronavirus SARS-CoV-2 has swept the globe resulting in millions of deaths. Recent descriptions of variants have raised concerns regarding the impact on the effectiveness of COVID-19 therapies and preventive strategies including monoclonal antibodies and vaccines. Though COVID vaccine scale-up in West Virginia is currently among the best in the nation, West Virginia’s population is highly vulnerable to emergent variants that may impact the effectiveness of current vaccines and therapeutic monoclonal antibodies. To suppress the ongoing pandemic it is critical to identify, track and isolate new variants before they spread and bring a wave of disease that is resistant to current vaccines. Noteworthy is that we have already established high throughput SARS-CoV-2 sequencing with long-standing collaborations between Marshall University, West Virginia University, and the West Virginia Department of Health and Human Resources. We are well positioned to provide rapid, impactful information regarding the prevalence, changing patterns, and clinical outcomes with respect to variants as well as on the effect of variants among those who have received a COVID-19 vaccine. This project will sequence SARS-CoV-2 from heterogeneous populations by leveraging three existing testing programs that include: 1) the Rapid Acceleration of Diagnosis in Underserved Populations (RADx-UP) that has already tested over 1,500 persons throughout the state, 2) surveillance testing among nursing home residents and staff, and 3) university surveillance testing. Through the RADx-UP initiative, testing is currently conducted in 37 counties; all positive tests will be sent for sequencing, enabling assessment of variants in disparate locations in West Virginia – some within 40 minutes of the metro Washington DC area and others in remote rural locations. Moreover, the WV RADx-UP initiative is also conducting testing among communities of color (predominantly Black/African American) enabling description of variants among this group in comparison to the general population of WV. Relevant to nursing home populations, age has been associated with lower antibody levels in both the Moderna and Pfizer Phase 3 vaccine trials. Nursing home patients may be more likely to have suboptimal immunity, a scenario that is ripe for emergence of existing or novel variants. Finally, university students by virtue of their mobility and variable adherence to social distancing measures suggest fertile ground for emergence of variants. Sequencing of all isolates from the WVU surveillance testing program will provide an excellent opportunity to assess cases caused by variants over time. As this project will support SARS-CoV-2 sequencing in multiple West Virginia populations, we are confident that this surveillance sequencing will quickly identify variant emergence and distributions so as appropriate public health measures may be implemented.