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A Comprehensive and Precise System: The United States Needs Political Will to Fully Institute Genomic Surveillance against COVID-19

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Nathan Myers
August 17, 2021

As the United States enters a new phase of the COVID-19 pandemic, the American public is facing the harsh reality that it is not enough to defend against SARS-CoV-2. All potential mutations of the virus must also be addressed. Currently the Delta variant has caused the federal government to reconsider its position on mask guidance and is creating controversies at the state and local level, particularly around school reopenings. This more contagious and virulent strain has brought into focus the necessity of expanding access to and utilizing genomic surveillance. The Centers for Disease Control and Prevention (CDC) defines genomic surveillance as decoding the genes of a virus like SARS-CoV-2 to, “Monitor how it changes over time into new variants, understand how these changes affect the characteristics of the virus and use this information to better understand how it might impact health.”

In his book The Premonition, Michael Lewis writes about how early on in the COVID-19 pandemic scientists tried to alert federal and state leaders about the utility of genomic surveillance in identifying individuals most responsible for spreading the virus. Dr. Joe DeRisi, a group of scientists and engineers and 200 volunteer researchers at the ChanZuckerberg Biohub processed 165,000 COVID-19 test samples for the State of California. They also provided whole genomic sequencing for any positive samples, facilitating a better understanding of how COVID-19 and its mutations were moving through communities. Now this type of genomic surveillance could prove particularly valuable in differentiating between Delta and other variants, as leaders must make decisions regarding, among other things, protecting children in schools.

The value of using genomic analysis to distinguish between the types of variants and to better understand how they spread has been recognized by some federal legislators. Senator Tammy Baldwin (D-WI) introduced the Tracking COVID-19 Variants Act of 2021 on February 4, 2021. The legislation calls upon the Centers for Disease Control and Prevention to provide guidance regarding the sequencing of the coronavirus, as well as to establish a program, “To strengthen genomic sequencing, analytics and disease surveillance activities.” This program would involve providing state and local health departments with grants and technical assistance to allow them to be better trained and equipped to use such techniques.

It should be noted that the federal government has previously supported the use of genomic sequencing in efforts to combat threats like antimicrobial resistance. Some states have been proactive in implementing genomic sequencing in the fight against COVID-19. Washington State reports that they are sequencing 10% of positive samples. Many states are not adequately equipped to keep up with the amount of sequencing necessary, requiring them to partner with local universities in order to close the resource gap. The federal government has been criticized for being slow to prioritize and support genomic surveillance against SARS-CoV-2. The CDC has put together a consortium of 200 labs to sequence samples and share information, while at the same time asking state and local health departments to provide more resources for sequencing. The Biden administration’s American Rescue Plan included $1.7 billion to fund a genomic sequencing network. Groups representing state and local interests, like the Association of State and Territorial Health Officials, were signatories to a letter sent to the House Appropriations Committee calling for $60 million to fund the Advanced Molecular Detection program at CDC, citing the need to build upon previous successes in genomic sequencing in combatting COVID-19.

Baldwin’s bill garnered 12 co-sponsors in the Senate, all of them Democrats except for independent Senator Angus King of Maine (who caucuses with the Democrats). It was referred to the Senate Health, Education, Labor and Pensions Committee, but no further action has been taken. There are several potential explanations for why the bill has not received any support from Republicans in the Senate. However, it is vital for the nation moving forward that collecting data on and tracking the spread of COVID-19 and its variants be acknowledged and supported as a top public health priority on a bipartisan basis.

It should be noted that another part of the Tracking COVID-19 Variants Act calls upon the National Center for Health Statistics to create a demonstration program linking databases containing information regarding social determinants of health with the National Death Index. This sheds light on the fact that even as we use the most cutting edge science to defend against public health threats, we must not lose sight of the fact that age-old factors such income inequality and inadequate healthcare access continue to play important roles in making some people considerably more vulnerable in a public health emergency.

As the United States confronts current and potential future mutations of COVID-19 while also facing limits on its ability to call for nationwide social distancing efforts, it is more important than ever for the United States to institute a comprehensive and precise surveillance system to identify the variants, where they are and how they are spread. Then hopefully federal, state and local officials can use that specific data to institute a targeted response. The tools and infrastructure exist, waiting for political will across parties and across levels of government to use it.

Author: Nathan Myers, Ph.D. is an Associate Professor in the Department of Political Science and Director of the Master of Public Administration at Indiana State University. His areas of research include public policy, public health emergency preparedness, and the governance of biotechnology. He is the author of “Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies.” Myers serves as an academic advisor to the Continuity of Supply Initiative and assistant director of Indiana State’s Center for Genomic Advocacy.

[email protected]; Twitter: nagremye1980

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