How to Keep New Variants From Emerging, and Ending the Pandemic
Cedars-Sinai Experts Explain How They Track COVID-19 Variants and What It Will Take to Finally Beat the Pandemic
As mask mandates disappear across the U.S., many are eager to return to pre-pandemic life. But scientists warn against letting down our guard too soon, pointing out that new variants could arise in the months ahead.
COVID-19 "is smart and contagious,” said Jasmine Plummer, PhD, assistant professor of Biomedical Sciences at the Cedars-Sinai Center for Bioinformatics and Functional Genomics and associate director of the Applied Genomics, Computation & Translational Core at Cedars-Sinai. “But we also know what we have to do to curb this pandemic.”
Plummer and Eric Vail, MD, assistant professor and director of Molecular Pathology in the Department of Pathology and Laboratory Medicine at Cedars-Sinai, explain why variants like delta and omicron keep emerging and what we should expect next.
First, how do different variants arise?
Vail: The reason why variants arise is because they are more fit in their environment than the previous variant. The previous variant gets outcompeted. So how do you outcompete another variant? You transmit to more people. And in order to transmit to more people, you become more infectious. Every single dominating variant that has come across has been more and more infectious. Almost assuredly, the next variant that arises will be more infectious.
How do you keep new variants from emerging?
Vail: The number one thing we all can do to keep variants from emerging is to get vaccinated. We have reams of clinical data that say we already have a way out of this pandemic, at least the worst aspect of it. And that’s with vaccinations. They basically train your immune system on how to recognize a pathogen and how to respond against it in a way that protects you. The most important thing we’ve learned from multiple studies is that if you have the vaccine and you have the booster, you have a much lower risk of being seriously ill.
So when people say the vaccines are not working, or they're not as effective with omicron, what advice would you give them?
Plummer: It's not as effective relative to the other variants we've seen because we allowed the opportunity for omicron to emerge. We didn't curve it fast enough. So compared to delta, for the same amount of viral exposure, the vaccine likely would have worked. But now for the same amount of viral exposure, you may be getting mild symptoms, but that doesn't mean vaccines are less effective. So yes, you are getting symptoms, but it's preventing you from getting in the hospital. So that's not a means to say, don't be vaccinated. We know omicron is smart and contagious, and the only thing that's going to make it milder is to definitely get vaccinated and a booster.
How do you track the emergence of new mutations?
Plummer: We track mutations using a genetic analysis. We hear people say sequencing and next-generation sequencing, and it gets kind of confusing, but it’s actually quite simple. We take the test swab and just take out the RNA that is the virus, and we put it on a sequencer and the sequencer just measures letters, which allows us to find what the mutations are in you versus me, and then we just do that across the population. This not only helps us to track what variants arise, but also who has omicron and who doesn't.
Vail: The really nice part of being in a medical system as strong as Cedar-Sinai is that we are also connected to patient data. When we discovered the CAL.20C variant in early 2021, we were able to go back into patient data, and really look at how each person with each variant did, what their vaccination status was, what other things they track with, and if they tracked with other comorbidities. I think that the patient data is very important so that we know as a new variant comes along, we can better understand its impact.
Is there a way to anticipate what may happen next with variants?
Plummer: While we can't say there isn’t going to be another variant, I think there has to be a shift in our reasoning of pandemic versus endemic. The hope is to get a vaccinated population where we can kind of keep it less contagious. Even if it's milder and it's contagious, we have vaccinations to help us. It's like what happened with the flu. We get into a situation where, eventually, it's endemic, where we just have new boosters and new vaccines ahead of time to kind of anticipate what the new variants are going to be, which is what happens with the flu shot.
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