When an Anne Arundel couple was tested for COVID-19 this month, the private lab used for processing their samples noticed something troubling.
One part of the three-part test wasn’t registering — a telltale signal that the virus the pair brought home from their extensive travels had mutated enough to throw off the results. State scientists later confirmed the virus was a variant first identified in the United Kingdom known as B117.
“With this U.K. variant, and others we’ve heard of such as from South Africa, our main concern is that it appears to behave differently, it appears more contagious,” said Dr. Jinlene Chan, Maryland’s acting deputy health secretary.
And more cases mean more hospitalizations and deaths at a time when much of the country is recording records. “If more people get sick, then we are more likely to have more complications,” Chan said.
On Friday, state health officials confirmed that another case of the variant, unrelated to the Anne Arundel couple, was discovered by Johns Hopkins Hospital. Chan said the state will continue monitoring for more cases of this variant and others that could pose a serious challenge to controlling spread of the coronavirus as efforts to vaccinate the public continue to lag.
Scientists say it’s common for viruses to mutate, though mutations found in variants mostly do not change the virus’ behavior and can even reduce the threat. But B117 appears far more infectious than earlier strains.
The variants haven’t been shown to make people more severely sick, though British researchers released a limited new analysis Friday suggesting there is a “realistic possibility” that B117 is more deadly.
Across the country, the U.S. Centers for Disease Control and Prevention warns, B117 is likely to become the dominant strain by March, with the “potential to increase the U.S. pandemic trajectory.”
Chan and other public health officials are urging people to double down on preventive measures, such as masking and distancing and getting a vaccine when one’s available to them.
Maryland’s death toll now exceeds 6,600, and hospitalizations exceed records set in the spring at just under 1,800.
Scientists say further spread could hamper recovery efforts, such as returning children to school and reopening businesses.
It’s not clear what other variants may be brewing. Scientists say it took a bit of luck to identify the U.K. variant because there’s not been much effort at doing genetic sequencing of virus samples taken from patients that would show mutations.
Chan said Maryland had been doing some limited sequencing. Now that variants have been found in multiple states, the CDC began a more coordinated surveillance effort this month by requesting more samples from states.
So far, the CDC says there are three “variants of concern” globally, including B117. The others have been found in South Africa and Brazil. Officials are trying to determine if another variant found in California is unique.
The U.K. variant was identified initially through a common polymerase chain reaction, or PCR, test that uses three pieces of the virus’ genetic code to look for an infection. British officials noticed one part wasn’t registering from some people’s swabs and later found the mutations.
Maryland officials have since asked labs to report tests showing such results.
“It was serendipitous that the lab was using a PCR test … that can identify the UK variant,” said Chan, adding that the Maryland state lab sequenced the virus’s code to confirm the variant.
There have been no other significant variants found in Maryland, but other scientists say there are likely many undetected mutations nationwide.
The viruses spread in the human body by replicating their genetic information, and each time there is a chance for mutation, said Matthew Frieman, an associate professor of microbiology and immunology in the University of Maryland School of Medicine and a coronavirus researcher.
A set of mutations produces variants, he said. The more concerning variants likely have been developing for some time, but there hasn’t been a coordinated effort to detect them.
“We’re still learning a lot about variants every day,” he said. “As more countries are doing sequencing, we’re finding more variants.”
The good news, Frieman said, is that the vaccines and therapeutics used for COVID-19 appear so far to work against the variants.
That could change as people develop disease-fighting antibodies to a specific coronavirus strain, through infection or vaccination, and the virus — which needs to propagate itself — looks for work-arounds.
“Two years from now we don’t what it will look like,” Frieman said, adding the vaccines could need to be updated occasionally or annually like the annual flu vaccine.
Frieman’s research has contributed directly and indirectly to coronavirus vaccines, first for past coronaviruses SARS and MERS, and now for the current virus. He continues to work on a vaccine from Gaithersburg-based Novavax, which entered phase 3, or late stage, testing in December at sites including the University of Maryland School of Medicine.
The vaccine is the fifth to enter phase 3 trial in the United States, including those from Pfizer-BioNTech and Moderna that already received emergency authorization for use from the U.S. Food and Drug Administration.
Others agree that the vaccines may have to be altered eventually, including Dr. Anna Durbin, a professor at the Johns Hopkins Bloomberg School of Public Health whose research involves evaluation of experimental vaccines.
However, during a recent talk to business leaders in Baltimore, she said unpublished studies show the vaccine is still effective against the B117 variant for now. One study specifically found the Pfizer vaccine was effective against the U.K. and South African variants, which share a mutation.
“It’s not like influenza,” Durbin said. “These are very small changes made with these variants. And if changes [in vaccines] need to be made, I’m confident we have the technologies already in place to make those changes.”
But Dr. Stanley Perlman, a professor in the University of Iowa’s department of microbiology and a long-time coronavirus researcher, said the evolution of this coronavirus is in “new territory.”
He said the most recent examples of coronaviruses posed far smaller threats than this virus. They were from the Middle East respiratory syndrome, or MERS, first reported in Saudi Arabia in 2012, and severe acute respiratory syndrome, or SARS, in discovered in China in 2002.
Perlman said SARS evolved to more easily infect humans but was never very transmissible. MERS transmitted even more poorly and evolved to become less virulent but continues to infect people periodically through camels.
There are other coronaviruses, including the common cold, which also continue to infect people but don’t cause severe respiratory illness.
“Viruses tend to mutate to transmit better, sometimes losing virulence in the process,” he said.
In a concerning development, the South African public health agency says the variant found there appears to have some resistance to natural antibodies formed in those infected — suggesting people could be re-infected.
Studies are underway to see if the vaccine is less effective against that variant, said Dr. Daniel Lucey, an infectious disease specialist who spent time in South Korea prepping health workers for MERS. Lucey is a professor in Dartmouth’s Geizel School of Medicine and adjunct professor of microbiology and immunology at Georgetown University Medical Center.
In a series of comments prepared for the Infectious Disease Society of America this month and provided to The Baltimore Sun, Lucey said scientists also still are seeking more basic answers, such as why concerning variants are emerging.
He said one hypothesis is that mutations are developing during prolonged infections in patients with compromised immune systems and in patients who received treatments of convalescent plasma from COVID-19 survivors. The “offspring” strains may be “more contagious or deadly, or both,” he said.
And, Lucey warned, in countries such as the United States with lots of cases, “additional variants with similar increased contagiousness should be expected in 2021.”
Baltimore Sun reporter Hallie Miller contributed to this article.
