Washington State Virologists Hunt Specimens for Omicron Variant, Confident They Can Spot It

Posted

Washington state's virologists are hunting for cases of the coronavirus's new, highly mutated omicron variant, which hasn't yet been detected in the United States but is worrying health officials around the world.

The state's genotyping system — which logs information from public health departments, universities and private labs — is searching for signs of omicron, as well as other new variants, state epidemiologist Dr. Scott Lindquist said during a Monday news briefing.

"We set this genotyping system up in Washington state well over a year ago, anticipating exactly what's unfolding right now, that there'd be an emergence of new variants," he said.

Details remain sparse on omicron's transmissibility and severity of illness compared to the delta variant's. Based on early data, the World Health Organization warned Monday that the global risk from the new variant, which was first identified in South Africa last week, is "very high" and that there are "considerable uncertainties."

"It's very possible it's already in the United States and it will just be a matter of finding it and characterizing it," state Secretary of Health Dr. Umair A. Shah said Monday.

As of Monday, omicron cases have also been identified in Canada, Germany, Britain, Belgium, Denmark, the Netherlands, Portugal and Spain.

At the University of Washington, research teams working to sequence virus samples are confident they'll be able to detect omicron infections once the variant lands in the state, said Alex Greninger, an assistant professor at UW's department of laboratory medicine and pathology, on Monday.

"Washington is one of the best-covered states" when it comes to sequencing, Greninger said. "We have sort of the best eyes out there when it comes to looking for these variants and reporting on them. As soon as omicron is here, we'll be one of the first to pick it up."

Now, he and his team are running about 800 to 1,000 sequences a week.

Greninger said Monday that his lab isn't worried about the new variant evading tests, noting that past variants have had "very little effect" on his team's testing performance. Almost all the molecular tests UW researchers are performing have at least two target genes, meaning that even if there were a mutation that affected one target, the other would pick it up, he said.

"Every test has sort of an assurance method with it," said Greninger, who's also the assistant director of the clinical virology laboratories at the UW Medical Center.

UW's rapid antigen tests largely target the virus's nucleocapsid protein, he said, which is not highly mutated in omicron. Most of the mutations in omicron, rather, are found in its spike protein.

In addition, Greninger noted that omicron has a similar "hallmark" to the coronavirus's alpha variant: a small deletion in its spike protein, which virologists will be able to detect easily because it's "highly specific" to omicron.



"That's a really detailed way, not just a passive system of looking for omicron," Lindquist said. "We're really getting very active in going after and finding it."

All labs throughout the state are also being asked to increase their volume and prioritize testing for people with a travel history, he added.

Concern about the new variant comes as hospitalizations continue to inch downward in Washington, with a seven-day average of about 694 COVID-19 hospitalizations Monday, compared to about 806 reported last week, Washington State Hospital Association CEO Cassie Sauer said Monday.

"That's about a 14% decrease in a week. That is great news," Sauer said. The number of patients on ventilators, however, increased by 6% in the past week — and an average of about 10 to 15 Washingtonians continue to die from the virus every day.

Acute care capacity also remains "quite tight," reflecting a need to juggle surgeries and delay care, Sauer said.

At Skagit Regional Health, a health care system serving Skagit Island and north Snohomish counties, hospital workers are caring for about 20 COVID patients — five who are intubated — out of about 110 admitted patients, said Dr. Connie Davis, the hospital's regional vice president and chief medical officer.

Like many other health care facilities in the state, Skagit Regional Health is particularly struggling to discharge patients who no longer require hospital care, Davis said.

Patients generally include those who have dementia or developmental delays and require special care, those who need longer-term care, and those with pediatric or behavioral health issues, she added.

"I would ask people to really look seriously at this, to realize if this is the behavior that's necessary for getting people to this type of care, the acute-care resources are going to be stressed and we are thus boarding more and more individuals in our emergency rooms," Davis said.

Greg Repetti, president of MultiCare's Deaconess and Valley hospitals in Spokane, said Monday that his health care system is facing similar challenges. As of Monday morning, about a third of Deaconess patients were eligible to move to nursing homes or long-term care centers but couldn't due to staffing shortages there, Repetti said.

"We have to have space in our hospitals to care for people," Sauer said. "... Hospitals should not be used as housing essentially for people who don't need hospital care but don't have another place to go."

While hospital leaders urged the public Monday not to panic about the new variant, Sauer noted that it's "not a time to let down guards" and renewed a push for people to get vaccinated, seek booster shots, stay masked and socially distance.

"There's a lot we don't know," Shah said Monday. "We're confident we're going to learn more. We're doing everything we can as a state to continue to stay on top of this in respect to genotyping and genosequencing, as well as making sure we let our community members know how they can protect themselves."