More contagious, hard to detect: Details on new COVID strain found in Mecklenburg

The testing infrastructure that hospitals and local health departments in North Carolina rely on is not equipped to routinely screen for the highly contagious UK coronavirus variant found in Mecklenburg County last weekend, officials said.

Top doctors from Atrium Health and Novant Health say they, like most hospital systems, aren’t able to routinely screen for the UK variant or other strains that have mutated from the novel coronavirus. Mecklenburg County Public Health Director Gibbie Harris says labs statewide have similar limitations.

“We don’t know how much of this new strain we have in our community. We know it’s here, and that’s the main thing we need to know right now,” Harris told reporters Tuesday.

Protecting yourself from the new strain, Harris said, requires the same safeguards promoted throughout the pandemic: Stay home, avoid gatherings with people you don’t live with, and wear a mask, among other precautions.

North Carolina’s first case of the UK variant — considered far more contagious than other coronavirus strains circulating across the world and now in the United States — was identified in Mecklenburg on Saturday.

It is the only known case of that variant in the state, though hospital leaders say Mecklenburg likely has far more cases circulating in the community, beyond the first infection reported.

Twenty-four states have confirmed cases of the UK variant, known as B.1.17.

Public health experts say in addition to the limited information about its prevalence in the state, the more contagious strain could pose challenges for contact tracing and other measures aimed at slowing transmission.

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Limits to screening

Among the steepest challenges to getting an accurate picture of the prevalence of coronavirus variants — including those observed in the UK, Brazil and South Africa — is screening the genetic material in a test sample.

Dr. Katie Passaretti, Atrium’s director of infection prevention, said limits to genomic sequencing — which scientists have relied on to analyze mutations to the coronavirus — make it difficult to pinpoint the transmission of virus strains locally.

“It’s a relatively small subset of samples that go for this specific strain typing,” Passaretti told reporters Monday afternoon.

“These strains absolutely are of concern ... It is just so, so important to continue masking when you’re with anyone outside of your household, maintaining those social distancing measures, and getting vaccinated as soon as your (priority) group has access to that.” Atrium has not processed any variant samples, Passaretti said.

On average, more than 4,600 coronavirus tests are administered in Mecklenburg daily, the latest county health data show. Officials disclose daily testing volumes, plus a breakdown of positive and negative results, but there’s no insight into which infections might be linked to mutations found abroad.

Novant doesn’t have the ability to conduct genomic sequencing either, infectious diseases specialist Dr. David Priest said Tuesday. He also anticipates more cases of mutated strains will emerge locally.

“Those variants have been found in 45 countries around the world, and they’re going to be found in the United States, as well,” Priest told reporters. “We’re not surprised when we hear reports that some have been discovered.”

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The UK variant sample detected from a Mecklenburg resident was processed by Mako Medical Laboratories and confirmed by the Centers for Disease Control and Prevention, the state Department of Health and Human Services said.

David Wessner, a professor of biology at Davidson College, said unlike the United Kingdom, the United States has not implemented a robust screening system to detect coronavirus variants. And while it’s very common for viruses to mutate, scientists who watch those changes can provide crucial information if variants are more transmissible or cause more severe illness.

Harris said her department is “always advocating for additional screening capacity” for variants.

“It’s difficult to know what’s happening in our communities, without the information that comes from that type of screening,” she said.

More contagious virus strain

State officials did not disclose any additional information about the Mecklenburg adult diagnosed with the variant, including the potential source of infection, recent travel history and how many people might have exposed.

Epidemiologists say the UK variant has not taken a firm hold in North Carolina yet.

Over the last two weeks, the number of new cases and hospitalizations has slowly declined — suggesting Mecklenburg is emerging from a post-holiday surge.

Mutant strains could thwart that progress, though it could take several weeks before case tallies — and later, hospitalizations — reflect the full impact. And an extremely limited supply of COVID-19 vaccines means only basic coronavirus safeguards, like mask wearing and social distancing, are available to blunt more outbreaks.

“We don’t have a good sense of widespread it is,” said Michael Thompson, associate chair of public health sciences at UNC Charlotte. “We have to be very cautious about large gatherings, unmasked (and in) close quarters ... It only takes one person to expose a lot of people.”

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In April, Charlotte was the original epicenter of North Carolina’s COVID-19 pandemic, partially since the region is a major travel hub. That could also explain why Mecklenburg was the first to report the UK strain — and could soon prompt similar concern in the Triangle, as people from abroad fly into Raleigh-Durham International Airport, said Jim Thomas, an epidemiologist at UNC Chapel Hill.

It’s only a matter of time before more variants are detected locally, Thomas said, though it is too early to know what preventive measures state leaders may enact. In Britain, a strict lockdown remains in effect through March.

“It doesn’t look good for the restrictions that we’re going to face,” Thomas said. “It could further postpone the data when schools are able to welcome kids to campus. The (case) downturn that we’ve seen from the holidays is a good thing ... this new variant could change all of that.”

Highly contagious mutations might further upend the work for contract tracers, who try to slow the spread of COVID-19 by notifying people about the need to quarantine and get tested the virus. For efficiency, Thomas said, health departments could consider prioritizing case investigations for individuals with international travel histories.

Wessner, of Davidson College, said knowing which strains are circulating in a community can be an important tool for making public health decisions.

“You’re probably going to see an uptick in number of cases just because the variant present here now can be spread more easily,” he said. “That’s going to have implications for the health care systems. If we have an uptick in cases, we’re going to have a greater strain on the hospitals. Knowing that it’s present gives you a warning of what may be coming down the road.”

Passaretti said the UK variant is believed to cause more severe illness, though it’s not “markedly higher” compared to the predominant virus in the U.S. right now.

“No matter what, more people infected means a bigger impact on the community,” Passaretti said. “You add even slight increase in severity of illness or risk of hospitalization, that adds to the concern level. It is important to control the spread as much as possible.”

Hannah Smoot contributed to this report.

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