Does a patient need to know which variant of COVID-19 infected them?

COVID-19 testing
Posted at 5:55 PM, Dec 01, 2021
and last updated 2021-12-01 19:22:18-05

KANSAS CITY, Mo. — Health leaders confirmed Wednesday a new omicron variant of COVID-19 was detected for the first time in the United States. But most patients will never know which SARS-CoV-2 strain infected them.

So far doctors have generally used the same treatment for all patients no matter which variant or strain infected them, so knowing the exact strain is not medically necessary on an individual level.

That approach could change if the omicron strain resists those treatments, called monoclonal antibodies.

“I think we still need to wait for the full information about how effective the monoclonal antibody cocktails are to this variant,” said Dr. Dana Hawkinson, University of Kansas Health System medical director of infection prevention and control. “That data should be coming up fairly soon.”

In the meantime, health departments and the Centers for Disease Control and Prevention want to know which variants are present in the community to help local leaders craft guidelines like travel restrictions, mask mandates, or limits on gathering sizes.

In Missouri, all positive COVID-19 test results get reported to the Department of Health and Human Services. It analyzes about 600 of those specimens on a regular basis for genomic sequencing. A spokesperson said the state shares that information with the CDC through its SPHERES consortium because sequencing “will improve our understanding of which variants are circulating in the U.S., how quickly variants emerge, and which variants are the most important to characterize and track in terms of health.”

In a written statement, the spokesperson explained the state works with the CDC so “public health experts in Missouri and nationwide will be able to monitor important changes in the virus as it continues to circulate as well as advance public health research in the areas of transmission dynamics, host response, and evolution of the virus.”

Missouri and Kansas do not send information on individual sequencing results to patients or test providers/administrators.

In Kansas, not every positive COVID-19 test result gets sent to the Department of Health and Environment. In November, the agency sequenced 3.3 percent of all positive tests it received.

Kansas also works with the CDC’s SPHERES program. A KDHE spokesperson said in a statement, “Having data on the predominant strains circulating adds another layer of understanding when we look at trends in cases, hospitalizations, deaths, the number of breakthrough infections, how well therapeutics work.”

Eurofins-Viracor’s Lee’s Summit, Missouri, laboratory detects strains and variants in positive COVID-19 test results for vaccine manufacturers who want to find out whether their vaccines are as effective against new strains.

Chief Scientific Officer Steve Kleiboeker explained the process of sequencing is expensive and time-consuming, taking roughly three to four days to get results.

Eurofins-Viracor has developed a two-in-one PCR test used in Europe which can detect both COVID and emerging strains with good precision.

“We could do these rapid, inexpensive PCR tests and help point the arrow to the samples that then need to be sequenced, which is more labor intensive and time intensive and costly,” Kleiboeker said. “It’s really a classic screening approach. You can take many hundreds, thousands, of samples and know where to look with your sequencing.”

Kansas City, Missouri, resident Reid Hildenbrand contracted COVID-19 in August. He never found out which strain infected him.

“When I got tested, I asked, ‘Hey, is it possible to know if this is delta variant? Is that something I’ll know in my results or whatever?’,” Reid described his surprise when he found out that would not be part of his results.

Kleiboeker said there may be a day when sequencing on an individual basis is necessary, but it’s too soon to say.

“That may be our next challenge down the road. We don’t know, we try to be ready for any challenge,” Kleiboeker said.