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The first known case of the B.1.351 South African variant of the COVID-19 virus in Nevada has been verified by the Nevada State Public Health Laboratory (NSPHL).
The new strain was detected in a sample collected in Reno. Following sequencing and analysis by NSPHL, the sample was confirmed as the South African variant on Wednesday, Feb. 17.
NSPHL Director Mark Pandori said the lab detected the case as part of its daily strain testing and sequencing program. He said sequencing on the sample was performed twice to confirm the variant. The B.1.351 strain was traced back to a person who traveled to South Africa and became symptomatic after arriving back in Reno.
Washoe County Health District (WCHD) Epidemiology Program Manager Heather Kerwin said that 90-95% of positive cases of COVID-19 in South Africa currently are being identified as this new variant.
She said the individual who tested positive for it was not in a contagious state while flying back to the U.S. and had only a few days thereafter for which they needed to account when speaking with contact tracers. Kerwin added that while the WCHD has had problems in the past with people who are uncooperative with contact tracers, this was not the case with this person—and added that everyone who was identified as having come in contact with the person has been asked to quarantine for a full 14 days regardless of whether they development symptoms.
Pandori stressed that the best way to prevent the spread of variants and the possibility of new mutations leading to even more variants is for people to isolate. He said the spread of variants is particularly concerning as it could put the community “potentially in a position where we’re facing a whole new foe, and we don’t want that.”
According to the Centers for Disease Control and Prevention (CDC), the variant has thus far been detected in 10 U.S. states.
The B.1.351 variant emerged independently of the B.1.1.7 “U.K.” variant, according to the CDC. However, like B.1.1.7, it also possesses mutations in the spike protein the virus uses to bind to, enter and infect human cells. The spike protein mutation may be associated with higher viral loads and may also hinder antibody binding, reducing naturally developed immunity and may have a negative effect on vaccine efficacy.
Dr. Pandori said the South African variant “may be less susceptible to neutralizing antibody such as those generated by vaccines, but it is not yet known to cause a more severe illness and is not thought to be more lethal than the regular COVID-19 strain.”
He added that while there is some evidence that existing vaccines may not be as effective against it, it does not “render the COVID vaccine totally ineffective.”
“The virus is copying itself very often now, and that is what leads to variation,” Pandori said. “It happens through a process called ‘mutating.’ The more a virus spreads in a community, the more opportunities it has to make mistakes when it copies itself. This leads to what we see here, and it’s a very natural part of viral evolution.”
The NSPHL has been analyzing positive COVID-19 virus samples for variants since mid-December 2020 through whole genome sequencing. The lab is working on surveilling nearly all positive COVID-19 cases for the B.1.1.7 and B.1.351 strains. This surveillance will continue on a daily basis going forward.
Dr. Pandori explained, “Daily sequencing of positive cases is not necessarily the norm but has been adopted as a strategy by the Nevada State Public Health Laboratory so that we can cast a wide and very sensitive net. Daily genetic testing will allow us to find cases closer to the time that they arrive, possibly limiting community spread.”
The NSPHL is using federal CARES Act funds to purchase equipment that helps them identify mutations within viruses through genetic sequencing. With the new equipment, scientists have the ability to screen positive cases for the genetics associated with any variants of interest—including the U.K. and South African strains—to determine when new strains are found in Nevada.
These types of research tools are helping scientists identify variants more quickly. However, Pandori stressed that continuing to follow mitigation guidelines like staying home when you can, wearing face masks, frequently washing hands and social distancing are among the most effective ways to fight the spread of COVID-19 and its variants in the community.
It is also important, he said, that wide-scale testing, contact tracing and isolating of new cases continue—as well as continued vaccination.
Delayed vaccine shipments and concerns of possible “line jumpers”
According to WCHD’s James English, Washoe County has yet to receive its weekly allotment of Moderna vaccine as a result of delays caused by huge winter storms across the country. He said WCHD and other area vaccine providers have worked together to move as much of the existing supply in the county around to cover vaccinations for people who are in need of their second doses of the vaccine—adding that there is still a chance the Moderna shipment could arrive Friday or Saturday, enabling the health district to move forward with planned vaccinations over the weekend.
English said Washoe County’s total vaccine allotment will not increase next week because it is planned for some people in government jobs as well as staff and legislators at the Nevada Legislature to receive vaccines next week, and those doses come out of the state’s total allotment.
As to community concerns that some people are being allowed to receive vaccines who are not currently prioritized under the “lanes” identified in the state’s vaccination playbook, English said the WCHD is aware and has worked to address the issue. While some vaccine providers are focused on vaccinating frontline essential workers in one lane, others are supposed to be sticking to the second outlined lane and prioritizing people based upon age.
“We have received quite a few complaints regarding how the federal partnerships with the pharmacies are operating. Some of them had gone into the essential workforce tier,” English said. “We believe that has been corrected. They were supposed to stay in the general population tier—in the population lane—so that should be corrected now.”
He added, “If we receive any complaints related to that, they are referred to the state and the governing boards, whether it’s a pharmacy or medical facility to look into those and ensure that only the proper people are being vaccinated to ensure equity. There is science behind how they wanted the vaccine deployed based on risk or exposure risk, so we need to try to stick to that as best as possible.”