Flying blind no way to survive pandemic — we need a powerful radar
The omicron variant of the COVID-19 virus emerged around Thanksgiving. The first confirmed case in the United States was recorded Dec. 1, and the Centers for Disease Control and Prevention estimated the prevalence for the week ending Dec. 18 had soared to 73% - an astounding and alarming leap, virtually displacing the delta variant. Now, the CDC has revised that week’s estimate down to 22.5%, a correction that underscores how the United States is flying blind in the pandemic storm.
Undoubtedly, omicron will continue to rise, but the initial, overly high estimate is a symptom of a serious, systemic gap in public health information. We have the technology to chart the whole genome of a viral sample. But the United States has not yet built a real-time system of viral genomic surveillance that would allow comprehensive tracking of variants as they move through the population. As it is now, the CDC pulls together genomic surveillance data from a variety of sources, including its own facilities, state public health labs, and university and private laboratories, but only a fraction of all pandemic samples are sequenced, and it can take weeks to build a reliable picture of how the variant is spreading. The CDC’S weekly prevalence estimates can also include projections from modeling, at least until hard data arrives. The most recent CDC estimate for omicron prevalence during the week ending Dec. 25 was 58.6% in the United States.
As Rajiv Shah, president of the Rockefeller Foundation, warned in a report, “One secret weapon has helped beat every disease outbreak over the last century; but it is not masks or social distancing, lockdowns, or even vaccines. Instead it is data . . . . Data is what moves us from a panic-driven response to a science-driven one.” The pandemic caught the United States and much of the world flat-footed, without that data, although some countries, such as
Britain, have made it a priority.
We need to know what variants are spreading where, in order to make critical decisions about in-person learning in schools or to distribute therapies aimed at specific variants, such as monoclonal antibodies. At-home diagnostic rapid tests are a growing plus, but if there is no collecting the data into a real-time surveillance system, the picture is incomplete. A simple smartphone app might help harvest this data; the technology would also have obvious benefits for flu, strep throat and other illnesses.
We have the National Oceanic and Atmospheric Administration
and its National Weather Service to warn of tornadoes and other weather dangers. The U.S. Forest Service has the National Avalanche Center to warn skiers and others. The U.S. military maintains early warning radars to spot ballistic missile threats. Now it is time to give viral genomic surveillance the same heft and priority. The Biden administration announced funding this year from the American Rescue Plan to help the CDC and states ramp up such surveillance, and states have been sequencing far more samples than in the past. But we cannot be satisfied until the nation has a radar that provides real-time, precise information about the microbial threats we face.