US COVID-19 Surveillance Needs an Urgent Boost

In Global Advocacy, Global Featured by Fiona Ip

Hopes for a steady decline and an eventual end to the COVID-19 pandemic in the United States are being dashed by a sudden upsurge in new infections and woefully inadequate epidemiological surveillance. AIDS Healthcare Foundation calls on the United States government to accelerate genomic sequencing of positive COVID-19 tests around the country and to develop a unified comprehensive plan for a robust virus monitoring network.

New cases are up 129.3% from their lowest point on June 20, 2021, according to CDC’s data on a seven-day moving average of recorded cases. The most common strain of the virus is the highly infectious Delta variant, but the US is falling behind other developed countries in tracking and identifying new strains. According to the Global Initiative on Sharing All Influenza Data (GISAID), since the beginning of 2020 the US has sequenced and shared genomic data for only 1.89% of all reported COVID-19 cases, whereas the UK and Australia have sequenced 10.5% and 58.5% of cases respectively.

“SARS-CoV-2 is highly prone to genetic variation as it replicates and spreads across different populations. These mutations give rise to some variants that are more resistant to existing vaccines. Because of this, a robust system of genomic sequencing is absolutely essential for us to keep up with the changing virus and adapt our treatments, prevention, and diagnostic strategies to it,” said Dr. Jorge Saavedra, Chief Executive of the AHF Global Public Health Institute at the University of Miami, who is a medical doctor with a background in infectious diseases.

A recent Business Insider story titled “The US doesn’t really know how widespread the Delta variant is because its virus sequencing is lagging far behind many other rich nations,” identified several reasons for the delays, mainly related to a patchwork of approaches to genomic sequencing across the country, including logistical challenges and regulatory constraints related to patient privacy.

“The US government has appropriated billions of dollars for the pandemic response and President Biden has invoked the Defense Production Act to accelerate access to diagnostics and technologies like genomic sequencing, however the rollout has been disappointingly slow as the GISAID data suggests,” added Dr. Saavedra. “With robust scientific and high-tech sectors, the United States should be leading the world in this regard and helping other countries to catch up with their own genomic sequencing efforts. Above all, what we urgently need now is an actionable plan on genomic sequencing in the United States, otherwise we risk incubating even more infectious variants, which could derail the recovery.”

AHF recently launched a grant program to support the scale-up of genomic sequencing efforts across the world, with programs already running, or in varying stages of development in the United States, Uganda, Kenya, Brazil, Mexico, Jamaica, Trinidad, India, Ukraine, Philippines, and Thailand. The US government could similarly support genomic sequencing efforts abroad, especially in developing countries, through development facilities such as for example the Global Fund to Fight AIDS, Tuberculosis, and Malaria. This approach would be mutually beneficial to the US and other nations, because no country is safe until all countries are safe and genomic sequencing is crucial to health solidarity and security of the world.

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