British scientists say the next dangerous Covid variant is likely already out there. We just don't know it yet
Cambridge, England (CNN)Almost a month into a third nationwide lockdown, most of England seems to be in hibernation: stores are shuttered, high streets are deserted, and trains are almost empty. But in one small village in the countryside near Cambridge, in eastern England, there is a hive of activity.
Dressed
in white lab coats and surgical masks, staff here scurry from machine
to machine -- robots and giant computers that are so heavy, they're
placed on solid steel plates to support their weight.
The
staff at the Sanger Institute are much more than essential workers --
right now, they're doing some of the most important work on Earth:
genetically sequencing the coronavirus. Internally, it's called "Project
Heron."
The
labor-intensive project, involving hundreds of people, is being done
just down the road from the Cambridge pub that Francis Crick walked into
in 1953 to declare he'd "found the secret of life" -- the structure of
DNA. Today that discovery is allowing scientists to spot dangerous
mutations in the genetic code of coronavirus that could make the pandemic much worse than it already is.
Industrial-scale sequencing
Every
day, vans arrive at the Sanger Institute carrying crates full of virus
samples from around the UK. The green crates are loaded into an
industrial-sized walk-in freezer, set up in the parking lot.
By
this point, there are no more cotton swabs. The samples -- both
positive and negative -- are in a solution of what's left over after
initial testing. The scientists don't need much.
Inside
the lab, a robot is programmed to pluck only the positive samples from a
small, plastic muffin tin-like plate and consolidate them onto a
separate tray which is sealed by hand. Hundreds of samples end up
consolidated into a single vial. In another lab, chemicals are added,
and shaken by a small machine, then pressed thin between two pieces of
glass. The glass plate is put into one of the giant sequencers, a loudly
humming machine that looks like a high-tech photocopier.
Fifteen
hours later, the computer spits out so much genetic data that entire
server farms have been built off-site to house it. From start to finish,
the process takes about five days. Around 10,000 samples are sequenced
each week in this lab alone -- around a quarter of the total number
sequenced globally.
Then comes the hard part: Combing through all that data.
"We're
looking for mutations that may allow the virus to either be more
transmissible or to cause more severe disease, and particularly now that
vaccines are beginning to be rolled out globally, we're looking
potentially for mutations that we think might affect the ability of the
vaccines to protect people," said Ewan Harrison, a microbiologist who is
helping coordinate the network of scientists working on the Covid-19
genomics operation in the UK.
Harrison
explains that if you sequence enough of the population you can see how
the virus has moved through the community and where there have been
groups of infections -- including super-spreader events. "That's really
powerful ... that's really at the heart of what viral sequencing is
for," he said.
Harrison
has played a leading role in the Covid-19 Genomics UK Consortium
(COG-UK) a team of hundreds of scientists at universities and labs
across the country that sprang up at the start of the pandemic, working
in unison to create and make sense of the genetic data being sequenced.
Finding the UK variant
Less
than two months ago, that network of scientists and Britain's growing
mountain of genetic data helped to identify and trace the spread of the variant
that has now become dominant in the UK. It was first spotted in Kent, a
rural county that also has some of the most deprived communities in
southeast England.
"People
in Kent weren't all having house parties and going to the same
supermarket," Public Health England spokesperson Ruairidh Villar told
CNN. His scientist colleagues quickly ruled out bad behavior.
And
yet, daily case counts continued to climb across the county, even while
they were falling in most other parts of the UK, which was under
national lockdown.
They
found the culprit in the UK's genomic database, which at the time
covered about one in every 10 positive Covid-19 samples in the country.
The
rogue strain of the virus, called B.1.1.7, had been circulating in Kent
since at least September. It spreads 30-70% more easily than the
original virus, according to Britain's chief scientific adviser Patrick Vallance.
It
didn't take long for B.1.1.7 to be detected in the capital, and
throughout the country. It has now been spotted in at least 70
countries, and most US states. The CDC says it could become the dominant
strain of coronavirus in the US by March.
Cambridge
University Professor Ravi Gupta said that, based on how quickly it
spread in the UK, "It's probable that the same thing will happen in the
US."
Inside
his lab, Gupta showed CNN a "phylogenetic family tree" -- the
equivalent of ancestry.com for Covid-19. On this tree, B.1.1.7 looks
like a second cousin, twice removed, from the original coronavirus first
identified in Wuhan, China. The genetic difference is 23 mutations, but
the real oddity is that B.1.1.7 has so few close "relatives."
"We
found very few -- virtually no sequences that are highly related to the
B.1.1.7 variant. In other words, it popped out of nowhere," said Gupta.
Scientists are unlikely to ever find "patient zero" of the new variant, but they have a theory.
Last year Gupta was studying a Covid-19 patient with a compromised immune system
who couldn't shake the virus for more than three months. Inside a body
that couldn't fight back, the virus had time to mutate much quicker than
it would being passed from person to person in the population.
Gupta
compared the virus of his patient, who eventually died, to the
sequencing database and found that there was a virus already circulating
that shared one key mutation with his patient: B.1.1.7.
"It
was really striking to see," he said. The patient didn't have B.1.1.7,
but the volume of mutations within their body illustrated for Gupta that
it's "very, very likely" that if there was a B.1.1.7 "patient zero"
they were an immunocompromised person. Harrison thinks so too.
Vaccines for a changing virus
Gupta's
pre-published lab research indicates the Pfizer/BioNTech vaccine is
still effective in beating the UK variant after one dose, though
slightly less so in blood taken from patients aged over 80. Other
studies on different vaccines have shown similar results. But the same
may not be true for every variant that comes along.
There
are already concerns about decreased vaccine effectiveness on the South
African variant, prompting vaccine makers like Pfizer and Moderna to
start working on booster shots to keep up with a changing virus.
Just
this week, Public Health England said a small sample of B.1.1.7 cases
from the UK have been found to contain a new mutation also present in
the South African variant. Early lab research suggests the so-called
"escape mutant" may help the virus evade antibodies produced by vaccines
-- potentially making them less effective.
Gupta
thinks the concern over these variants is well deserved. "These viruses
are already on their way to becoming more resistant to the immune
system and to vaccines," he said.
The
UK variant, like others, has changes on the so-called "spike protein,"
the part of the virus that helps it invade a human cell. Scientists
think this could be why it's more transmissible than earlier strains and
also causes worries for the vaccine, as those currently developed work
using the spike protein.
Before
vaccines can be adapted to the changing virus, samples need to be
sequenced. The Sanger Institute, together with 16 smaller British labs,
account for around half the world's total sequencing effort. Many
countries don't have the ability to sequence any Covid-19 samples at
all.
"We
talk about the UK variant and South African variant and Brazil variant
-- but the irony is it's probably just that these are the countries that
have advanced sequencing capacity and [the variants] may well have
emerged elsewhere but we simply won't know it. And there may be others,"
said Villar.
Gupta
and Harrison believe it's likely that there are already dangerous
variants of the virus spreading in countries where scientists won't be
able to spot new variants as they arise.
"These
immunocompromised individuals are scattered around the world," said
Gupta. "So, it is very likely there are undetected variants out there."
The
British government has announced plans to expand its sequencing work to
countries that can't do their own. The exact details are still being
ironed out.
"It's
trying to find those countries that don't have the capacity to sequence
themselves, [or have] very low capacity, to improve our global
awareness of mutations that could have absolutely devastating public
health impacts," said Villar. "Obviously that brings incredible benefits
globally but also protects the UK from variants that may endanger the
public here too."
Villar
says he is sure that the Sanger Institute will be involved in the
effort and that the British government is planning a "significant
increase in the capacity of both sequencing and analysis" to help in the
global fight against Covid-19.
Harrison
isn't sure exactly what his role will be, or when he'll go back to his
old job. A year ago, he was studying why people are colonized with
methicillin-resistant Staphylococcus aureus (MRSA) -- a dangerous,
antibiotic resistant strain of bacteria -- before being diverted to
"Project Heron."
Others
were sequencing human genomes, plants, parasites or cancer cells. All
of that has been put on hold for something much more urgent.
"It's
been a long, long year," he said. "But you know, I think that we're all
very proud of what we've achieved in terms of the genomics program."
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