Reopening during a pandemic isn’t simple. As portions of the United States and countries across the globe reopen, they face enormous challenges. There are on-going worries about testing availability––both for the novel coronavirus 2019 (SARS-CoV-2, the RNA virus that causes COVID-19) itself and for its associated antibodies. There are concerns about the general public’s willingness to follow social distancing guidelines and wear face masks. Plus, reopening a shuttered business is no guarantee its customers will return. Considering the months-long onslaught of bleak news, many will shun familiar enjoyments like eat-in dining or concerts even after they are made available. Genomics could provide a roadmap to truly safe reopening.
The study of a person’s genes, the ways they interact, and how they behave in various environments, genomics has helped researchers develop diagnostic tests for diseases. Our DNA––deoxyribonucleic acid––holds the body’s instruction manual. DNA directs how our cells operate. Nearly every cell contains a complete copy of the human genome’s three-billion DNA base pairs. By sequencing the viral genome for SARS-CoV-2, researchers have been able to better understand aspects of this novel virus’ unique structure. This was a vital first step toward developing accurate tests for the virus.
What’s in a name?
The first severe acute respiratory syndrome (SARS) was a pandemic preview. Also called a “novel coronavirus” or “SARS-CoV,” it began in November of 2002 after most likely spreading to human beings from infected bats in southern China. It reached Hong Kong in late February of 2003. That year there were more than 8,000 likely cases and nearly 800 deaths. Hard to believe, but just a few months ago, top scientists were confident SARS-CoV-2 infection and the associated disease, COVID-19, would not be as widespread nor as deadly as SARS.
Instead, while SARS was mainly confined to Asia, COVID-19 is a truly global pandemic. What is often forgotten is that this “novel” virus is not completely new. Earlier this year, the Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses produced a paper that described the virus as a variant of the coronavirus that caused the SARS outbreak in 2002. It named the new virus “severe acute respiratory syndrome-related coronavirus 2, or SARS-CoV-2.” The World Health Organization refused to adopt the name. The WHO was worried that it would create unnecessary panic, especially for people living in Asia. To scientists across the globe, this recent outbreak was not surprising. For nearly 20 years, they had been warning people that a virus similar to the 2002 SARS outbreak could spark a global pandemic. Steven Soderbergh’s prescient thriller Contagion was even partly based on it. Despite the cautions, governments across the world seemed ill prepared. Fortunately, scientists were ready.
It took years before the SARS genome could be sequenced. Less than two weeks after the first COVID-19 cases were reported, Chinese scientists didn’t just sequence its genome. They quickly posted the data online at virological.org and GenBank. The information was also sent to the World Health Organization. The laboratory at the Shanghai Public Health Clinical Centre led by Professor Zhang Yongzhen took these steps because they believed authorities hadn’t sufficiently warned the public. People were not just being told that there had been no new cases reported in Wuhan for over one week. Authorities had also emphasized that there were no clear cases of human-to-human transmission. This was, of course, wrong. But authorities responded by ordering the lab closed for “rectification” on January 12––the day after the sequence was posted online. By then, the information was available for anyone.
Sharing Vital Virus Data
Like Linux–the open source operating system–the platforms of Nextstrain.org and GISAID are open-source. They offer genomicists across the world opportunities to upload data and examine trends. Sequencing genomes reveals the way the virus changes and mutates as it spreads. This work can aid the development of a safe vaccine. Global collaboration is also vital to the COVID-19 host genetics initiative, where members of the human genetics community generate, share, and analyze data in hopes of discovering the genetic determinants for COVID-19 susceptibility, severity, and outcomes.
The National Institutes of Health (NIH) is well known globally for its 2003 Human Genome Project. As the NIH explains on its website, “This extraordinary undertaking produced a very high-quality version of the human genome sequence that is freely available in public databases.” Today they are spearheading genomic studies to help prevent, diagnose, and treat COVID-19. Their resources have also examined how the virus can affect seemingly similar people in vastly different ways. The answer may well be genetic. One study conducted after the 2002 SARS pandemic showed that the genome CXCL10(-938AA) was always protective whenever it appeared.
Knowing this type of immunity on a genetic level is vital to safely reopening society. Unlike earlier pandemics, scientists have been able to collect incredible amounts of data even as the virus spreads. Nasal swabs used to determine if someone is positive have been examined. Researchers have followed up with many who tested positive, determining the disease’s severity and progression.
Already a global center for genomic study, New York has become a vital laboratory. Recent tests suggest nearly 14% of the state’s population contracted the virus sometime this year.
In New York City, it’s close to one out of five. This and many other studies demonstrate that many who contract the virus don’t exhibit symptoms. A majority of people who get COVID-19 won’t require medical intervention. Antibody testing has been seen as a way to safely get people back to work. Yet, while getting the virus might confer immunity over a period of time, it is not yet certain if this occurs, and, if so, for how long. Plus, in order to develop antibodies, someone must first get the virus.
If a gene or combination of genes is identified that confers either full immunity to SARS-Cov-2 or assures an individual they will only have mild symptoms in the case of infection, those individuals can be less concerned about contracting the virus. In addition, the presence of such a protective state could be used to identify those who are best equipped for jobs as public facing front-line workers. In other words, success in this work could help some sectors of society safely reopen long before a vaccine is developed, manufactured, and distributed to the billions of people that need it.
- A Brief Guide to Genomics
- The chronology of the 2002-2003 SARS mini pandemic
- The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2
- The public health impact of COVID-19: why host genomics?
- Candidate genes associated with susceptibility for SARS-coronavirus
John Bankston is a published author of over 150 nonfiction books for children and young adults including biographies of Jonas Salk, Gerhard Domak, and Frederick Banting.
Surya Singh, MD
Founding Medical Partner
Dr. Singh is actively licensed & board certified in internal medicine. He is currently the CEO of gWell, Inc, a genomics and wellness focused digital health company, and serves as a senior advisor and board member for mission aligned companies and non-profits. In addition, he is an Adjunct Instructor of Medicine at Harvard Medical School. He was formerly Corporate Vice-President and Chief Medical Officer of Specialty Pharmacy at CVS Health, and was an attending physician for many years at the Brigham and Women’s Hospital in Boston.