A day after Colorado officials identified the first known case of COVID-19 variant B.1.1.7 in the United States, local public health officials are continuing to work to identify anybody else who may have been exposed and any other potential cases of the variant.
The variant, which had previously been reported in the United Kingdom, was found in a man in his 20s working in Elbert County, officials announced Tuesday. The Colorado Department of Public Health and Environment (CDPHE) said its lab was the first in the country to identify the new variant, but it's unlikely the man is the first person to have it in the United States.
Dr. Emily Travanty, scientific director with the Laboratory Services Division of the CDPHE, noted a second "highly suspicious" case of B.1.1.7 in the same county, but said the results remain unconfirmed as of 10:30 a.m. Wednesday. Initial testing of this second sample shows most of the same mutations associated with the variant, but analysis is not complete yet, she explained in a press conference with Gov. Jared Polis on Wednesday.
Both individuals are Colorado National Guard personnel who were deployed to support staffing at the Good Samaritan Society assisted living center in Simla in Elbert County, said Dr. Rachel Herlihy, state epidemiologist with the CDPHE. Their deployment began Dec. 23. They were both tested Dec. 24.
Neither individual has traveled internationally in the weeks prior to the tests. Both are isolating for 10 days — the confirmed case in a home in Arapahoe County and the suspected case in a hotel in Lincoln County. The man with the confirmed case has mild symptoms.
The assisted living center in Simla has an ongoing outbreak, and COVID-19 cases were first detected in mid-December following routine surveillance testing, Herlihy said. To date, 20 of the 34 regular staff — not National Guard members — and all 26 residents have previously tested positive for COVID-19. Four residents have died.
Testing is underway to determine if the variant is affecting residents and Herlihy said preliminary results show no evidence the variant is circulating there, but testing will continue Wednesday.
The National Guard member's infection of B.1.1.7 was confirmed with a PCR test, Travanty said. The variant has a distinct molecular signature, or a specific sequence in the S gene.
PCR tests look to the presence of three COVID-19 genes in each sample: the S gene, N gene, and ORF1ab. Typically, if they're found, the patient is positive, Travanty explained. A sample of the B.1.1.7 variant results in only two of the genes, though — it lacks the S gene. The presence of the N gene, and ORF1ab means that a person is positive. The S gene is still present in those samples, but it has mutated and is typically undetectable in routine PCR tests. Travanty said this is called the "S drop-out profile" and is a signature marker of this specific COVID-19 variant.
When the state lab learned about this new variant, it set up a screen to capture samples where the two other genes were detected, but the S gene wasn't. Samples that meet this profile were flagged so researchers can do more research, Travanty said.
"Today, we've conducted sequencing on 24 of these suspicious samples and our scientists have found two samples that contain mutations in the S gene," she said.
Another 12 are ready for testing, she said. CDPHE will continue to look for mutations in older samples and future ones.
COVID-19 has many variants and early evidence has shown that B.1.1.7 might spread faster, but doesn't seem to include more severe symptoms, said Dr. Eric France, chief medical officer with the CDPHE. However, there is concern that if it's more transmissible, it could lead to more hospitalizations, more filled ICU beds, and the potential to overwhelm the health care systems, he said.
A note on the door of the Simla location Wednesday said no visitors were being let inside until further notice.
A Colorado National Guard member deployed to help at the Good Samaritan Society assisted living center tested positive for the #COVID19 variant B.1.1.7 according to health officials— Adi Guajardo (@AdiGTV) December 30, 2020
Experts are now examining a second highly suspicious case also linked to a National Guard member pic.twitter.com/KVQZ3mbB3Y
Randy Fitzgerald, the regional vice president for Good Samaritan Society, reiterated that employees and residents were being tested for the variant and said they were looking forward to being vaccinated starting next week:
“The Good Samaritan Society – Simla learned that an allied health worker at our location tested positive for COVID-19. State officials confirmed this individual has the new variant strain of COVID-19. The health, safety and well-being of our residents, staff and the community we serve remains our top priority. The Colorado Department of Health and Environment have been on-site to test employees and residents for the variant. We expect to have the results in the next few days. We will continue to work closely with the state while following the CDC’s infection control measures.
“We look forward to beginning vaccinations at this location next week. In nursing homes across the nation, we’ve seen the tragic impact of COVID-19. The vaccine is a huge milestone in the fight against this virus and will help keep our residents and staff safe. But the fight against COVID-19 isn’t over yet. Everyone has a responsibility to help slow the spread of this virus to protect the most vulnerable in our community. We encourage everyone to continue to follow all of the CDC guidelines – wear a mask, keep a distance, limit your time with large crowds, wash your hands, stay home if you’re sick – and get your flu shot now.”
A health care worker who lives in Simla but does not work at the facility, who agreed to speak with Denver7 on the condition her name not be used, said she learned about the variant Tuesday night and said there was worry within the small community about its ramifications.
“There is a big older population here. If the people there were working and they went to the store that everybody goes to, who knows how many people could have spread it,” she said
The woman said that people in town are concerned about where the National Guard member contracted the variant and whether it has spread around the community. She has already received the first dose of the COVID-19 vaccine but worries about what a more transmissible virus could do to the small community.
“When this first started, I said I kind of feel blessed that I live here because we’re kind of secluded,” she said. “Now, this happened and I said, ‘Of all places, it had to be Simla.’”
During the press conference Wednesday, Polis announced changes to the phases and schedules for vaccinations in Colorado. Read more here.
Denver7's Adi Guajardo contributed to this report.