Case of lambda variant shows up in MUSC's COVID testing

July 09, 2021
The words Lambda Strain on an illustration of the lambda variant.
Health experts are watching lambda's progress but not sounding an alarm in the U.S. iStock

The COVID-19 variant known as lambda has arrived in the U.S., scientists at the Medical University of South Carolina report. They recently found it in a virus sample taken in April from a patient in the Greenville area.

While lambda’s presence in the U.S. hasn’t received much attention, a public database for scientists shows there have actually been more than 600 cases of lambda across the country, including six in South Carolina.

Julie Hirschhorn, Ph.D., director of Molecular Pathology at MUSC, said there’s a likely reason lambda’s arrival hasn’t been talked about more. “I think it's fair to say that’s because it's not classified as a variant of interest or variant of concern by the CDC. So even though these may be sequenced, they’re probably being lumped into an ‘other’ category.”

Brannon Traxler, M.D., public health director at the South Carolina Department of Health and Environmental Control, confirmed that. “While this is something to monitor, the lambda variant is not as worrisome as others at this time. The CDC, and therefore DHEC, does not report on cases of the variant because the CDC does not classify it as a variant of interest or a variant of concern,” she said.

“The variant result remains reportable to DHEC through the standard reporting channels and mechanisms, and we will continue to monitor this variant and the others.”

While, as she noted, the Centers for Disease Control and Prevention hasn’t raised an alert about lambda, the World Health Organization has. It calls lambda a variant of interest, meaning genetic changes may help it spread more easily and make people sicker.

Lambda has certainly shown it can cover plenty of ground. The variant, first spotted in Peru last year, quickly made its way to other countries in South America — and now, North America.

Scott Curry, M.D., an infectious disease specialist at MUSC Health and an assistant professor in the College of Medicine, said lambda may be even more prevalent than it seems. “I would be surprised if it hasn’t been all over the place for a long time.”

But to put things in perspective, while lambda is here, it’s far from the dominant COVID strain. It’s not even close.

Hirschhorn’s lab tests, or sequences, every positive case of COVID-19 collected by MUSC Health. And in its latest test run, it found the alpha variant — formerly known as the U.K. variant — is responsible for almost 80% of all COVID infections.

She’s also keeping an eye on another variant that’s been in the news lately: delta. It’s been described as incredibly contagious. And it’s showing up here, too. “For now, what we sequenced from the end of May and June, 4% of those cases were the delta variant,” Hirschhorn said.

Curry said anyone who gets COVID at this point should assume they have a variant. “There’s almost no plain COVID left. According to our most recent test, almost 97% of cases have a variant of interest or variant of concern.”

That’s a problem in what Curry called a highly unvaccinated state. “Charleston County is the best of all South Carolina's counties in terms of vaccination, but that's only six in 10 eligible persons. If you factor the kids back into the equation, which I think really you should, if you're looking at how much herd immunity we have, it's just 50/50, even in the best-vaccinated county in the state.”

Traxler said it’s a reminder of the importance of getting everyone who’s eligible vaccinated. “Vaccinations are the number one way to protect ourselves from these variants and to end this pandemic.”

Right now, kids 11 and under aren’t eligible to get vaccinated, although Curry predicted that will change in September or October as clinical trials testing the vaccines’ safety in kids wrap up.

“I'm worried about the fall, because we've got every 11-year-old and younger kid, all going to be clustered in schools without masks. That's going to be a big risk,” Curry said.

“One kid who brings one of these variant infections into the classroom can cause more kids to be infected than we would have seen with that same scenario last year,” he said, since schools and students will be much less likely to take pandemic precautions than they did earlier in the pandemic.

But there are a couple of key factors in our favor. COVID case numbers are relatively low these days. And the vaccines appear to work against the variants so far.

“COVID has mutated, but it hasn’t evolved to the point where it’s escaping vaccine protection. That's good. But it's also evolved to the point where those who are unvaccinated to get it are going to transmit it more, and possibly get sicker,” Curry said.

Knowing about that possibility gives doctors’ offices and hospitals a heads-up about what may lie ahead. In the meantime, Hirschhorn’s lab will keep sequencing and letting the public know what it finds.

“We'll continue to try and monitor this the best that we can. I feel very fortunate that we're in an academic medical center that is supportive of this sequencing effort,” she said.

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