Political momentum for the monitoring and surveillance of Covid-19 is “fading”, the Australian virologist who developed a world-first method for rapidly isolating and characterising variants said.
Prof Stuart Turville, with the University of New South Wales Kirby Institute, said while the impact of Covid-19 in Australia is waning, the Sars CoV-2 virus that causes disease is constantly changing and “there is still a lot we don’t know”.
“How and why did the virus change between Delta and Omicron?” he said.
“From that change and in the face of vaccination, what is the virus up to now in our bodies? For those who cannot sustain a robust vaccine response such as the elderly and immunocompromised, what does the virus now do? Will the virus turn up again and surprise us?
“There are many jigsaw pieces we still don’t have. We won’t find them unless we look.”
Turville and his team developed a method to speed up the process of isolating and characterising the risks posed by variants of concern.
Called R-20, the methodology was used to rapidly analyse all major circulating viral variants in Australia, and helped researchers to ascertain that the vaccine-induced antibody response to Omicron was weaker than it was to the original Sars-CoV-2 strain.
Turville acknowledged that funding thousands of people across multiple Australian institutions to track, trace and sequence the virus across all cases is no longer necessary or realistic. Monitoring needs to be consolidated and pragmatic, he said.
“But the fear both myself and my colleagues have is that the political momentum to support us has simply moved on,” he said.
“Both here and in the United States there is an element of ‘Thank you for your service, job well done’. There are still people working on this, we are still monitoring, still daily looking closely at understanding what the virus is up to and doing.
“But the support for us to do it is starting to fade. The wind is out of the funding sails.”
Guidelines for Covid-19 vaccination from the Australian Technical Advisory Group for Immunisation (Atagi) state that ongoing surveillance of infection rates, clinical outcomes, new variants and vaccine effectiveness is needed to inform future recommendations for additional booster doses.
The inaugural chair in epidemiology at Deakin University, Prof Catherine Bennett, agreed “the surveillance hasn’t moved into a sustainable national system, and I would have expected that before we got to widespread community transmission,” she said.
“We are still seeing waves of mutations,” Bennett said. “We need good data to know how that impacts our population, and every population will be slightly different. Different populations, even different states, saw different variants at varying times, which perhaps might lead to changes in immunity across variants.”
She said genomic sequencing is now mainly examining samples from cases in hospital, whether they are in hospital for Covid or not. These cases may not represent what is spreading in the general population.
“As an epidemiologist I want to know whether the mix of variants appearing in hospital are different to those in the general community, to see if a certain variant is more likely to put you in hospital than others,” Bennett said.
“We need to actively go out and do community based testing on an intermittent basis. That way we can look at the whole iceberg, not just the tip of it.”
Melissa Davey Medical editor
@MelissaLDavey