James Musser, MD, spoke with The New York Times about how COVID-19’s genetic code plays a vital role in controlling the virus.
Since last March, a team of researchers led by Dr. James Musser, chair of the department of pathology and genomic medicine at Houston Methodist Hospital, have been sequencing the viral genomes drawn from patients — 20,000 genomes so far. This new study has found that every coronavirus variant of concern to researchers around the world has been circulating in Houston at a low level for at least six to eight weeks. Houston is the first U.S. city to find all of the variants, including those recently reported in California and New York and the ones found in Brazil, Britain and South Africa.
The discovery mainly highlights how little is actually known about the variants — their true whereabouts, prevalence and impact — as no other American city has the data in place to make such a survey possible.
Dr. Musser said the team had also analyzed detailed information on the infected patients. By linking the data sets, scientists can begin to ask vital questions: How do these variants affect the ability of the virus to spread, if at all? Do they make the symptoms any more or less severe? Are they any more or less resistant to vaccines, pre-existing immunity or treatment with monoclonal antibodies?
Before the pandemic took off in Houston, the team had set up a plan to match any variant it found with the clinical course of patients infected with it.
“If you don’t have the sequencing matched up with patient data, they are far, far less interesting, if not uninterpretable,” Dr. Musser said.
To Dr. Musser’s knowledge, Houston is the only city with the patient and sequencing data to address those questions. Iceland is undertaking a similar effort, he said, and he expects Israel to do so, also.
So far, researchers have tried to infer the effect of variants by looking at their prevalence in different populations and by doing laboratory studies. Those can provide important clues, Dr. Musser said, but to make the best use of those data, they must be linked to patient data.
Some critics, including Dr. Eric Topol, the founder and director of the Scripps Research Translational Institute, have said that the attention given to the succession of new variants — “scariants,” he has called them — has done little more than frighten the public.
Dr. Musser agreed, referring to such reports as “mutant porn.” Highlighting the existence of variants without indicating whether they make any functional difference to real-world patients was no more enlightening than collecting stamps or identifying the birds flying overhead, he said: “‘There’s a bird. There’s another bird.’”
He added: “I think the crucial thing in all of this is that it is extraordinarily difficult for both the medical and lay public to really sort through all this noise about variants. At the end of the day, does any of this mean a hill of beans to anyone?”
James M. Musser, MD, PhD is the Past-President for the Federation of American Societies for Experimental Biology (FASEB) and a Past-President of the American Society for Investigative Pathology (ASIP). He currently serves as Chair of the Department of Pathology and Genomic Medicine and the Director of the Center for Molecular and Translational Human Infectious Diseases Research at Houston Methodist. Dr. Musser was the recipient of the 2017 ASIP Rous Whipple Award, the 2007 ASIP Chugai Award for Excellence in Mentoring and Scholarship, and the 1999 ASIP Outstanding Investigator Award.