The Pathology and Laboratory Medicine (PaLM) team in London, Ont., is now screening all COVID-19-positive samples from southwestern Ontario for variants of concern.
The new service at PaLM, a joint venture between the London Health Sciences Centre and St. Joseph’s Health Care London, is part of provincial screening efforts to identify variant of concern cases, which now account for roughly 90 per cent of new cases in Ontario.
“Variant of concern screening has been live in Ontario for a few months now, but that work was being done exclusively at Public Health Ontario in Toronto,” says Chief Laboratory Officer Mike Kadour.
“We are now participating to help lighten the load and improve the timeliness for our communities in southwestern Ontario.”
Kadour says after the initial lab test for COVID-19 comes out positive, the lab conducts variant of concern screening “to identify if there is particular mutations associated with some of these emerging variants.”
The N501Y mutation is associated with the B.1.1.7 variant, first identified in the U.K., while the E474K mutation is associated with both the B.1.351 variant, first identified in South Africa, and the P.1 variant, first identified in Brazil.
LHSC says specimens with the N501Y mutation only are considered to be B.1.1.7 and will not be sequenced further, while specimens with both or just the E484K mutation “will be forwarded to the Public Health Laboratory for additional sequencing and variant/lineage characterization.”
London’s screening capabilities will certainly save the province time, Kadour says, but “the important part here” is that the screening provides information — like where variants are spreading and how quickly — that informs the response to the pandemic.
“Variant of concern screening is really part of Ontario’s surveillance activities for us collectively to be prepared and aware and then adjust our responses as a whole.”
LHSC says the screening will not impact the process for individuals in the region waiting for their COVID-19 test results. They’ll still get their results via the Ontario Health portal and any identified variant results “will be communicated separately to the appropriate public health unit for follow-up.”
PaLM has the capacity to process up to 10,000 COVID-19 tests daily and “regularly” meets a 24-hour turnaround time for results.
Throughout the pandemic, LHSC says “PaLM has expanded its regional collaboration to include seven public health units, long term care/retirement home operators and primary care providers.”
“It takes a lot of skilled individuals like our microbiologists, our medical lab technologists and assistants and our colleagues in our I.T. group, so on and so forth to put all the sort of pieces together,” says Kadour.
He also said the team is prepared to redesign the test along with their colleagues at Public Health Ontario and across the province in response to any new variants that emerge.
“This is not one that’s going to stand still,” he says.
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