Welcome to Traitwell and Common Good Genetics!
Twenty years after the human genome project we need leadership and boldness, not one-size-fits-all mandates.
In a recent Clubhouse discussion with former New York Times reporter Alex Berenson, we brought up the underexplored role of genetics in the pandemic. Berenson is a high-profile skeptic concerning the government’s coronavirus policies. And yet even he was unaware of the numerous peer-reviewed genome wide associated studies (GWAS) which point to the role of genomics in who does and who doesn’t get severe COVID-19 symptoms.1
The risks here aren’t trivial and have serious public policy ramifications. A recent paper suggests that the major genetic risk factor for severe COVID-19 symptoms is DNA inherited from Neanderthals. The risk factor is carried by about 50% of South Asians and 16% of Europeans. “The individuals of Bangladeshi origin in the UK have an about two times higher risk of dying from COVID-19 than the general population,” the paper’s authors note. These findings are significant and yet genomic discussions about the virus have eluded public conversation.
You would expect to see higher coronavirus rates in those areas which have higher frequency of rs35044562. And indeed you do.
Papua New Guinea’s headlines tell the story. Here’s CNN:
Until recently, PNG had largely managed to stave off a major coronavirus outbreak. At the end of February, the country had only reported 1,275 cases, according to Johns Hopkins University.
But over the past month, cases have more than tripled. PNG has now reported at least 4,660 Covid-19 cases and 39 related deaths, including that of MP Richard Mendani, who died age 53 earlier this month, according to a Radio New Zealand report. On Friday, the country reported 560 new infections -- its highest for a single day -- with Prime Minister James Marape admitting there is "rampant community transmission."
Try as the government might, Papua New Guinea is most assuredly going to suffer.
If their entire population were sequenced, how might the outcome be any different? We don’t know. This is a matter of understanding how genetics limits our public health options and effectiveness or how we might envision better solutions based on genomic knowledge. We might even imagine a sort of Google where you might be able to search the populace or yourself for certain traits. But we're not there yet. Why not?
Vaccine rollouts do start with broadly defined groups that are more likely to get sick: the old, the chronically ill, the frontline health workers, etc. If we do have to vaccinate everyone in these groups, why not start with those most likely to get ill due to their genetics? Why take a one-size-fits-all approach when we don't have to?
At Traitwell we want to put genetics into the conversation. We agree with 23andMe cofounder Anne Wojcicki about the importance of genetics in making decisions. “Studies show that treatments that have been validated with genetic data are twice as likely to succeed when compared to traditional approaches,” Wojcicki’s company once claimed. She has used this talking point quite often.
But alas. 23andMe is more interested in selling its users’ data to pharmaceutical companies. It’s slow to integrate the latest GWAS findings.
We won’t be. In fact, covidforecaster.com – Traitwell’s first project – uses this science to help people understand their own individual risks.
Covid Forecaster won’t be our first genetic app. Indeed, nearly every crisis we face today can be attributed to some extent to genetic causes. So let’s understand what they are. Well-meaning political concerns ought not to bar us from taking these questions seriously or from using the latest in genomic research to find solutions.
We will find that there is a better way than the one-size-fits-all approach which does little to take care of the public. We are unique individuals – not faceless members of CDC-defined "at risk populations" or "groups at increased risk," and our policies should reflect that genetic diversity. Traitwell will bring genetics to the national conversation in the public interest. It’s time. And it's going to be exciting.
Ellinghaus, D. et al. Genomewide association study of severe COVID-19 with respiratory failure. N. Engl. J. Med. https://doi.org/10.1056/NEJMoa2020283 (2020).