HJNO Sep/Oct 2022

HEALTHCARE JOURNAL OF NEW ORLEANS I  SEP / OCT 2022 35 For weekly eNews updates and to read the journal online, visit HealthcareJournalNO.com and immunology at Tulane University School of Medicine. “This gives us a very granular, very detailed idea about those early days…basically December of 2019, where we can actually pinpoint the location of where this virus emerged into the human population.” Using data from the World Health Organization and China, the team examined the first 174 cases in the Hubei province in December 2019. They mapped out proximity to the market for 155 of the cases where they had information about where the first patients lived. “We actually found that most of those early cases were clustered very tightly around the market,” Garry said. “Wuhan is a very large city. It’s got 10 million people. That’s bigger than New York City. And the area we’re looking at is a very tiny area about the size of a football field, in that very large city where most of those cases were clustered.” One of the key findings in the study is that early COVID-19 patients who were “unlinked” to the market — meaning they didn’t work there, didn’t know someone who worked there, and had not recently visited there — lived closer to the market than patients with a direct link to the market. Researchers suspect that these patients were exposed as the outbreak migrated into the surrounding neighborhood. Health officials collected samples from animal cages, vendor stalls, and other surface areas throughout the market and performed PCR testing on the samples. Using this information along with images from Google Maps and other sources, researchers created a detailed map of where the virus was found throughout the market. Spatial analysis showed that SARS-CoV-2-positive environmental samples were associated with the southwest corner of the market, which is the same section where vendors were selling live mammals, including red foxes, raccoon dogs, and other species known to be susceptible to SARS-related coronaviruses. “We don’t know precisely which animal it was,” Garry said. “There were several animals that we know can be infected pretty efficiently with SARS-CoV-2 and that, in the wild, they could have picked up this infection. Then they were caught and brought to the market to be sold.” The second study examined how the virus emerged into the human population from two distinct lineages. The first lineage was closer to the original SARS viruses circulating in bats. It likely then jumped over to another animal host and then ultimately infected humans. However, the study showed that the second SARS strain emerged in people first and both were likely circulating in animals at the market. To reduce the risk of future pandemics, it is crucial to understand how these viruses evolved and made the leap from animals to people, Garry said. LSUHealth NO Precision Medicine Lab Finds New Omicron Subvariants LSU Health New Orleans’ Precision Medicine Lab has found two new SARS-CoV-2 variants in Louisiana. BE.1 and BF.1 are subvariants of the Omicron Variant of Concern that has driven the latest surge. The lab identified three cases of BE.1 and one case of BF.1 in tests performed at the end of June. “To our knowledge, these Omicron subvariants have not been reported in the United States until now,” said Lucio Miele, MD, PhD, co-director of the Precision Medicine Lab and professor and head of genetics at LSU Health New Orleans School of Medicine. “Their possible clinical and public health significance is still unknown.” LSU Health New Orleans is part of a multistate group supported by the National Institute of General Medical Sciences (NIGMS) that monitors SARS-CoV-2 sequence diversity in Institutional Development Award states. LSU Health New Orleans also partners with the Louisiana Department of Health, Ochsner and BIE, a Louisiana company experienced in infectious disease bioinformatics, to collect samples from COVID tests and sequence them to determine what is circulating in the State. “The pattern that is emerging from the data is one whereby once a dominant variant emerges, such as Delta and Omicron, the genetic diversity of the virus temporarily drops as the new variant takes over,” said Miele. “After that, multiple subvariants emerge from mutations of the dominant variant. This is the most important time to monitor the emergence of new subvariants, especially if their numbers start increasing, and determine what’s different about them. This kind of information is critical to understanding transmission or resistance to therapeutics.” Variants of SARS-CoV-2 have become increasingly better able to spread and to evade immunity. Omicron is more transmissible than Delta was, and Omicron subvariants BA.4 and BA.5 seem to have the ability to infect people who were immune to earlier variants and subvariants. Some have also shown resistance to monoclonal antibodies used to reduce the severity of COVID-19. Jeffrey Fernandez Named New Ochsner Health Plan CEO Jeffrey Fernandez, Ochsner Health senior vice president and executive advisor, has assumed the role of CEO of the new Ochsner Health Plan (OHP). He replaces Terry Shilling, who has served in a consulting role to lead the implementation of OHP. Fernandez has demonstrated more than 20 years of managed care leadership experience – much of that in the Medicare Advantage industry. Prior to joining Ochsner in August 2021, he served as SVP of Humana’s Medicare West segment and was responsible for Medicare Advantage operations in 17 states (including Louisiana) and more than 1 million members. His responsibilities also included leading their nationwide MarketPoint sales organization, where he was responsible for external, career, and telesales distribution for Humana’s Medicare Advantage products. Fernandez received a bachelor’s degree in marketing from LSU, an MBA from the University of New Orleans, and then went on to achieve a law degree from Loyola University New Orleans College of Law. Louisiana Medicaid Funds Two Universities to Conduct Research Louisiana Medicaid is awarding more than $673,000 in Medicaid federal dollars to the LSU Health Sciences Center (LSUHSC) and Pennington Biomedical Research Center (PBRC) to conduct research on covered Medicaid priorities over a two-year period. Findings from the research projects will guide policy-making and promote innovation and new approaches to address Medicaid priorities.