February 2, 2021 — The Maryland Department of Health has sent a letter to Maryland clinicians to request assistance with identifying specimens for genetic sequencing to surveil for SARS-CoV-2 variant strains. As you know, Infections with the B.1.1.7 (emerged in the United Kingdom), B.1.351 (emerged in South Africa), and P.1 (emerged in Brazil) SARS-CoV-2 lineages have already been confirmed in the United States, including both B.1.1.7 and B.1.351 in Maryland. Clinicians are requested to use an online form https://redcap.link/qx8ieby3 to securely submit case information about COVID-19 cases in certain groups (see below). In addition, local health departments may also use this form to notify MDH about cases in the following groups:
- Individuals who first test positive for COVID-19 after receiving COVID-19 vaccination (either one or two doses)
- Severely immunocompromised  individuals with prolonged COVID-19 infection
- Individuals suspected of reinfection – specifically, symptomatic individuals who test PCR positive for SARS-CoV-2 more than 90 days after an initial infection from which they clinically recovered
- Individuals with recent international travel (travel in the 14 days prior to symptom onset)
- Any other individuals for whom you have clinical suspicion of infection with a possible variant (e.g., unusual clinical manifestation, etc.)
If you are aware of COVID-19 cases in people in any of the above detailed groups to be considered for sequencing prioritization:
- If possible, contact the testing laboratory to ensure the original specimen is not discarded
- Complete and submit case information securely online at: https://redcap.link/qx8ieby3
Specimens should not be sent to MDH Public Health Laboratory unless approved and requested by MDH.
MDH will notify the respective LHDs of any variants identified.
For questions, or if you are unable to use the form, please email mdh.COVIDsequencing@maryland.gov or call 410-767-6700. Please do NOT include any patient personal identifiable information in the email.
 Examples of individuals who are severely immunocompromised include people who are on chemotherapy for cancer, who are within one year of receiving a hematopoietic stem cell or solid organ transplant, who have untreated HIV infection with CD4 T lymphocyte count <200, who have combine primary immunodeficiency disorder, or who have received prednisone >20mg/day for more than 14 days. https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html