1- Monday Infectious Disease News – 20th September

1 – WHO says delta remains the ‘most concerning’ Covid variant despite emergence of mu

• The fast-spreading delta variant remains the “most concerning” coronavirus strain despite the emergence of the mu variant, WHO officials said.
• The mu variant, which was added to the WHO’s list of variants “of interest” last week, has mutations that suggest it could evade the immune protection provided by natural infection or vaccination.
• Delta has rapidly spread to at least 170 countries, including the U.S., since it was first detected in India in October, quickly becoming the dominant variant in many of those regions, according to the international health agency.

Source: CNBC

2 – COVID-19: New Mu variant could be more vaccine-resistant

• Mu is the fifth variant of interest to be monitored by the WHO since March. It has a number of mutations that suggest it could be more resistant to vaccines, the health agency warned, but stressed that further research would be needed to confirm this.
• Preliminary data show a reduced effectiveness of vaccines “similar to that seen for the Beta variant”.
• Mu was first identified in Colombia in January 2021, and since then, there have been “sporadic reports” of cases and outbreaks in South America and Europe, WHO said.
• While the global prevalence of Mu among sequenced COVID-19 cases is below 0.1%, its prevalence has “consistently increased” in Colombia and Ecuador, where it is now responsible for around 39% and 13% of infections, respectively.

Source: UN News

3 – Estimating the impact of reopening schools on the reproduction number of SARS-CoV-2 in England, using weekly contact survey data

• Schools were closed in England on 4 January 2021 as part of increased national restrictions to curb transmission of SARS-CoV-2. The UK government reopened schools on 8 March.
• Although there was evidence of lower individual-level transmission risk amongst children compared to adults, the combined effects of this with increased contact rates in school settings and the resulting impact on the overall transmission rate in the population were not clear.
• This study results suggest that reopening schools would likely halt the fall in cases observed between January and March 2021 and would risk a return to rising infections, but these estimates relied heavily on the latest estimates or reproduction number and the validity of the susceptibility and infectiousness profiles we used at the time of reopening.

Source: BMC

4- The association between mechanical ventilator compatible bed occupancy and mortality risk in intensive care patients with COVID-19: a national retrospective cohort study

• The literature paints a complex picture of the association between mortality risk and ICU strain.
• In this study, they sought to determine if there is an association between mortality risk in intensive care units (ICU) and occupancy of beds compatible with mechanical ventilation, as a proxy for strain.
• Increasing occupancy of beds compatible with mechanical ventilation, a proxy for operational strain, is associated with a higher mortality risk for individuals admitted to ICU.
• Further research is required to establish if this is a causal relationship or whether it reflects strain on other operational factors such as staff.
• If causal, the result highlights the importance of strategies to keep ICU occupancy low to mitigate the impact of this type of resource saturation.

Source: BMC

5 – Pre-existing health conditions and severe COVID-19 outcomes: an umbrella review approach and meta-analysis of global evidence

• This study applies an umbrella review approach to summarise the global evidence on the risk of severe COVID-19 outcomes in patients with pre-existing health conditions.
• Risk of undesirable COVID-19 health outcomes is consistently increased in certain patient subgroups across geographical regions, showing high variability in others.
• The results can be used to inform COVID-19 vaccine prioritisation or other intervention strategies.

Source: BMC

6 – Interventions to control nosocomial transmission of SARS-CoV-2: a modelling study

• The functional relevance of pre-existing cross-immunity to SARS-CoV-2 is a subject of intense debate.
• Emergence of more transmissible SARS-CoV-2 variants requires more efficient control measures to limit nosocomial transmission and maintain healthcare capacities during pandemic waves.
• Yet the relative importance of different strategies is unknown.
• In this study they developed an agent-based model and compared the impact of personal protective equipment (PPE), screening of healthcare workers (HCWs), contact tracing of symptomatic HCWs and restricting HCWs from working in multiple units (HCW cohorting) on nosocomial SARS-CoV-2 transmission.
• In response to the emergence of more transmissible SARS-CoV-2 variants, PPE use in all hospital wards might still be most effective in preventing nosocomial transmission.
• Regular screening and contact tracing of HCWs are also effective interventions but critically depend on the sensitivity of the diagnostic test used.

Source: BMC

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