Category: Covid-19

GlaxoSmithKline PLC and partner Vir Biotechnology Inc. are straining to meet soaring demand for their Covid-19 antibody treatment after the highly mutated Omicron variant knocked out the two competing products.

Demand has jumped in recent weeks for the treatment, called sotrovimab, because it is the only antibody drug authorized in the U.S. for the newly infected that has been found to work against Omicron.

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GlaxoSmithKline Racing to Provide Only Effective Covid-19 Antibody Treatment - The Wall Street Journal

When the coronavirus pandemic was first declared, Spaniards were ordered to stay home for more than three months. For weeks, they were not allowed outside even for exercise. Children were banned from playgrounds, and the economy virtually stopped.

But officials credited the draconian measures with preventing a full collapse of the health system. Lives were saved, they argued.

Now, almost two years later, Spain is preparing to adopt a different COVID-19 playbook. With one of Europe's highest vaccination rates and its most pandemic-battered economies, the government is laying the groundwork to treat the next infection surge not as an emergency but an illness that is here to stay. Similar steps are under consideration in neighboring Portugal and in Britain.

A teacher wearing a face mask to protect against the spread of coronavirus checks the temperature of her student at Maestro Padilla school as the new school year began in Madrid, Sept. 7, 2021. With one of Europe's highest vaccination rates and its most pandemic-battered economies, the Spanish government is laying the groundwork to approach the virus in much the same way countries deal with flu or measles.

Manu Fernandez / AP

The idea is to move from crisis mode to control mode, approaching the virus in much the same way countries deal with flu or measles. That means accepting that infections will occur and providing extra care for at-risk people and patients with complications.

Spain's center-left prime minister, Pedro Snchez, wants the European Union to consider similar changes now that the surge of the omicron variant has shown that the disease is becoming less lethal.

"What we are saying is that in the next few months and years, we are going to have to think, without hesitancy and according to what science tells us, how to manage the pandemic with different parameters, he said Monday.

Snchez said the changes should not happen before the omicron surge is over, but officials need to start shaping the post-pandemic world now: We are doing our homework, anticipating scenarios."

The World Health Organization has said that its too early to consider any immediate shift. The organization does not have clearly defined criteria for declaring COVID-19 an endemic disease, but its experts have previously said that it will happen when the virus is more predictable and there are no sustained outbreaks.

Its somewhat a subjective judgment because its not just about the number of cases. Its about severity, and its about impact, said Dr. Michael Ryan, the WHOs emergencies chief.

Speaking at a World Economic Forum panel on Monday, Dr. Anthony Fauci, the top infectious diseases doctor in the U.S., said COVID-19 could not be considered endemic until it drops to "a level that it doesnt disrupt society.

The European Centre for Disease Prevention and Control has advised countries to transition to more routine handling of COVID-19 after the acute phase of the pandemic is over. The agency said in a statement that more EU states in addition to Spain will want to adopt "a more long-term, sustainable surveillance approach.

Just over 80% of Spain's population has received two vaccine doses, and authorities are focused on boosting the immunity of adults with third doses.

Vaccine-acquired immunity, coupled with widespread infection, offers a chance to concentrate prevention efforts, testing and illness-tracking resources on moderate- to high-risk groups, said Dr. Salvador Trenche, head of the Spanish Society of Family and Community Medicine, which has led the call for a new endemic response.

COVID-19 "must be treated like the rest of illnesses," Trenche told The Associated Press, adding that "normalized attention" by health professionals would help reduce delays in treatment of problems not related to the coronavirus.

The public also needs to come to terms with the idea that some deaths from COVID-19 will be inevitable," Tranche said.

We can't do on the sixth wave what we were doing on the first one: The model needs to change if we want to achieve different results," he said.

The Spanish Health Ministry said it was too early to share any blueprints being drafted by its experts and advisers, but the agency confirmed that one proposal is to follow an existing model of sentinel surveillance currently used in the EU for monitoring flu.

The strategy has been nicknamed flu-ization of COVID-19 by Spanish media, although officials say that the systems for influenza will need to be adapted significantly to the coronavirus.

For now, the discussion about moving to an endemic approach is limited to wealthy nations that can afford to speak about the worst of the pandemic in the past tense. Their access to vaccines and robust public health systems are the envy of the developing world.

It's also not clear how an endemic strategy would coexist with the "zero-Covid" approach adopted by China and other Asian countries, and how would that affect international travel.

Many countries overwhelmed by the record number of omicron cases are already giving up on massive testing and cutting quarantine times, especially for workers who show no more than cold-like symptoms. Since the beginning of the year, classes in Spanish schools stop only if major outbreaks occur, not with the first reported case as they used to.

In Portugal, with one of the world's highest vaccination rates, President Marcelo Rebelo de Sousa declared in a New Year's speech that the country had "moved into an endemic phase." But the debate over specific measures petered out as the spread soon accelerated to record levels almost 44,000 new cases in 24 hours reported Tuesday.

However, hospital admissions and deaths in the vaccinated world are proportionally much lower than in previous surges.

In the United Kingdom, mask-wearing in public places and COVID-19 passports will be dropped on Jan. 26, Prime Minister Boris Johnson announced Wednesday saying that the latest wave had "peaked nationally."

The requirement for infected people to isolate for five full days remains in place, but Johnson said he will seek to scrap it in coming weeks if the virus data continues to improve. Official statistics put at 95% the share of the British population that has developed antibodies against COVID-19 either from infection or vaccination.

As COVID becomes endemic, we will need to replace legal requirements with advice and guidance, urging people with the virus to be careful and considerate of others, Johnson said.

For some other European governments, the idea of normalizing COVID-19 is at odds with their efforts to boost vaccination among reluctant groups.

In Germany, where less than 73% of the population has received two doses and infection rates are hitting new records almost daily, comparisons to Spain or any other country are being rejected.

We still have too many unvaccinated people, particularly among our older citizens, Health Ministry spokesman Andreas Deffner said Monday.

Italy is extending its vaccination mandate to all citizens age 50 or older and imposing fines of up to 1,500 euros for unvaccinated people who show up at work. Italians are also required to be fully vaccinated to access public transportation, planes, gyms, hotels and trade fairs.

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Europe considers new COVID-19 strategy: accepting the virus - OPB News

Destinations where you can travel with proof of COVID-19 recovery

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5 countries you can travel to with proof of COVID-19 recovery - The Points Guy

COVID-19 will continue but the end of the pandemic is near  The Lancet

Excerpt from:

COVID-19 will continue but the end of the pandemic is near - The Lancet

Despite the drop-off in cases, thousands of new infections are still reported daily in Massachusetts, with hospitals across the state overwhelmed by more than 3,000 COVID-19 patients. Hospitalizations seem to be leveling off, but Steve Walsh, president and CEO of the Massachusetts Health & Hospital Association, said hospitals remain very much in the midst of a COVID-19 peak.

Based on our experience with this virus, we know that even as the number of new cases dip, the resulting hospitalizations do not subside until well after, Walsh said in a statement.

State data released Thursday show that about half the people hospitalized with COVID-19 were admitted for other reasons and happened to test positive for the virus upon admission. But experts noted that even these incidental cases increase burdens because the patients have to be isolated, and a COVID-19 infection can worsen whatever illness the patient arrived with.

The case numbers mirror reductions of coronavirus measured in waste water, said Stephen Kissler, a postdoctoral researcher studying the spread of infectious diseases at the Harvard T.H. Chan School of Public Health. Ive been looking at waste water as my leading indicator, Kissler said.

Coronavirus in waste water started declining in early January, taking the same hairpin turn seen a week later in the state case data. The latest data show the prevalence of the virus back down to levels seen in late December.

COVID-19 cases have long been undercounted, and that problem has likely worsened with the recent popularity of home testing, Kissler said. But, the current decline in cases probably isnt just due to a bunch of people switching to at-home testing.

Kissler expects cases to continue their downturn, but wonders whether it will plateau at a high level, as happened with Delta.

Im not sure what to expect with Omicron but we seem to be through the worst of it, at least in terms of cases, he said, adding that hospitalizations may continue to rise.

Asked what lies ahead, Kissler draped his response in caveats, saying he was cautiously optimistic that by summer the acute phase of the pandemic would end and the disease would become endemic meaning it would not go away altogether but could be managed like other health problems.

But Kissler added, There are lots of endemic diseases that kill hundreds of thousands of people. The transition to endemicity is not a statement of success. He envisions a time when COVID-19 spread will at least be predictable perhaps requiring the resumption of precautionary measures every winter.

One of the things that wont go away is some degree of masking during the winter months, he said.

The months and years ahead may involve a kind of guerrilla warfare against COVID-19, in which responses will vary based on local conditions, such as the percentage of vaccinated people and elderly people, and the rate of spread in the community, Kissler said.

Others offered an even rosier view. Dr. Ali H. Mokdad, professor of health metrics sciences at the University of Washingtons Institute for Health Metrics and Evaluation, said the next two or three weeks would be difficult in many places. By March and April, however, We will be in a very good position, he said.

Omicron, he said, is running out of people to infect. As a result, the variant is going to end the pandemic phase of COVID-19. The virus will still circulate and mutate, but its effects will be similar to the flu which also can be quite deadly, taking 52,000 lives in the 2017-2018 season, but which doesnt restrict activities.

The coronavirus that sparked the pandemic spread easily because the human immune system had never seen it before. But now, even if new variants come along, We are at a very high level of protection, Mokdad said. We know it, we have seen it, weve been exposed either through infection or vaccination.

Even if we have a surge, a new variant, even if its more dangerous than Omicron, we know how to deal with it, he said.

Meanwhile, the mRNA vaccine technology behind the Moderna and Pfizer/BioNTech vaccines will enable manufacturers to quickly target new variants, or perhaps develop a vaccine that will work on any variant, Mokdad said.

Some experts see a day when COVID-19 may cause even milder symptoms. Paul Bieniasz, head of the laboratory of retrovirology at Rockefeller University, said that a completely plausible and optimistic view holds that the coronavirus will one day join other coronaviruses in causing illnesses such as the common cold.

But that is not inevitable, he said, because new variants will undoubtedly emerge. What keeps me awake at night is thinking about what the properties of the next variant will be . . . and how effectively our immune systems will be able to deal with it, he said.

Indeed, researchers are beginning to see the emergence of an Omicron sibling, the subvariant called BA.2, that seems to be growing quickly in Denmark. Its not yet clear whether BA.2 may be more transmissible and more virulent, or able to better evade vaccines than Omicron.

What the successive waves have taught us, especially Omicron, is that these variants can change the world in a matter of days, said Lemieux, of Mass. General, who is also co-leader of the viral variants program at the Massachusetts Consortium on Pathogen Readiness.

The Broad Institute of MIT and Harvard, which sequences the genomes of most COVID-19 samples taken in Massachusetts, has detected just a handful of the BA.2 subvariant in Massachusetts, said Bronwyn MacInnis, director of pathogen genomic surveillance.

It seems to be highly transmissible, she said. It has recently become the dominant strain in several countries, but so far the numbers are low in the US.

Dr. Andrea Ciaranello, director of the perinatal infectious disease program at Mass. General, said she remained concerned about the failure to vaccinate people worldwide.

Its really important for us to remember that only about 50 percent of the people in the world have had their primary vaccine series and there are huge disparities among countries with some as low as 10 percent, she said Tuesday. We saw the last couple of variants emerge from largely unvaccinated populations.

We may have gotten a little bit lucky with Omicron, if it turns out to be less severe intrinsically, she said. We may not get so lucky next time.

Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer. Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar. Martin Finucane can be reached at martin.finucane@globe.com.

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COVID-19 cases have peaked in Massachusetts - The Boston Globe

Key Takeaways

The COVID-19 pandemic created unprecedented health and education challenges for children with disabilities, many of whom receive special education services. Recently, the Omicron variant, slowing vaccination rates among children, and state bans on school mask mandates have impacted school operations during the new year as well as the health, safety, and educational progress of children with special education plans. Many children receiving special education services have substantial health care needs, and services available through a childs health insurance plan, such as Medicaid, can complement special education services. This brief describes how Medicaid and special education services work in meeting childrens needs, explores how the pandemic has affected children who receive special education services, and identifies key issues to watch moving forward. Key findings include the following:

Students with special education plans may be entitled to compensatory services to make up for lost skills due to pandemic related service disruptions, and some children, such as those with disabilities related to long COVID, may be newly eligible for special education services. Medicaid can play an important role in ensuring that children receive preventive services that may have been delayed during the pandemic and access services to address needs that may have arisen due to the pandemic.

The COVID-19 pandemic has had a disproportionate impact on people with disabilities, including children, whose health and functional needs place them at increased risk of severe illness or death from COVID-19 and who may require special education services that may not be adequately provided in education settings modified by the pandemic. There are an estimated 6.7 million children, or 9% of all children in the U.S., who currently have special education plans, and over two-thirds of these children have special health care needs. Throughout the pandemic, these children have experienced delayed or missed services and losses in instructional time, which can have implications for their ability to continue to progress in their education. As a major health insurance provider for children with special education plans, Medicaid can provide important services to these children as well as ensure that children receive other preventive services that may have been delayed during the pandemic and access services to address needs that may have arisen due to the pandemic, such as mental health treatment.

While students have largely returned to in-person learning this school year, challenges for children receiving special education services remain. A number of lawsuits are challenging state bans on school mask mandates, arguing that these bans violate the right of children with disabilities to safely attend school. Further, the recent, rapid spread of the Omicron variant has created additional instability for students and some schools have temporarily switched to remote learning, a move that may make it difficult to provide all needed services to children with special education plans. While the Pfizer-BioNTech COVID-19 vaccine is now authorized for school-aged children, vaccination among young children is not yet widespread. This brief explains how Medicaid and special education services intersect, explores the pandemics implications for children receiving special education services, and identifies key issues to watch moving forward. For additional context, the appendices provide information on what is required under federal special education law and includes supporting data tables.

If a child is eligible for both special education services and Medicaid, federal law requires state Medicaid programs to pay for services that are both educationally and medically necessary. This is an exception to the general rule that usually makes Medicaid the payer of last resort when other sources of coverage are available. If a device or service included in a childs special education plan under the Individuals with Disabilities Education Act (IDEA) is also medically necessary, then Medicaid is obliged to pay before the school district. For more on what is required under the federal IDEA, see Appendix A. Children also may qualify for additional services covered by Medicaid, beyond what is required by the IDEA. For example, a child with cerebral palsy may need physical therapy to improve mobility and manage muscle contractures. The IDEA might require the school district to provide physical therapy so that the child can access and progress in their education, such as therapy targeted to moving around the school or developing skills related to their educational goals. If the child requires additional physical therapy for other purposes, such as to facilitate their ability to transfer in and out of a wheelchair at home or skills needed to access the community outside of school, such services could be medically but not educationally necessary and therefore available under Medicaid.

The scope of services that must be provided to children under federal Medicaid law is broader than what is required under the IDEAs definition of related services. The Early Periodic Screening Diagnostic and Treatment (EPSDT) provision requires state Medicaid programs to cover all services that are necessary. . . to correct or ameliorate. . . physical and mental illnesses and conditions. . . . Like the IDEA, EPSDT applies to Medicaid enrollees from birth through age 21. To receive federal matching funds, state Medicaid programs must cover a minimum set of services for adults (such as inpatient hospitalization and physician services) and can choose to cover additional services (such as private duty nursing and rehabilitative services). However, EPSDT means that there are no optional services for children; instead, if medically necessary, all services must be covered for children, regardless of whether the state chooses to cover them for adults.

Medicaid, together with the Childrens Health Insurance Program (CHIP), covers half of all children with current special education plans (Figure 1). Medicaid/CHIP is the only source of coverage for nearly four in 10 children nationwide receiving special education services, while over one in 10 have Medicaid/CHIP to supplement private insurance. Medicaid covers services that private insurance typically does not, including long-term services and supports (LTSS) and home and community-based services (HCBS), and has cost-sharing protections that help keep health care affordable for families. The share of children with special education plans covered by Medicaid/CHIP varies by state, ranging from 26% to 71%, reflecting variation in state choices about optional Medicaid eligibility pathways for children with disabilities (Appendix B Table 1).

A majority of children with special education plans covered by Medicaid/CHIP alone are children of color and live in low-income households (Appendix B Table 2). Medicaid/CHIP-only children with special education plans are more likely to be non-Hispanic Black or Hispanic compared to children with private coverage only. Medicaid/CHIP-only children with special education plans also are more likely to live in a household with an income at or below 138% of the federal poverty level (FPL, less than $29,974/year for a family of three in 2020) when compared to those with private insurance only. Additionally, most children (68%) receive their first special education plan between the ages of 4 and 11 regardless of health coverage type.

Children with special education plans covered by Medicaid/CHIP are more likely to have greater health needs compared to those with private insurance only. Medicaid/CHIP-only children with special education plans are more likely to have multiple chronic conditions and multiple functional difficulties, with over half of the Medicaid/CHIP-only group reporting four or more functional difficulties or four or more chronic conditions, compared to 38% of those with private insurance only (Appendix B Table 2). Further, children with special education plans covered by both Medicaid/CHIP and private insurance are more likely than children covered by Medicaid/CHIP alone to have four or more functional difficulties, four or more chronic conditions, or three or more service needs. These children are also more likely than children with Medicaid/CHIP alone to have special health care needs and health that usually or always affects daily activities somewhat or a great deal. Medicaid coverage can address gaps in private coverage, and children covered by both Medicaid/CHIP and private insurance often have complex health needs and are more likely to be eligible for Medicaid through a disability-related pathway. Further, parent/caretakers of Medicaid/CHIP-only children with special education plans are also more likely to parent alone and face challenges with their own physical and mental health compared to those with private insurance only.

Many children with special education plans experienced missed or delayed services and loss of instructional time during the pandemic. One report estimates that school attendance and engagement has declined since the start of the pandemic, with early data suggesting larger declines for children with disabilities. A survey released early in the pandemic (May 2020) found 40% of parents of students with special education plans reported their child was not receiving any support, and only 20% reported their child was receiving all the services they required. School districts reported it was more or substantially more difficult to provide hands-on instruction accommodations and services such as speech, physical, or occupational therapy during pandemic school closures. Students with disabilities experienced a loss of instructional time, and may have started the 2021 school year up to one year behind. Remote learning may have also been hindered by a lack of access to the internet and assistive technology to which students with disabilities have access when attending school in-person. Low-income children and children of color faced increased health and economic challenges during the pandemic, and children with special education plans within these groups, many of whom are covered by Medicaid/CHIP, likely faced additional barriers to learning and accessing services during the pandemic.

Students with special education plans may be entitled to compensatory services to make up for lost skills due to school closures or other pandemic related service disruptions. The Department of Education (DOE) guidance advises special education teams to make individualized decisions about the needs for additional services as schools return to normal operations. The American Academy of Pediatrics noted the critical role of school-based services such as physical, occupational, and speech-language therapies and mental health services which often were disrupted during the pandemic. Other researchers have found service disruptions in these areas during the pandemic, noting that some services may be challenging or even impossible to deliver virtually, leaving children with special health care needs who could not receive in-person services with unmet needs. Further, according to DOE guidance, some children may be newly eligible for special education services, as those with disabilities related to long COVID can qualify for services under the IDEA or Section 504. For more information about eligibility under both laws, see Appendix A.

As most schools returned to in-person learning in the fall of 2021, lawsuits have been filed in a number of states challenging government bans on school mask mandates as violating the rights of children whose health conditions put them at increased risk of severe illness or death from COVID-19. Although the CDC recommends distancing and masks for all staff and students regardless of vaccination status for in-person learning, some state and local governments have prohibited school districts from adopting school mask mandates. Multiple lawsuits have been filed arguing that these bans prevent children with disabilities from attending school safely in person, in violation of the Americans with Disabilities Act and Section 504. Federal district courts in Iowa, South Carolina, and Tennessee have granted preliminary injunctions blocking governors bans on school mask mandates. On the other hand, the 5th Circuit Court of Appeals has put on hold a Texas federal district courts permanent injunction that blocked a governors ban on school mask mandates, which means that the ban will go into effect while the appeal is pending. Additionally, a Florida federal district court denied a motion for a preliminary injunction in a case seeking to block a similar governors ban. All of these cases are currently on appeal.

Some school districts are struggling to stay open amid the rapid spread of the Omicron variant. Despite calls from the Biden Administration, governors, and mayors for schools to remain open, many school districts have decided to temporarily return to remote learning following the recent spike in COVID-19 cases. School districts are facing high case rates among students and staff, making it difficult to re-open and maintain student safety. At the same time, returning to virtual learning makes it more difficult for school districts to provide all needed services to students with special education plans and may put these children at further risk for falling behind.

COVID-19 vaccine uptake among young children has slowed. Children ages 5 and older are now eligible to be vaccinated against COVID-19. Following an initial wave of enthusiasm and a slight uptick for a period in December, vaccine uptake among 5-11 year-olds, who recently became eligible, has declined. As of January 12, 2022, 27% of 5-11 year-olds and 64% of 12-17 year-olds have received at least one dose of the COVID-19 vaccine. There may be unique challenges to vaccinating young children, particularly those from low-income families who may face additional barriers to access, and Medicaid can play a role in facilitating access to vaccines for these children. Further, the US Food & Drug Administrations (FDA) recently authorized booster shots of Pfizer-BioNTechs COVID-19 vaccine for children ages 12 to 15.

Children who receive special education services already faced disparities compared to their non-disabled peers and lost instructional time and disruptions in access to related services during the pandemic have exacerbated those differences. Medicaid, together with CHIP, covers half of children with special education plans, and these children have greater health needs compared to children with special education plans covered by private insurance. This means Medicaid supports children with special education plans by providing both educationally and medically necessary services as well as ensuring that children receive the other medical and preventive services they need.

Read more from the original source:

The Intersection of Medicaid, Special Education Service Delivery, and the COVID-19 Pandemic - Kaiser Family Foundation

The SARS-CoV-2 Alpha variant, once known as B.1.1.7, carries a mutation at the site where its spike protein is cleaved by an enzyme called furin.

Scientists believed that this mutation might contribute to Alphas increased transmissibility or disease severity.

However, a recent study from researchers at Cornell University, in Ithaca, NY, suggests that this mutation at the furin cleavage site did not influence Alphas ability to spread between or infect cells.

In other words, mutations other than the ones at the furin cleavage site are probably responsible for Alphas increased abilities to transmit and to cause disease.

The recently emerged Omicron variant has many mutations that are similar to Alphas, including the mutation at the cleavage site for furin.

The studys lead author, Dr. Gary Whittaker, a virologist at Cornell, explains, Omicron has a lot of the same features as Alpha. So what we learned about Alpha helps us understand Omicron and possible future variants.

The increased contagiousness but reduced disease severity of Omicron, compared with Alpha, are likely due to other genetic differences.

The new study appears in the journal iScience.

Errors during the replication of the SARS-CoV-2 virus result in mutations in its genome. This produces variants.

Although mutations are constantly produced as SARS-CoV-2 replicates, only a small number of these mutations are responsible for an increase in transmissibility or disease severity.

Variants of concern, which have increased transmissibility, disease severity, or ability to evade the immune system, tend to carry multiple mutations in their genomes.

Experts have yet to understand the precise role of individual mutations in enhancing the transmission of the virus or causing more severe disease.

The Alpha variant, which was first identified in the United Kingdom in the fall of 2020, was 4571% more transmissible than the wild-type SARS-CoV-2 that originated in Wuhan, China. Alpha was also associated with an increase in disease severity.

The Alpha variant had 23 mutations in its genome, including nine in the gene coding for the spike protein.

Scientists have observed multiple spike protein mutations in the different variants of concern, and some of these mutations are associated with increased transmissibility.

The spike protein is expressed on the surface of SARS-CoV-2, and it allows the virus to bind to the angiotensin-converting enzyme 2 receptor on the surfaces of human cells.

The cleavage of the spike protein at a specific site by the enzyme furin, which human cells express, is thought to be essential to facilitate the entry of the virus into airway epithelial and lung cells.

One mutation in the spike protein gene of the Alpha variant is at the furin cleavage site. Changes in the sequence of this site may influence the transmissibility of SARS-CoV-2.

The present study characterized the ability of this mutation at the Alpha variants furin cleavage site to influence the virus ability to infect and replicate in human cells.

To understand the impact of this particular mutation, the researchers first used a bioinformatics approach. Bioinformatics involves using software tools to analyze biological data, and it can predict the structure of proteins using genetic information.

The bioinformatics analysis predicted that the mutation at the furin cleavage site in the Alpha variant would slightly enhance the cleavage of the spike protein by the furin enzyme.

The researchers also conducted a biochemical assay in the laboratory to confirm this. They incubated a short fragment of the spike protein containing the furin cleavage site from the Alpha variant and wild-type SARS-CoV-2 with furin.

The assay showed that the spike protein fragment from the Alpha variant was cleaved to a slightly greater extent than the wild-type SARS-CoV-2, but only at a specific pH.

The researchers then used pseudoparticles to assess the impact of the mutation at the furin cleavage site on the ability of SARS-CoV-2 to enter human cells.

These pseudoparticles consist of a surrogate virus other than SARS-CoV-2 that expresses a specific SARS-CoV-2 protein. They have the essential components to infect a cell but cannot replicate, making them harmless.

In the present study, the researchers used pseudoparticles expressing the spike protein from wild-type SARS-CoV-2 and the Alpha variant.

The researchers also used a third type of pseudoparticle that expressed a modified form of wild-type SARS-CoV-2 spike protein that included one particular alteration found in the Alpha variant.

This modified wild-type SARS-CoV-2 spike protein only had one change at the furin cleavage site, which was caused by a specific mutation of the Alpha variant, but it did not have the other changes seen in the Alpha variants spike protein.

The researchers compared the ability of these three pseudoviruses expressing different spike proteins to infect Vero cells, which are laboratory-cultured kidney cells.

SARS-CoV-2 can enter cells by two main pathways. One involves the fusion of the virus envelope with the membrane of human cells and is mediated by an enzyme called TMPRSS2, which is on the surface of human cells. In the other pathway, the virus is engulfed by fluid-filled bodies called endosomes that are present inside the cells.

The researchers used two types of Vero cells. One expressed TMPRSS2 and favored entry by fusion. The other cell line favored the entry of the virus by the endosomal pathway.

There was no difference in the abilities of the pseudoviruses expressing the three different spike proteins to infect either type of Vero cells.

In other words, the presence of the mutation at the furin cleavage site of the Alpha variants spike protein did not enhance cell entry through either the TMPRSS2 or endosomal pathways.

Since Vero cells are derived from the kidney, the researchers then infected laboratory-cultured cells from the human respiratory tract with the pseudoparticles expressing the three spike proteins.

The pseudoparticles expressing the spike from the Alpha variant were slightly more effective at infecting respiratory tract cells than those with the wild-type virus spike.

Interestingly, the pseudoparticles carrying the wild-type SARS-CoV-2 spike with the mutation at the furin cleavage site did not differ from the wild-type virus in their ability to infect respiratory tract cells.

The results of the experiment with respiratory tract cells suggest that mutations other than the one at the furin cleavage site are probably responsible for the increased capacities of the Alpha variant to transmit and to cause disease.

The researchers then compared the ability of samples of wild-type SARS-CoV-2 and the Alpha variant to replicate in the two Vero cell lines and human respiratory tract cells.

Similar viral titers were observed in all three cell types, suggesting that the Alpha variant did not replicate more quickly than wild-type SARS-CoV-2.

The SARS-CoV-2 spike protein is also known to mediate the fusion of infected cells with adjacent uninfected cells, thus facilitating the spread of the virus throughout the lungs.

Because there were no differences between the Alpha variants and wild-type SARS-CoV-2s abilities to infect or replicate in human cells, the researchers decided to investigate any differences in the abilities of these spike proteins to induce cell fusion. The researchers found that the Alpha variants spike did not enhance cell fusion in the two Vero cell lines.

In summary, the study suggests that the specific change at the furin cleavage site in the Alpha variants spike protein may increase its cleavage. But it does not boost the variants ability to infect or replicate in human cells.

As Dr. Whittaker notes, the furin cleavage site may, in fact, be relatively inconsequential.

The Delta variant, which was first identified in India in late 2020, was found to be more contagious than previous variants of concern, including the Alpha variant. The Delta variant also caused more severe disease.

Like the Alpha variant, the Delta variant has a mutation at the furin cleavage site. However, this mutation is different from Alphas and is associated with increased cleavage by furin.

This mutation of Deltas is also associated with enhanced cell entry and cell-to-cell fusion, and increased disease severity.

However, the Omicron variant that emerged in November 2021 has an identical mutation to the Alpha variant.

Dr. Whittaker says: Omicron went back to square one. It returned to the same genetic change in the furin cleavage site that Alpha had. It essentially took a large step back in its evolutionary trajectory as a disease agent.

Alpha would cause cells to fuse. Delta would fuse cells even more. but then Omicron comes along, and its host cells arent fusing at all. It has gone completely backward, he explains.

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COVID-19: Studying variants' mutations overturns assumptions - Medical News Today

Massie, who also said he is not vaccinated, is a fierce critic of White House chief medical adviser Dr. Anthony Fauci, and has been among the loudest voices in Congress against vaccine and mask mandates.

"I have tested positive for SARS-CoV2. (Home test, confirmed by lab PCR.) I had cold/allergy symptoms for 1 day, and seem to be over it," he tweeted.

"I will not be voting, meeting in person, or making public appearances until next week," he continued. "I am not vaccinated or boosted."

He also suggested his case is mild because he's been previously infected by Covid-19.

"I can't guarantee, but I suspect my symptoms have been very mild due to prior infection 2 years ago. Also, perhaps this was omicron?" he said on Twitter.

Massie also tweeted last week he and his staff would not order from restaurants following Washington, DC's newly implemented vaccine mandate at public establishments.

"On Wednesday, I tested positive for COVID-19. I am vaccinated, boosted, experiencing mild symptoms and remain in good spirits," the Arizona Democrat said in the statement. "My staff and I will follow Centers for Disease Control and Prevention guidance on testing and quarantine procedures including notifying those who may have been in close contact."

This story and headline have been updated with additional details.

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Two years into COVID-19 pandemic, state still determined to reach the unvaccinated - KOMO News

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