New WHO Variant of Interest (Mu): what we know

What We Know About Mu, the WHO’s Latest Variant of Interest
[Media report.] According to Public Health England, the variant shares mutations with other variants, most notably the Beta (B.1.351) variant first identified in South Africa. These include the E484K and K417N mutations, which researchers have linked to immune escape. K417N is also seen in the “Delta plus” variant. Additionally, Mu has the P681H mutation seen in the Alpha (B.1.1.7) variant, which is associated with increased transmissibility. Detailed studies of the Mu variant’s characteristics have yet to be conducted, but it exhibited Beta-like escape of vaccine-induced immune protection in preliminary data presented to the WHO’s Virus Evolution Working Group.

Effect of mutation and vaccination on spread, severity, and mortality of COVID-19 disease
The present work aims to compare the spread and the severity of the different waves using the available data of confirmed COVID-19 cases and death cases in 12 countries with the highest total performed tests in the world (Italy, Brazil, Japan, Germany, Spain, India, USA, UAE, Poland, Colombia, Turkey, and Switzerland). In all the selected 12 countries, Wave 2 had a much higher number of confirmed cases than that in Wave 1. However, the death cases increase was not comparable with that of the confirmed cases to the extent that some countries had lower death cases than in Wave 1, UAE, and Spain. Waves 3 and 4 have had lower confirmed cases than Wave 2, however, the death cases were variable in different countries. The death cases in Waves 3 and 4 were similar to or higher than Wave 2 in most countries. Wave 2 of COVID-19 had a much higher spread rate but much lower severity resulting in a lower death rate in Wave 2 compared with that of the first wave. Waves 3 and 4 have had lower confirmed cases than Wave 2; that could be due to the presence of appropriate treatment and vaccination. Further studies are needed to explain these findings.

SARS-CoV-2 Variant Tracking and Mitigation: Strategies and Results from In-Person Learning at a Midwestern University in the 2020/2021 School Year
[Preprint.] This study includes 14,894 individuals from the university population who tested on campus for COVID-19 during the spring 2021 semester. Between January and May 2021, the university conducted 196,185 COVID-19 tests and identified 1,603 positives – ∼89% students – with 687 identified via PCR of saliva specimens. The Alpha (B.1.1.7) variant constituted 44% of total positives sequenced. By May 20, 2021, 91% (10,068) of students, 92% (814) of faculty, and 72% (2,081) of staff were vaccinated. The 7-day rolling average of positive cases peaked at 37 cases on February 17 but declined to zero by May 14, 2021. The 7-day moving average of positive cases was inversely associated with the cumulative vaccination rate.

Analysis of the Effects of COVID-19 Mask Mandates on Hospital Resource Consumption and Mortality at the County Level
We assess the effects of a county-wide mask order on per-population mortality, intensive care unit (ICU) utilization, and ventilator utilization in Bexar County, Texas. From June 2, 2020 through August 12, 2020, there were 40,771 reported cases of COVID-19 within Bexar County, with 470 total deaths. The average number of new cases per day within the county was 565.4 (95% confidence interval [CI] 394.6–736.2). The average number of positive hospitalized patients was 754.1 (95% CI 657.2–851.0), in the ICU was 273.1 (95% CI 238.2–308.0), and on a ventilator was 170.5 (95% CI 146.4–194.6). The average deaths per day was 6.5 (95% CI 4.4–8.6). All of the measured outcomes were higher on average in the postmask period as were covariables included in the adjusted model. When adjusting for traffic activity, total statewide caseload, public health complaints, and mean temperature, the daily caseload, hospital bed occupancy, ICU bed occupancy, ventilator occupancy, and daily mortality remained higher in the postmask period. There was no reduction in per-population daily mortality, hospital bed, ICU bed, or ventilator occupancy of COVID-19-positive patients attributable to the implementation of a mask-wearing mandate.

Rapid initiation of nasal saline irrigation to reduce morbidity and mortality in COVID+ outpatients: a randomized clinical trial compared to a national dataset
[Preprint.] Objective To determine whether initiating nasal irrigation after COVID-19 diagnosis reduces hospitalizations and death, and whether irrigant composition impacts severity. Interventions Participants were randomly assigned adding 2.5 mL povidone-iodine 10% or 2.5 mL sodium bicarbonate to 240ml of isotonic nasal irrigation twice daily for 14 days. Results Analyzed by intention-to-treat, by day 28, COVID-19 symptoms resulted in 1/42 hospitalizations in those irrigating with alkalinization, 0/37 in the povidone-iodine group, (1.27%) and no deaths. Of nearly three million CDC cases, 9.14% were known to be hospitalized, with an additional 1.5% mortality in those without hospitalization data. The total risk of hospitalization or death (10.6%) was 8.4 times that of enrolled patients (SE=2.74; P=.006). 62 completed daily surveys (78%), averaging 1.8 irrigations/day. Eleven had irrigation complaints, and four discontinued. There were no significant differences by additive. Conclusion SARS-CoV-2+ participants initiating nasal irrigation were over 8 times less likely to be hospitalized than the national rate.