20/12/2023

COVID-19: Tracking new variants

Update 20 May 2024: Singapore facing new Covid-19 wave
Globally, the predominant Covid-19 variants are still JN.1 and its sub-lineages, including KP.1 and KP.2 which currently account for over two-thirds of cases in Singapore

Singapore is seeing a new Covid-19 wave, with rising cases of infection in the last two weeks, said Health Minister Ong Ye Kung on May 18. “We are at the beginning part of the wave where it is steadily rising,” said Mr Ong. “So I would say the wave should peak in the next two to four weeks, which means between mid- and end of June.”

The Ministry of Health (MOH) said that to protect hospital bed capacity and as a precaution, public hospitals have been asked to reduce their non-urgent elective surgery cases and move suitable patients to facilities like transitional care facilities or back home through Mobile Inpatient Care@Home. Mr Ong urged those who are at greatest risk of severe disease, including individuals aged 60 years and above, medically vulnerable individuals and residents of aged care facilities, to receive an additional dose of the Covid-19 vaccine if they have not done so in the last 12 months.

MOH said the estimated number of Covid-19 cases in the week of May 5 to May 11 rose to 25,900 cases, compared with 13,700 cases in the previous week. The average daily Covid-19 hospitalisations rose to about 250 from 181 the week before. The average daily intensive care unit (ICU) cases remained low at three cases, compared with two cases in the previous week. Mr Ong said that if the number of Covid-19 cases doubles one time, Singapore will have 500 patients in its healthcare system, which is what Singapore can handle. However, if the number of cases doubles a second time, there will be 1,000 patients, and “that will be a considerable burden on the hospital system”, he noted.


The FLiRT family of COVID-19 variants and what we know about the KP.2 strain

Another COVID-19 wave has hit SingaporeCOVID-19 wave has hit Singapore, with the KP.1 and KP.2 variants accounting for more than two-thirds of cases here. The two strains belong to a new family of subvariants called “FLiRT”, which is also spreading elsewhere in the world.

KP.1 and KP.2 belong to a group of COVID-19 variants scientists have nicknamed “FLiRT”, after the technical names of their mutations. The strains in FLiRT are all descendants of the JN.1 variantJN.1 variant, an offshoot of the Omicron variant. The JN.1 variant spread rapidly around the world several months back and was responsible for Singapore's COVID-19 wave last December. The KP.2 strain, in particular, appears to be spreading faster than KP.1. In May, KP.2 was classified by the World Health Organization as a Variant Under Monitoring. This signals to public health authorities that a COVID-19 variant may require prioritised attention and monitoring.

KP.2 was first detected in India in early January. It has since become the dominant strain in the United States, accounting for about 28 per cent of infections in the country in mid-May. This is up from just 6 per cent in mid-April and 1 per cent in mid-March, according to data by the US Centers for Disease Control and Prevention (CDC). KP.2 has also spread to other countries, including China, Thailand, Australia, New Zealand and the United Kingdom.


How serious is JN.1, WHO's latest COVID-19 variant of concern that is dominating Singapore cases?
The World Health Organization has just classified the new COVID-19 strain JN.1 as a "variant of interest". (Photo: iStock)

A fairly new COVID-19 strain, JN.1, that accounts for the vast majority of Singapore's latest wave of infections, was classified as a "variant of interest" on Tuesday (Dec 19) by the World Health Organization (WHO).

The Ministry of Health (MOH) said last Friday that Singapore recorded an estimated 56,043 COVID-19 cases in the week of Dec 3 to Dec 9, a surge of 75 per cent from the week before that. The ministry is advising members of the public to wear masks in crowded spaces even if they are not sick, and has opened a second COVID-19 treatment facility to care for COVID-19 patients who do not need intensive hospital care. Cases have since plateaued over the past week, as the seven-day moving average on Dec 17 was 7,730, down from the 7,870 cases on Dec 12.

In its statement last Friday, MOH said that the vast majority of cases it sees come from the JN.1 strain, though it did not provide an exact figure. It is the newest strain's transmissibility that has spurred WHO to treat it as a "variant of interest". In a statement on Tuesday, WHO said that the JN.1 strain was tracked as part of its parent strain BA.2.86 - also known as the "Pirola" strain and is a variant of interest to WHO.


What are the symptoms of JN.1?

It’s not known whether JN.1 causes different symptoms from other variants, according the CDC.

“Right now, there’s nothing that says that JN.1 infection is any different from previous COVID variants in terms of disease severity or symptoms, but we’re paying close attention,” says Pekosz. The symptoms of JN.1 appear to be similar to those caused by other strains, which include:
  • Sore throat
  • Congestion
  • Runny nose
  • Cough
  • Fatigue
  • Headache
  • Muscle aches
  • Fever or chills
  • Loss of sense of taste or smell
According to the CDC, the type and severity of symptoms a person experiences usually depends more on a person’s underlying health and immunity rather than the variant which caused infection. While severe infections do still occur, overall “(COVID-19) is causing a lot of milder illness,” says Schaffner. Some doctors have reported that upper respiratory symptoms seem to follow a pattern of starting with a sore throat, followed by congestion and a cough, NBC News previously reported. “The virus is adapting. ... I think it’s getting better at infecting humans and evading pre-existing immunity in the population ... but it’s not changing symptomology too much,” says Pekosz. At this time, there’s no evidence that JN.1 causes more severe infection, the experts note.


What to Know About COVID FLiRT Variants
Virologists are keeping an eye on several COVID variants that have all picked up the same set of mutations. Here’s what that means

At the end of March, the KP.2 variant was causing about 4% of infections in the U.S., according to the CDC, while its parental strain, JN.1, was causing over 50% of infections at that time. As of early May, KP.2 makes up about 28% of infections, overtaking JN.1 as the dominant variant.

KP.2 is one of several variants being referred to as “FLiRT variants,” named after the technical names for their mutations. The prevalence of these variants comes at a critical time, when experts are deciding how to formulate the fall COVID vaccine. In this Q&A, Andy Pekosz, PhD, a professor in Molecular Microbiology and Immunology, explains what virologists like him are seeing, whether these variants might cause a summer wave of infections, and how people can protect themselves.

What are these “FLiRT variants”? This is the term being used to describe a whole family of different variants—including KP.2, JN.1.7, and any other variants starting with KP or JN—that appear to have independently picked up the same set of mutations. This is called convergent evolution. They are all descendants of the JN.1 variant that has been dominant in the U.S. for the past several months. The particular mutations that people refer to as “FLiRT”s or “FLip”s refer to specific positions in the spike protein—in this case, positions 456, 346, and 572. Viruses like SARS-CoV-2 mutate frequently, and when they mutate to evade recognition by antibodies, this often weakens their ability to bind to the cells they want to infect. We then see mutations appear that improve that binding ability. This is a cycle we have seen many times with SARS-CoV-2. The fact that these different variants are picking up the same mutations tells virologists that this combination of mutations is helping the virus accomplish these goals most efficiently.


Monitoring Variant Proportions

SARS-CoV-2, the virus that causes COVID-19, is constantly changing and accumulating mutations in its genetic code over time. New variants of SARS-CoV-2 are expected to continue to emerge. Some variants will emerge and disappear, while others will emerge and continue to spread and may replace previous variants.

To identify and track SARS-CoV-2 variants, CDC uses genomic surveillance. CDC's national genomic surveillance system collects SARS-CoV-2 specimens for sequencing through the National SARS-CoV-2 Strain Surveillance (NS3) program, as well as SARS-CoV-2 sequences generated by commercial or academic laboratories contracted by CDC and state or local public health laboratories. Virus genetic sequences are analyzed and classified as a particular lineage. The proportions of SARS-CoV-2 variants in a population are calculated nationally, by HHS region, and by jurisdiction. The sequences analyzed through CDC's national genomic sequencing and bioinformatics efforts fuel the comprehensive and population-based U.S. surveillance system established to identify and monitor the spread of variants.

Rapid virus genomic sequencing data combined with phenotypic data are further used to determine whether COVID-19 tests, treatments, and vaccines authorized or approved for use in the United States will work against emerging variants.


What to Know About the ‘FLiRT’ Variants of COVID-19

T
he COVID-19 lull in the U.S. may soon come to an end, as a new family of SARS-CoV-2 variants—nicknamed “FLiRT” variants—begins to spread nationwide. These variants are distant Omicron relatives that spun out from JN.1, the variant behind the surge in cases this past winter. They’ve been dubbed “FLiRT” variants based on the technical names for their mutations, one of which includes the letters “F” and “L,” and another of which includes the letters “R” and “T.”

Within the FLiRT family, one variant in particular has risen to prominence: KP.2, which accounted for about 25% of new sequenced cases during the two weeks ending Apr. 27, according to data from the U.S. Centers for Disease Control and Prevention (CDC). Other FLiRT variants, including KP.1.1, have not become as widespread in the U.S. yet.

Researchers are still learning about the FLiRT variants, and many questions remain about how quickly they’ll spread, whether they’ll cause disease that’s more or less severe than what we’ve seen previously, and how well vaccines will stand up to them. Here’s what we know so far.


What to Know About JN.1, the Latest Omicron Variant
Vaccines, tests, and antivirals are still effective tools in the latest COVID surge

In early November 2023, the JN.1 variant caused less than 5% of COVID-19 cases in the U.S. Now it is estimated to cause more than 60% of them. Virologists including Andy Pekosz, PhD, a professor in Molecular Microbiology and Immunology, are paying attention. Here, Pekosz explains what virologists are seeing, what this new variant means for case rates and treatments, and why it’s so important for more people to get the updated COVID-19 vaccine rolled out this fall.

What is JN.1? A SARS-CoV-2 variant called BA.2.86 emerged a few months ago and caught virologists’ attention because it contains many more mutations—about 30 of them—to evade immunity than any other variant circulating at that time. However, the BA.2.86 variant never came to dominate among the group of SARS-CoV-2 variants that were circulating in the late summer/early fall of 2023. The JN.1 variant is a descendant of BA.2.86 that has acquired the ability to transmit efficiently through an additional one or two mutations. It has the immune evasion of its parent but has now mutated to transmit more efficiently.

What’s happening now with this variant? The increase in the number of cases caused by JN.1 corresponds to an overall increase in COVID-19 cases. Symptoms of JN.1 infection are very similar to those of previous omicron variants, and it doesn’t seem to cause more severe disease, either. There is some suggestion that JN.1 may be causing more diarrhea than previous variants, but we don’t have any firm data supporting that yet. 


New COVID-19 variant alert! KP.2 can evade your immunity—Here’s how you can protect yourself
Covid New Variant, FLiRT KP.2: An offshoot of the Omicron strain, KP.2 was first detected in India in early January this year

The new COVID-19 variant, KP.2, is causing a rise in cases globally. In India, nearly 100 COVID-19 cases have been reported across India. On Wednesday, China’s Health authorities said that the variant is unlikely to trigger a new infection wave in the country. An offshoot of the Omicron strain, KP.2 was first detected in India in early January this year.

Dr Rahul Kendre, Lung transplant Physician and Interventional Pulmonologist, DPU Super Specialty Hospital, Pimpri, Pune told Financial Express.com that new COVID variants have come up, and this time, it is not a single mutant that we need to be worried about. Rather, it is a group of mutants, collectively named FLiRT. 
“It has been named FLiRT, based on the technical names for their mutations, one of which includes the letters “F” and “L”, and another of which includes the letters “R” and “T”. The FLiRT variant group comprises KP.2, KP.3, JN.1.7, JN.1.1, and KP.1.1,” Dr. Kendre told Financial Express.com.

While KP.2 is circulating faster, the other FLiRT variant, KP.1.1 variant, is not widespread yet, he said. “The KP.2 (JN.1.11.1.2) variant is a descendant of JN.1 bearing both S:R346T and S:F456L; KP.2 has three substitutions in the S protein including the two above and additional one substitution in non-S protein compared with JN.1 KP.2 is said to be much better at evading immunity and is slightly more infectious than JN.1 variant,” he explained.


What to know about JN.1, the dominant COVID-19 variant in US

Nearly all COVID-19 cases in the United States right now are being caused by one, highly contagious variant called JN.1. The fast-spreading omicron subvariant currently accounts for over 93% of cases nationwide and the majority of infections globally. 
JN.1 is a direct descendant of the BA.2.86 variant, or “Pirola," which has been circulating since last summer. Compared to its parental strain, JN.1 has an additional mutation that affects its ability to evade immunity, according to experts.

In December, JN.1 overtook other highly transmissible variants — including HV.1 and EG.5 or Eris — to become the dominant strain in the U.S. By January, JN.1 was the most prevalent strain worldwide. The JN.1 variant is currently considered the fastest-growing variant in the country, according to the U.S. Centers for Disease Control and Prevention. During a two-week period ending Feb. 3, JN.1 made up 93.1% of cases in the U.S., up from 87% during the previous two-week period ending on Jan. 20, according to the CDC. This was a steep increase from 62% during the two-week period ending on Jan. 6 and 44% during the two-week period ending on Dec. 23.

As JN.1 swept across the country in the last two months, COVID-19 infections and hospitalizations also rose steadily. According to data models, the U.S. just faced its second-largest COVID wave, smaller than only the original omicron surge in late 2021 and early 2022. The JN.1 variant may be "intensifying the spread of COVID-19 this winter," the CDC said in an update on Jan. 5. Waning immunity, low COVID-19 vaccine uptake, and holiday gatherings likely also fueled the recent wave of cases. Although COVID-19 cases and hospitalizations have started to decline in the U.S., respiratory virus season isn't over yet. As JN.1 continues to circulate, RSV and influenza activity remains high in many parts of the country.


Dry Cough: Causes, Symptoms & Treatments

A dry or unproductive cough doesn’t produce mucus. A tickling sensation in the throat can make you have a dry cough. Dry coughs can come on after a cold or flu or if you have COVID-19. Other conditions like GERD, heart failure and lung cancer can cause chronic dry coughs. You may also have chest tightness with a dry cough. A dry cough doesn’t produce mucus. Because there isn’t mucus blocking the lungs or airways, nothing comes out when you cough. This lack of mucus (phlegm) makes it an unproductive cough.

What’s the difference between a dry cough and a wet cough?
  • A cough is your body’s way of clearing the lungs and airways of irritants so you can breathe better.
  • When you have an illness that affects your respiratory system, you may cough up mucus. This is a wet cough. Healthcare providers consider a wet cough to be productive because it clears phlegm (mucus) from the lungs and airways. If too much phlegm builds up in the lungs, you may become short of breath and develop other problems.
What are the symptoms of a dry cough?
  • With a dry cough, you may feel a tickling sensation in your throat. You may try to clear your throat by coughing. As you forcefully expel air, your throat can become irritated and dry. You may develop a sore throat.
Possible Causes - Do colds, flu and COVID-19 cause a dry cough?
  • Colds and flu tend to cause wet, productive coughs when you’re sick. Later, dry coughs may linger during recovery.
  • It can take a while for inflammation from respiratory infections to go away. During this time, the lungs and airways may be extra sensitive to inhaled irritants. This sensitivity can make your throat more ticklish, causing you to cough.
  • Most people who get sick with COVID-19 have dry coughs — not wet coughs like with the cold or flu. However, wet coughs can also happen with COVID-19 infections. Your healthcare provider may recommend a COVID-19 test to identify the cause of the cough.
Care and Treatment - How can I treat a dry cough and tight chest?
  • Most dry coughs clear up when you treat the underlying cause. Over-the-counter (OTC) cough medicines aren’t usually that helpful. And children younger than 4 years of age shouldn’t take any cough medicine because of the risk for serious side effects.
These at-home remedies can help:
  • Drink plenty of liquids to stay hydrated. Try hot tea or water with honey and lemon to soothe irritated airways.
  • Suck on cough drops or hard candies. Sucking on a hard lozenge promotes saliva production that soothes the throat. But don’t give cough drops or hard candies to children under 4. They can choke.
  • Take a spoonful of honey. Studies show that honey stops coughs as well as (or better than) most OTC cough medicines. Your healthcare provider can recommend the right amount of honey based on the ill person’s age. Never give honey to a child under 1 year of age. In babies, honey can cause botulism.
  • Use a humidifier. A cool-mist humidifier puts moisture into the air. This extra moisture soothes nasal passages and sore throats and eases dry coughs. You can also get more moisture by taking a steamy shower or hot bath.

New weekly COVID-19 cases admitted to hospitals and ICUs highest for 2023

The number of new COVID-19 patients admitted to hospitals in Singapore jumped to 965 in the past week, up from 763 the previous week, with those admitted to intensive care units (ICU) going up from 23 to 32 in the same period.

These are the highest numbers of new weekly hospitalisation and ICU admission for COVID-19 patients in 2023. By comparison, the weekly hospitalisation number for the week before last was 460 while that for new ICU admission was nine. The estimated number of COVID-19 infection cases for the week of Dec 10 to Dec 16 was also the highest recorded for the year, with 58,300 cases for epi-week 50, up from the previous record of 56,043 cases in the preceding week.

These latest figures were published on the Ministry of Health's website on Thursday (Dec 21) evening. The figures show that the seven-day moving average estimated daily number of cases has been dropping in recent days, decreasing from 7,730 on Dec 17 to 6,820 the following day and then 6,530 cases on Dec 19. "Healthcare utilisation indicators such as hospitalised and ICU cases typically lag behind the estimated weekly number of infections," said MOH on its website.

related:


More hospitalisations as Singapore’s Covid-19 cases hit record high for 2023

Covid-19 infections and hospitalisations are increasing, putting a strain on hospitals here. The Ministry of Health (MOH), which raised the alert, has also reassured people that the numbers are not as high as during the pandemic, and that the circulating variants are not known to cause more severe illness.

In the week ended Dec 2, 32,035 people were diagnosed with Covid-19 – the highest number of infections recorded this year. The previous high was 28,410 infections a week in March. The latest number is almost 10,000 more than the 22,094 diagnosed the previous week. The number of weekly infections has been hovering around 15,000 over the past two to three months. The number of people being hospitalised and needing intensive care treatment has also gone up.

An MOH statement on Dec 8 said the average daily Covid-19 hospitalisations rose to 225 from 136 the week before, and the average daily intensive care unit (ICU) cases increased to four cases compared with one case in the previous week. Nine people severely ill with Covid-19 were admitted to a hospital ICU in the week of Nov 26 to Dec 2, up from four the previous week. But as hospitalisation and need for intensive care treatment usually lag behind infections, the numbers could go up in the coming weeks.


Singapore sees jump in COVID-19 infections with recent doubling of cases

There has been a significant rise in COVID-19 infections in Singapore, the Ministry of Health (MOH) said on Saturday (Dec 2), urging people to keep up to date with their vaccinations. The number of estimated COVID-19 infections doubled to 22,094 in the week of Nov 19 to 25, compared with 10,726 in the previous week.

“The average daily COVID-19 hospitalisations and ICU cases have remained stable,” the ministry added. MOH said the rise in infections could be due to factors such as the year-end travelling season and waning population immunity. 

EG.5 and its sub-lineage HK.3 remain the predominant subvariants in Singapore, accounting for more than 70 per cent of the cases sequenced. “Currently, there is no indication that the predominant subvariants are more transmissible or cause more severe disease compared to other circulating variants,” MOH said.


18% of recent COVID-19 community cases in Singapore infected by EG.5 Omicron subvariant

About 18 per cent of recent COVID-19 community cases in Singapore were infected with the EG.5 Omicron subvariant, the Ministry of Health (MOH) said on Tuesday (Aug 8). The first local case infected with the subvariant was detected on May 5.

According to the World Health Organization (WHO), currently available evidence does not suggest that the subvariant has contributed to any significant increase in cases, disease severity, or deaths, as compared with other circulating strains, said the ministry.

The number of COVID-19 cases hospitalised or in intensive care has remained stable, said MOH, adding that it will continue to monitor the local situation closely.



Singapore faces new COVID-19 wave, more infections in coming weeks: Ong Ye Kung

Singapore is facing another surge in COVID-19 infections, and Minister of Health Ong Ye Kung said that more cases and hospitalisations are expected in the upcoming weeks. The minister was speaking during the official opening of the Stepping Stones Rehabilitation Centre and Serenity Centre at the Institute of Mental Health on Friday (6 October).

He revealed that over the past two weeks, the estimated daily cases have risen from about 1,000 - which was the count three weeks ago - to 2,000 cases. The surge in cases is primarily driven by two variants, namely EG.5 and its sub-lineage HK.3, both of which are descendants of the XBB Omicron variant. These two variants now account for over 75 per cent of the total cases.

Ong emphasised that, as with the last COVID-19 wave from March to May, there are no plans to impose social restrictions. "We will treat this as an endemic disease, and live with it," Ong stated. "There has been no evidence to suggest that the new variants are more likely to lead to severe illnesses compared to previous variants. "All indications show that current vaccines continue to work well in protecting us against severe illnesses if infected by these new variants."



Singapore experiencing new COVID-19 wave, more people expected to fall sick in coming weeks

Singapore is experiencing another COVID-19 infection wave, with more people expected to fall sick and be hospitalised in the coming weeks, Health Minister Ong Ye Kung said on Friday (Oct 6). However, he added that there are no plans to impose any social restrictions, as with the last wave which occurred from March to April.

Speaking at the official opening of the Stepping Stones Rehabilitation Centre and Serenity Centre at the Institute of Mental Health, Mr Ong revealed that the estimated daily cases has risen from about 1,000 three weeks ago to 2,000 for the past two weeks. The spate of cases is driven by mostly two variants - the EG.5 and its sub-lineage HK.3 - both of which are descendants of the XBB Omicron variant. "Together, they now account for over 75 per cent of our daily cases," Mr Ong said.

During the peak in April, the number of infections rose to about 4,000 cases a day. "We will treat this as an endemic disease, which is in line with our strategy, and we will live with it," he said. "After all, there has been no evidence to suggest that the new variants are more likely to lead to severe illnesses compared to previous variants.

related:


Number of Covid-19 infections in Singapore more than doubled in Sept 17-23 week

There was a spike in the number of Covid-19 infections here in the week of Sept 17 to 23. The 14,843 people diagnosed with the disease are more than double those in the previous week, when 6,401 cases were recorded. 
In the previous 10 weeks, between July 9 and Sept 16, the number of infections each week ranged from 3,485 to 7,045.

Singapore no longer requires reporting of Covid-19 cases, so these numbers generally reflect those who sought medical care. The Ministry of Health (MOH) said it is monitoring the situation, but does not think there is a need to worry as the number of people infected “is currently low compared to previous waves”. “The average daily new Covid-19 hospitalisations and average daily new ICU (intensive care unit) cases have also remained low,” it said about the current spike in cases on its Covid-19 website.

The peak number of infections this year was 28,410 a week at the end of March. That week, 159 people were hospitalised, a slight increase over the 139 in the previous week; and seven needed to be admitted to intensive care, up from six in the previous week. However, hospitalisation and the need for intensive care usually lag infections. The infection peak at the end of March had led to a higher number of hospitalisations and admissions to the ICU in April.


Long-term Covid-19 vaccination strategy still unknown as virus is constantly mutating: NCID head
As the number of severe Covid-19 cases declines, it will become increasingly difficult to evaluate the effectiveness of vaccines against such cases. PHOTO: ST FILE

It is hard to have a long-term vaccination strategy to deal with Covid-19 as the virus is unstable and constantly mutating, with an unknown seasonal pattern and unknown ways of interacting with other respiratory germs.

As the number of severe cases of the coronavirus declines, it will also become increasingly difficult to evaluate the effectiveness of vaccines against such infections in the future.

National Centre for Infectious Diseases (NCID) executive director Vernon Lee said this on Wednesday at the first Asia-Pacific Immunisation Coalition and Asia Dengue Voice and Action Summit on Infectious Diseases and Immunisation.


Singapore updates COVID-19 vaccine advisory, recommends new dose about a year after last shot
A medical worker prepares a dose of the Pfizer Cominarty COVID-19 vaccine in Nice, France on Dec 7, 2022. (Photo: REUTERS/Eric Gaillard)

Singapore has updated its COVID-19 vaccine recommendations, encouraging people aged six months and above to receive an additional dose in 2023 or 2024. Previously, the recommendation was for people aged 60 and above, residents of aged care facilities and the medically vulnerable to receive a one-year booster dose.

“Beyond this group, the EC19V (Expert Committee on COVID-19 Vaccination) encourages all individuals aged six months and above to also receive the additional dose for 2023/2024, particularly for healthcare workers and household members/caregivers of medically vulnerable individuals,” the Ministry of Health (MOH) said in a media release on Saturday (Oct 28).

Eligible individuals may receive the additional dose about a year – and no earlier than five months - after their last shot. “EC19V encourages all persons to ensure that their COVID-19 vaccination status is up-to-date and based on the prevailing recommendations for them,” the committee said.


New EG.5 Omicron sub-variant accounts for 18% of recent COVID-19 cases: MOH
New EG.5 Omicron Subvariant contributes to 18% of recent community Covid-19 cases, according to the Health Ministry. (PHOTO: Getty Images)

About 18 per cent of the recent COVID-19 cases in the community in Singapore are from the new EG.5 Omicron sub-variant. The Ministry of Health (MOH) told Yahoo Southeast Asia on Friday (11 August) that the number of COVID-19 cases being treated in hospitals or intensive care units has remained stable.

The EG.5 sub-variant was first identified in Singapore in a case on 5 May. MOH referred to information from the World Health Organization (WHO) stating that currently-available evidence does not indicate that the EG.5 subvariant has led to a significant rise in COVID-19 cases, severe disease or deaths, compared to other strains that are currently circulating.

Popularly referred to as "Eris" by internet users, the EG.5 Omicron sub-variant has taken over as the predominant strain of COVID-19 in the United States, as reported by the US Centers for Disease Control and Prevention. MOH said it is monitoring the local situation closely. According to the MOH, this sub-variant was initially detected overseas in February and has since been identified in over 51 countries.


Variants of the Virus

New variants of SARS-CoV-2, the virus that causes COVID-19, will continue to occur. CDC coordinates collaborative partnerships which continue to fuel the largest viral genomic sequencing effort to date. The Omicron variant, which emerged in November 2021, has many lineages. New lineages continue to emerge and spread in the United States and globally.

Viruses constantly change through mutation and sometimes these mutations result in a new variant of the virus. Some changes and mutations allow the virus to spread more easily or make it resistant to treatments or vaccines. As the virus spreads, it may change and become harder to stop.

Understanding the Variants:
  • How Variants Work - If you think about a virus like a tree growing and branching out, each branch on the tree is slightly different than the others. By comparing the branches, scientists can label them according to the differences. These small differences, or variants, have been studied and identified since the beginning of the pandemic. Some variations allow the virus to spread more easily or make it resistant to treatments or vaccines. Those variants must be monitored more carefully.
  • How the Virus May Change - As a virus spreads, it has a chance to change. As genetic changes happen over time, the virus that causes COVID-19 begins to form genetic lineages. The SARS-CoV-2 virus can be mapped out similar to a family tree. All lineages have names to help scientists talk about them. SARS-CoV-2 lineages with similar characteristics may affect how fast the virus spreads, the severity of illness it causes, or the effectiveness of treatments against it; some of these may be classified by the World Health Organization (WHO) or the U.S. SARS-CoV-2 Interagency Group (SIG). All lineages currently circulating are classified as part of the Omicron variant.

What to Know About the New Covid Variants
EG.5 is spreading quickly, but experts say it’s no more dangerous than previous versions. Another new variant, called BA.2.86, is being closely watched because of its mutations

Concern is rising about the Covid-19 variants EG.5 and BA.2.86. In August, EG.5 became the dominant variant in the United States, and the World Health Organization classified it as a “variant of interest,” meaning it has genetic changes that give it an advantage and its prevalence is growing. BA.2.86 is much less widespread, making up only a tiny fraction of cases, but scientists are alarmed by how many mutations it carries. So how worried should people be about these variants:
  • EG.5 - While severe illness in older adults and people with underlying conditions is always a concern, as is long Covid in anyone who gets infected, experts say EG.5 does not pose a substantial threat — or at least no more of one than any of the other major variants currently circulating. “It’s a concern that it’s increasing, but it doesn’t look like something that’s vastly different from what’s already been circulating in the U.S. for the past three to four months,” said Andrew Pekosz, a professor of molecular microbiology and immunology at Johns Hopkins University Bloomberg School of Public Health. “So I think that’s what tempers my concern about this variant, at this point in time.” Even the W.H.O. stated in its announcement that, based on the available evidence, “the public health risk posed by EG.5 is evaluated as low at the global level.”
  • The variant was identified in China in February 2023 and was first detected in the United States in April. It is a descendant of the Omicron variant XBB.1.9.2 and has one notable mutation that helps it to evade antibodies developed by the immune system in response to earlier variants and vaccines. That advantage may be why EG.5 has become the dominant strain worldwide, and it could be one reason Covid cases have been rising again. That mutation “may mean that more people are susceptible because the virus can escape a little bit more of that immunity,” Dr. Pekosz said.
  • But EG.5, which has also been called Eris, does not appear to have any new capacities when it comes to its contagiousness, its symptoms or its likelihood of causing severe illness. Diagnostic tests and treatments such as Paxlovid continue to be effective against it, Dr. Pekosz said. Dr. Eric Topol, executive vice president of Scripps Research in La Jolla, Calif., said he isn’t overly worried about the variant; however, he would feel better if the new vaccine formulation, which is expected to be rolled out in the fall, was already available. The updated booster was developed based on another variant that is genetically similar to EG.5. It is expected to provide better protection against EG.5 than last year’s shot, which targeted the original coronavirus strain and a much earlier Omicron variant that is only distantly related.
  • BA.2.86 - The other new variant that scientists are watching closely is BA.2.86, nicknamed Pirola. Descended from a different Omicron variant, BA.2.86 has been definitively tied to a few dozen cases of Covid across four continents, but experts suspect it is more widespread. Scientists are particularly concerned about this variant because of the number of mutations it carries. Many of them are in the spike protein, which is what the virus uses to infect human cells and what our immune systems use to identify it. According to Jesse Bloom, a professor at the Fred Hutchinson Cancer Center who specializes in virus evolution, the mutations in BA.2.86 represent “an evolutionary jump similar in size” to the changes in the first Omicron variant compared to the original coronavirus strain.

Tracking SARS-CoV-2 variants

All viruses, including SARS-CoV-2, the virus that causes COVID-19, change over time. Most changes have little to no impact on the virus’s properties. However, some changes may affect the virus’s properties, such as how easily it spreads, the associated disease severity, or the performance of vaccines, therapeutic medicines, diagnostic tools, or other public health and social measures. 

In June 2020, the WHO Virus Evolution Working Group was established with a specific focus on SARS-CoV-2 variants, their phenotype and their impact on countermeasures. This later became the Technical Advisory Group on SARS-CoV-2 Virus Evolution. In late 2020, the emergence of variants that posed an increased risk to global public health prompted WHO to characterize some as variants of interest (VOIs) and variants of concern (VOCs) in order to prioritize global monitoring and research, and to inform and adjust the COVID-19 response. From May 2021 onwards, WHO began assigning simple, easy-to-say labels for key variants.

Considerable progress has been made in establishing and strengthening a global system to detect signals of potential VOIs or VOCs and rapidly assess the risk posed by SARS-CoV-2 variants to public health. It remains critical that these systems are maintained, and data are shared, according to good principles and in a timely fashion, as SARS-CoV-2 continues to circulate at high levels around the world. While monitoring the circulation of SARS-CoV-2 globally, it also remains essential to monitor their spread in animal populations and chronically infected individuals, which are crucial aspects of the global strategy to reduce the occurrence of mutations that have negative public health implications. In March 2023, WHO updated its tracking system and working definitions for variants of concern, variants of interest and variants under monitoring. They can be found here. The previous working definitions can be found here.


What You Need to Know About XBB.1.5, the Latest Omicron Variant
XBB.1.5 is a reminder that we have the tools to fight off COVID—but we need to use them effectively

Four weeks ago, the XBB.1.5 variant caused less than 10% of COVID-19 cases in the U.S. Now it causes more than 25% of them. Virologists including Andy Pekosz, a professor of Molecular Microbiology and Immunology, are paying attention. Should the general public be concerned? Here, Pekosz explains what virologists are seeing, what this new variant means for case rates and treatments, and why it’s so important for more people to get the bivalent booster.

The XBB family of variants emerged a few months ago and caught virologists’ attention because it contains more mutations to evade immunity than any other variant. The XBB.1.5 variant has a mutation virologists believe is helping the virus better bind to cells and thus be more transmissible. The XBB.1.5 virus has quickly become a higher percentage of total COVID cases in the United States. However, we’re not seeing this variant cause the same type of surges in overall cases that omicron did when it entered the population last winter.

This latest variant should be a reminder that we have tools to fight off COVID infection and minimize severe disease: The vaccines are still protecting against severe disease, and antivirals are still capable of treating infection from XBB.1.5. We just have to use these tools more effectively than we have over the last six months. The period of infectiousness for XBB.1.5 is very similar to that of the other omicron variants that have been circulating over the past year: You are contagious one to two days before your symptoms begin, and you are still contagious for at least two to three days after your symptoms begin—though some people can continue to have the detectable live virus for up to a week after symptom onset. After exposure, it may take 5 days before you begin to develop symptoms.


WHO warns new Omicron spinoff XBB.1.16 is ‘one to watch,’ but hasn’t shown to be more severe

The World Health Organization is monitoring the Omicron subvariant XBB.1.16, which has been identified in about two dozen countries. The subvariant has not been found in the United States, but it is similar to the XBB.1.5 subvariant that has been dominant in the country since January.

XBB.1.16 has one additional mutation that, according to lab studies, makes it more infectious and potentially more pathogenic, Maria Van Kerkhove, WHO’s technical lead for Covid-19, said at a recent briefing. “This is one to watch,” she said. “It’s been in circulation for a few months. We haven’t seen a change in severity in individuals or in populations, but that’s why we have these systems in place.”

Most of the samples of XBB.1.16 are from India, where it has become dominant. Weekly Covid-19 cases in the country have more than doubled in the past week but remain far below peak levels, WHO data shows. Omicron remains the variant of concern worldwide and hundreds of sublineages continue to circulate.


What is the XBB Covid-19 variant and should its rapid spread cause concern?
Despite the rise in cases driven by the XBB coronavirus strain, experts said that there is no need to retighten Covid-19 safety measures here

A new Omicron subvariant, known as XBB, has been behind the increase in Covid-19 cases here in recent weeks. 

Health Minister Ong Ye Kung said that this new strain is responsible for half of all daily cases now compared to none just three weeks ago. “So (it is) obviously outcompeting BA.2.75 and also BA.5," Mr Ong told reporters on Tuesday (Oct 11), after he had received his bivalent vaccine at the Commonwealth joint testing and vaccination centre. On the same day, the Ministry of Health (MOH) refuted rumours circulating on messaging platform WhatsApp that there is a rapid and large increase in Covid-19 cases here with severe illness and deaths due to the XBB strain.

“While there is an increase in local cases driven by XBB, including the post-weekend spike this Tuesday, the number of severe cases has remained relatively low,” it said. But is this increase driven by the new strain a cause for concern and should Singapore retighten Covid-19 safety measures?


What is known about new Covid variant XBB.1.5?

A new Covid sub-variant is causing some concern in the US, where it is spreading rapidly. Some cases have also been recorded in the UK, so what do you need to know about XBB.1.5? It is yet another offshoot of the globally-dominant Omicron Covid variant. Omicron has outperformed the earlier Alpha, Beta, Gamma and Delta coronavirus variants since emerging in late 2021.

Omicron has also given rise to many more contagious sub-variants. XBB.1.5 evolved from XBB, which began circulating in the UK in September 2022. XBB had a mutation that helped it beat the body's immune defences, but this same quality also reduced its ability to infect human cells. Prof Wendy Barclay from Imperial College London said XBB.1.5 has a mutation known as F486P, which restores this ability to bind to cells while continuing to evade immunity. That makes it spread more easily. She said these evolutionary changes were like "stepping stones", as the virus evolves to find new ways of bypassing the body's defence mechanisms.

The Wellcome Sanger Institute in Cambridge is sequencing at least 5,000 Covid samples a week, as part of continuing efforts to track variants. The institute's Dr Ewan Harrison thinks XBB.1.5 probably emerged when someone got infected with two different Omicron types. "A bit of the genome from one virus gets joined up with another bit from a second virus, and they merge, and that goes on to transmit." The World Health Organization (WHO) confirmed that XBB.1.5 has a "growth advantage" over other sub-variants seen so far. But the WHO said there was no indication so far that it was more serious or harmful than previous Omicron variants.


What COVID-19 variants are going around in September 2023?

There are currently more than 5,772 patients hospitalized in the United States per week, with 15% of those being ICU patients. The most recent data on the test positivity rate is from the week of June 2-8, which was 7.2%. When test positivity is above 5%, transmission is considered uncontrolled. Since many are using home tests that are not reported through public health or are not testing at all, the official case counts underestimate the actual prevalence of COVID-19.

What COVID-19 variant are we on? Currently, the dominant variant nationwide is EG.5, with 21.5% of cases, followed by FL.1.5.1, with 14.5% of cases, and XBB.1.16.6 with 9.2% of cases. "The original omicron variant is gone now," says Dr. Rupp. "Currently subvariants of omicron are circulating, including EG.5, XBB.1.5, and XBB.1.16."

In the week ending September 2, 2023, there were 4,726 COVID-19 tests performed in Nebraska, with 649 positive results. This is a 13.1% positivity rate, down 2.1% from the week prior. When you receive a COVID-19 test, you won't find out which variant caused your infection. That's because COVID-19 tests only detect the presence of the virus – they don't determine the variant. Genomic sequencing looks at the genetic code of the virus to determine which variant caused the infection.


New variant spreading across UK - as overall cases continue to rise
Scientifically known as EG.5.1, it is descended from the Omicron variant of COVID, and already accounts for one in seven new cases, UKHSA data shows

A new COVID variant is spreading across the UK, according to the UK Health Security Agency (UKHSA) - and already makes up one in seven new cases. Scientifically known as EG.5.1, it is descended from the Omicron variant of COVID. The UKHSA has been monitoring its prevalence in the country due to increasing cases internationally, particularly in Asia, and it was classified as a variant here on 31 July.

In the week beginning 10 July, one in nine cases were down to the variant. The latest data suggests it now accounts for 14.6% of cases - the second most prevalent in the UK. It appears to be spreading quickly and could be one reason why there has been a recent rise in cases and hospitalisations. COVID-19 rates have continued to increase - up from 3.7% of 4,403 respiratory cases last week to 5.4% of 4,396 this week. The latest data also shows the COVID-19 hospital admission rate was 1.97 per 100,000 population, an increase from 1.17 per 100,000 in the previous UKHSA report.

Officials say they are "closely" monitoring the situation as COVID case rates continue to rise. "We have also seen a small rise in hospital admission rates in most age groups, particularly among the elderly," said Dr Mary Ramsay, head of immunisation at the UKHSA. "Overall levels of admission still remain extremely low and we are not currently seeing a similar increase in ICU admissions. "We will continue to monitor these rates closely."


SARS-CoV-2 variants of concern as of 21 September 2023

Variant classification serves as an important communication tool for alerting EU/EEA countries about the emergence of SARS-CoV-2 variants with concerning properties likely to impact the epidemiological situation in the EU/EEA.

ECDC utilises three categories of variant classification to communicate increasing levels of concern about a new or emerging SARS-CoV-2 variant: variant under monitoring (VUM), variant of interest (VOI) and variant of concern (VOC). ECDC variant classification criteria and recommended Member State actions are outlined here.

New evidence is regularly assessed on variants detected through epidemic intelligence, rules-based genomic variant screening, or other scientific sources. If a decision is made to add, remove, or change the category for any variant, the tables are updated to reflect this change. The tables are regularly sent for consultation to ECDC and WHO Regional Office for Europe’s joint virus characterisation working group.


As a new variant emerges, is Covid coming back to the UK?

Vaccines, available only to h.igh-risk groups, have been brought forward as cases begin to rise and the British winter looms.

The vaccine campaign against Covid-19 has just been brought forward by a month in the face of changes in the disease’s behaviour. The decision was made as the UK heads into autumn and has raised concerns that the nation faces a new wave of a disease that triggered a national lockdown three years ago. Here we look at the issues involved and scientists’ responses to the threats that lie ahead.

Are cases on the rise? Scientists say that the daily number of new positive tests and the proportion of tests coming back positive have been increasing since the end of June. In addition to waning immunity to Covid-19, poor summer weather and the screening of blockbuster films such as Barbie and Oppenheimer may have caused increased indoor mixing, setting off rises in infections.


What is the new Covid-19 strain ‘Pirola’ and should Singapore be worried about its spread?

A new Covid-19 virus strain BA.2.86, also known as “Pirola”, is raising eyebrows among global health experts due to its numerous mutations that could have implications on its infectivity. While research is ongoing, vaccines are expected to remain effective in mitigating severe complications from infection.

Pirola is a newly recognised variant of Omicron, an earlier variant of the original Sars-CoV-2 coronavirus that causes Covid-19. In Singapore, the Ministry of Health (MOH) said that no cases of Pirola have been identified so far. Responding to queries about whether Singaporeans should be concerned about the spread of this new strain, it said on Wednesday (Sept 6) that prevailing Covid-19 vaccines in the national vaccination programme "continue to offer good protection against severe disease".

"The Ministry of Health will continue to closely monitor BA.2.86 and other emerging Sars-CoV-2 variants, as well as vaccine developments." The new strain has more than 30 mutations to its spike protein compared to earlier Omicron subvariants, which is why it has been dubbed a “variant under monitoring” by the World Health Organization (WHO).

related:


The 'highly mutated' COVID variant BA.2.86 — known as Pirola — has landed in Australia

A new COVID variant nicknamed "Pirola" has been detected in Australia after sparking a sped-up vaccination program in the United Kingdom. A new variant in itself is not unusual — viruses evolve and change over time, and new mutated versions pop up frequently. However, this one caught the attention of scientists.

What is BA.2.86, aka the Pirola variant? According to the British Medical Journal, Pirola appears to have evolved from the Omicron subvariant BA.2, which was widely circulating in early 2022. One case has been detected in Australia, in a laboratory in Western Australia, genomic sequencing data shows. However, there could be more out there because only a fraction of all COVID-19 infections get submitted to for testing. WA's health department said the case in Australia was "closely related – without significant differences – to those BA.2.86 strains reported from other countries".

The World Health Organization labelled BA.2.86 a "variant under monitoring" — which means they're keeping a close eye on it — in mid-August. It has not been formally called a "variant of concern" yet or given a Greek name like Omicron or Delta. Pirola is an informal nickname the variant received on social media from a community who track COVID variants.


Pirola Covid strain: What are the symptoms of the new variant?

The highly mutated new Covid variant Pirola has seen cases spike in the UK promoting the UK government to bring forward autumn jabs.

Pirola, or BA.2.86, is the latest Omicron strain to appear this summer, sparking concern among experts because it has 34 more mutations, which could make it easier to evade vaccines. Its emergence comes as the UK has seen 100,516 new cases of Covid as of 10 September, according to The Zoe Health Study.

Pirola has so far been detected in 15 countries worldwide, according to the Covid variant tracker GISAID. including:
  • Denmark
  • France
  • USA
  • Sweden
  • Thailand
  • Israel
  • Spain
  • Canada
  • Portugal
  • Australia
  • Germany
  • South Korea
  • Japan

What to Know About EG.5 (Eris)—the Latest Coronavirus Strain

A Yale Medicine expert explains whether EG.5 is more transmissible or severe than previous Omicron subvariants. Viruses mutate, so it was only a matter of time before yet another new SARS-CoV-2 strain (the virus that causes COVID-19) emerged and started to spread.

This summer, that strain is called EG.5, or, informally, Eris (nicknamed after the Greek goddess of strife and discord). A descendant of Omicron, Eris is already the dominant coronavirus subvariant in the country, infecting more people than any other single strain. So far, EG.5 isn’t setting off any alarms as far as disease severity, although early reports show it may be more transmissible—it has surpassed XBB.1.16 (or Arcturus), another highly contagious Omicron subvariant that was in the news just a few months ago.

“I am not aware of data that suggests EG.5 leads to worse cases of COVID-19 compared to prior variants,” says Scott Roberts, MD, a Yale Medicine infectious diseases specialist. But early reports have shown EG.5 has been spreading faster than any other currently circulating strain. Dr. Roberts answered questions about the summer uptick in COVID-19 cases and shared what we need to know about EG.5.


What to know about 'Eris,' the new COVID-19 subvariant sweeping the US

The EG.5 "Eris" variant is now the dominant COVID-19 strain in the U.S. Here's what to know about transmission and symptoms. A new COVID-19 variant called EG.5 is sweeping across the United States as cases and hospitalizations rise. The fast-spreading subvariant, nicknamed Eris, is now the dominant strain circulating in the U.S., health officials say.

Right now, EG.5 accounts for the largest proportion of COVID-19 infections in the U.S., more than any other variant, according to the latest data from the U.S. Centers for Disease Control and Prevention. EG.5 is a subvariant of omicron and a descendant of the XBB sublineage, which means it’s related to the previous dominant strains circulating this past year. According to the CDC, EG.5 made up an estimated 20.6% of new COVID cases during a two-week period ending on Aug. 18.

After EG.5, the next most common subvariant was another omicron XBB descendant, FL.1.5.1, which accounted for 13.3% of cases, and XBB.1.16 (also called “Arcturus”), which made up 10.7% of cases. On Aug. 9, the World Health Organization decided to classify EG.5 to a “variant of interest." According to the latest WHO data, EG.5 and XBB.1.16 are now the most prevalent COVID-19 strains worldwide, both accounting for 21% of sequences globally.


New COVID variant BA.2.86 is now in 5 states. Here's what to know

It has been detected in Michigan, New York, Ohio, Texas and Virginia. More health officials across the U.S. are reporting new cases of the COVID variant BA.2.86. On Thursday, a genome sequencing team at Houston Methodist Hospital said it had identified the first case in Texas, a member of team wrote on X, formerly known as Twitter. On the same day, Ohio Department of Health Director Dr. Bruce Vanderhoff confirmed that one case has been detected in his state.

These states join Michigan, New York and Virginia, according to health officials and the open global genome sequencing database GISAID. There have been hundreds of variants of the original SARS-CoV-2 virus that led to the COVID-19 pandemic in January 2020, but most eventually disappear. Public health experts around the world are keeping track of BA.2.86 because of its high number of mutations. "It is starting to spread here in the United States, as well as in other parts of the world. It's clearly contagious, as are all of these subvariants of omicron," Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, told ABC News. "As we all know, these COVID viruses are not localized just to one country or another. They don't need a passport. They're capable of spreading ... and can spread rapidly around the world."

BA.2.86 was the strain first detected in Denmark on July 24 of this year, then Israel, followed by Michigan in August. It has since been reported in Canada, England, France, Portugal and South Africa, according to GISAID. It has more than 30 mutations to the spike protein -- which the virus uses to attach to and infect cells -- and is why Schaffner said he and other experts believe it may be contributing to the increase in COVID hospitalizations in the U.S.


WHO skips two letters in Greek alphabet in naming Omicron COVID variant
The World Health Organization dubbed the next coronavirus variant rising in South Africa as Omicron. REUTERS/Denis Balibouse

The emergence of the Omicron variant of COVID-19 has international health experts worried, financial markets roiled and the Internet confused over how the new name was chosen.

The World Health Organization appeared to skip two letters in the Greek alphabet when it announced Friday the name for the latest coronavirus variant, which was first identified in South Africa.

Nu and Xi were apparently the next letters in the Greek alphabet that have yet to be used for a variant, according to data on their website. Internet pundits and politicians speculated that the group skipped Nu to avoid confusion with the word “new” and passed on Xi because of its written similarity to the name of Chinese leader Xi Jinping.


WHO Skips Two Greek Alphabets When Naming Omicron Covid Variant

No Xi Variant? Is It Fear Of China?

The World Health Organization skipped two letters of the Greek alphabet when naming omicron, a newly identified variant of the Covid-19. The agency reportedly skipped ‘nu’ to stop the confusion with new and ‘xi’ to avoid offending Chinese leader Xi Jinping.

Omicron was first reported to WHO by scientists in South Africa and has been identified in several other countries as well.


A note on COVID-19 and its variants

In an effort to make it easier for the public and media to discuss variants, WHO convened experts from various organizations and divisions of WHO to “consider easy-to-pronounce and non-stigmatizing labels.” Which is why there are now Greek Alphabet names for the various variants, at least those that WHO has declared “Variants of Concern” and “Variants of Interest.”

Wuhan or wildtype - The first strain to be identified that originated in the city of Wuhan, China. Greek Alphabet names for the various variants:
  • Alpha (UK) - Dubbed B.1.1.7, the UK variant was first identified in the fall of 2020. It spreads more easily and quickly than other variants, according to the CDC, and potentially is 30% more lethal than the wildtype version, although that is still being investigated. It was first detected in the U.S. at the end of December 2020.
  • Beta (South Africa) - Dubbed B.1.351, it emerged independently of B.1.1.7 (UK) and was first detected in South Africa in early October 2020. It shares some of the same mutations as the UK strain. Cases in the U.S. were first reported at the end of January 2021. At this time, it is the variant that has most experts the most concerned, because it seems less responsive to existing vaccines and antibody therapies. That said, current evidence suggests it does respond to them, just not as well as the other major known variants.
  • Gamma (Brazil) - The Brazilian variant is called P.1 and was first identified in people traveling from Brazil during routine testing in Japan, in early January. It appears to have a group of additional mutations that affect its ability to be recognized by antibodies, according to the CDC. It was first observed in the U.S. at the end of January 2021.
  • Iota (New York) - This variant first appeared in New York City and then sporadically in the northeast. It has been named B.1.526. It has been named B.1.526. One of the mutations is similar to that seen in the South African variant that seems to help it evade the body’s response to vaccines. The data on this has, as of February 25, 2021, not been peer-reviewed. The mutation of concern is called E484K, which has been observed in at least 59 different lineages of coronavirus. This means it is evolving independently around the world in what is called convergent evolution.
  • California - This variant is called B.1.427/B.1.429 and appears different than the UK variant. One of the mutations, called L452R, affects the virus’s spike protein, which may allow it to attack itself more efficiently to cells, making it more infectious. Again, like the New York variant, the data has not yet been peer-reviewed. However, it appears to be associated with severity of disease and increased risk of high oxygen requirement. In particular, this virus appears to be prevalent in the San Francisco area.
  • Delta (India) - The Indian strain what is being dubbed a “double mutant” variant, B.1.617, which had two key mutations observed in other coronavirus variants. The variant was actually first sequenced in a global database of COVID-19 variants in October 2020, but went largely unnoticed. The B.1.617 strain carries features from two lineages, the California variants (B.1.427 and B.1.429) and the ones in South Africa (B.1.351) and Brazil (P.1). The Indian variant’s two prominent mutations include a position 452 of the spike protein and the second at 484. It is believed that existing vaccines should be effective against the variant. It is believed to be about 60% more contagious than the Alpha variant.
  • Mu or B.1.621, in September 2021 was categorized by the WHO as a “variant of interest.” It appeared to originate in January 2021, in Columbia, but does not appear to have spread much around the world.

COVID-19: The Omicron Variant

Singapore is experiencing a 23 per cent week-on-week increase in COVID-19 community cases, driven largely by the Omicron subvariants BA.4 and BA.5, said the Ministry of Health (MOH) on Tuesday (21 June). While the BA.2 subvariant still accounts for the bulk of Singapore's cases, the proportion of BA.4 and BA.5 infections is rising, MOH said in a press release.

About 30 per cent of community cases in the past week were that of the BA.4 and BA.5 subvariants compared to 17 per cent, 8 per cent and 3 per cent for the previous three weeks, respectively. "The surge in BA.4 and BA.5 cases is likely to continue, driven by their higher transmissibility compared to BA.2," said MOH. The country confirmed its first three cases of the BA.4 and BA.5 variants, which have been driving South Africa's fifth COVID wave, in May.

Current safe management measures, including the requirement to wear masks while indoors and vaccination-differentiated measures for some higher-risk activities, will remain, MOH added. It will also continue genomic surveillance for circulating subvariants in Singapore, including requiring some infected cases to take an additional government-funded polymerase chain reaction swab for genomic sequencing.


COVID-19: The B117 Strain
B16172 - The India Variants

Why vaccinated people dying from Covid-19 doesn't mean the vaccines are ineffective. Former US Secretary of State Colin Powell died on Monday of Covid-19 complications. His family announced that he was fully vaccinated. He was 84 years old, and had multiple myeloma, a blood cancer.

Health officials worry that anti-vaccine activists will seize upon Powell's death to make the claim that vaccines don't work. If you can still die after being vaccinated for Covid-19, what's the point of getting the vaccine?

What's the answer to that question? I discussed it with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of a new book, "Lifelines: A Doctor's Journey in the Fight for Public Health."


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