Coronavirus variants and what we know

Omicron is the newest coronavirus variant and is also the quickest to be labeled as a variant of concern by the World Health Organization.

Its emergence has already led to travel restrictions, while high-level government meetings and vaccine makers promise to start working on strain-specific vaccines just in case.

It has a long way to go to take over from Delta, the current variant that dominates all over the world. There’s a long list of variants that at first frightened the world before falling off the map can be a reminder that viruses are unpredictable.

WHO designates coronavirus variants as either variants of concern. The five currently meet the definition for variants of concern: Alpha, Beta, Gamma, Delta and Omicron.

The first sample of the Omicron was taken November 9. It got noticed because of a surge of cases in South Africa.

Some of those mutations were already recognized from other variants and were known to make them more dangerous, including one called E484A.

It also carries a mutation called N501Y, which gives both Alpha and Gamma their increased transmissibility. Like Delta, Omicron also carries a mutation called D614G, which appears to help the virus better attach to the cells it infects.

What worries scientists is the number of mutations affecting the spike protein. That’s because most of the leading vaccines target the spike protein. Vaccines made by Pfizer/BioNTech, Moderna, Johnson & Johnson, AstraZeneca and other companies all use just small pieces or genetic sequences of the virus and not whole virus. So a change in the spike protein that made it less recognizable to immune system proteins and cells stimulated by a vaccine would be a problem.

There’s no evidence this has happened but there is no way of knowing by looking at the mutations alone. Researchers will have to wait and see if more breakthrough infections are caused by Omicron than by other variants.

Delta

The Delta variant of coronavirus is now the dominant lineage in the US and much of the world. The Delta variant accounts for 99.9% of cases in the US, according to the US Centers for Disease Control and Prevention. It quickly took over from the Alpha variant in most countries.

Delta also carries a cluster of mutations on the spike protein. It can also evade the immune system, which may mean people who have been infected once with an older variant may be more likely to catch it again. 

Alpha

First identified as a variant of concern last December, the Alpha variant of coronavirus was worrying public health officials last spring. It swept across England quickly and then out into the world, quickly becoming the dominant lineage in the United States. It has now been demoted to “Variant Being Monitored” by the CDC because of its low impact in the US.

It was shown to be at least 50% more transmissible than older lineages. It carries 23 mutations, including one called N501Y that increases transmission. It’s fully susceptible to monoclonal antibody treatments and vaccines.

Beta

First seen in South Africa, the Beta variant has both an E484K mutation that is linked with immune escape and the N501Y mutation suspected of helping make many other variants more contagious. It has been shown to be 50% more transmissible than older strains.

Blood tests and real-life use both suggest it can infect people who have recovered from coronavirus and also people who have been vaccinated against Covid-19.

It was overtaken by Delta in South Africa and has never gained much of a foothold in the US, despite the worry it caused, and is now designated a Variant Being Monitored by the CDC.

Gamma

The P.1 or Gamma variant that swept Brazil also never gained much ground elsewhere and is also now a CDC Variant Being Monitored.

Gamma carries both E484K and N501Y mutations, with more than 30 others. It has been demonstrated to evade the effects of Lilly’s monoclonal antibody treatment but not one made by Regeneron. Blood tests show it might partly escape both natural and vaccine-elicited immune responses.

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Yes, there will be a flu season this year, CDC says

Flu season might be getting underway. While influenza activity is very low in the United States, it’s getting started and there’s enough to indicate that there will be at least some kind of flu season this year. THis is much different from last year, when an emphasis on frequent handwashing, mask use, closures of schools and businesses, and social distancing shut down transmission of the virus.

It’s always impossible to predict what a flu season will look like, but reports of more flu cases have caught her team’s attention and have her thinking flu season may have returned after its one-year break.

The CDC estimates that the flu kills anywhere from 12,000 to 61,000 people a year in the United States. During the first week of November, 14% of deaths were attributable to influenza, pneumonia or Covid-19. Only 0.3% of specimens tested came back positive for influenza this past week, and just 295 people have been hospitalized for flu.

The CDC confirmed it was helping state and local health officials in Michigan investigate an outbreak of more than 500 cases among students at the University of Michigan, the biggest outbreak so far.

Influenza is complicated because several different types and strains circulate. A strain known as H3N2, which has been around for decades, is what’s infecting people. Flu vaccines also protect against a strain known as H1N1, which appeared and caused a mild pandemic in 2009, as well as two influenza B strains.

The CDC recommends that just about everybody six months and older should get a flu vaccine every year. That’s because the virus mutates and the formulation often gets tweaked, but also because people’s immunity changes from year to year.

Brammer said vaccine manufacturers are projecting they’ll make 200 million doses of flu vaccine this year, which is the biggest supply ever.

Many Americans are also being advised to get booster doses of Covid-19 vaccines and it’s safe and convenient to get them together. The CDC, however, is worried because flu vaccination appears to have fallen behind schedule.

The CDC says, however, that overall more people say they plan to get vaccinated against influenza this year than last year. It says 58.5% of people surveyed say they plan to get a flu shot, compared to 54.8% who got one last year.

The CDC found that 70.6% of adults who are vaccinated against coronavirus or definitely plan to get a Covid-19 vaccine have received or intend to receive a flu vaccine for the 2021-22 season. Just 11% of adults who say they probably or definitely will not get a coronavirus vaccine say they’ll get a flu vaccine.

So far, 162.5 million doses of flu vaccine have been distributed. Vaccine manufacturers are continuing to make and distribute flu vaccines.

 

 

Health plans have improved their digital member engagement efforts, but they have more opportunities to tailor their activities to improve care management.

In 2021, Wellframe surveyed 1,126 health plan members across the United States to better understand the expectations of healthcare consumers. Respondents spanned three age groups 18–34 (32%), 35–55 (32%), and 55+ (36%).

While most respondents indicated positive experiences with digital advocacy and personalized care , a large minority wants more from the health plans.

Building on these positive experiences of digital advocacy can bridge the gap between what members want and what health plans can do to help. Digital advocacy can address all of these concerns by giving members a single person to reach out to from their smartphone.

When it comes to personalized care, 49 percent indicated they received health information that was too generic and lacked personalization. The majority of members are interested in services that enable them to find and schedule appointments with providers suited to their individual health needs. Something as simple as making care advocates available to these individuals could streamline this process.

Chronic disease is prevalent among the United States population. The Centers for Disease Control & Prevention (CDC) reports that 60 percent of adults live with one chronic disease and 40 percent live with two or more.

Managing chronic diseases is a daily activity, one which members often struggle to handle on their own. More than one-third of respondents say they are proactively managing their health “somewhat well” or “not well” between doctor’s visits.

Without a doubt, the COVID-19 pandemic has shone a light on challenges to accessing necessary care during a public health crisis. Mental health services are in high demand, with 38 percent of respondents seeking support from their health plans since March 2020. Of those with mood disorders, that percentage is nearly twice as high. There is much more that payers can do to address mental health coverage and access, especially in light of a growing body of literature indicating a strong connection between physical and behavioral health.

A lack of care access is an even greater threat to members facing a variety of barriers due to social determinants of health. Nearly a third of respondents have a household income below $20,000. Of these vulnerable individuals, nearly one in five had difficulty finding a provider and/or making appointments, and a similar percentage lacked availability to meet with a provider. Considering the prevalence of chronic disease and the risks associated with missed care, health plans must identify opportunities to support these members. Robust care management technologies can empower care plans to provide greater convenience and improve communication with members.

Members view their health plans as a means to a healthier life. The time is ripe for health plans to implement digital tools and services that eliminate the inefficiencies that have historically plagued the healthcare system and forced individuals to forgo care or neglect their health. The solution is to meet members where they are and provide resources tailored to their specific needs.

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