CMAAO Coronavirus Facts and Myth Buster: New CDC School Guidance; New local mutations in Maharashtra; Post-acute sequelae of SARS-CoV-2 infection

Dr KK Aggarwal President CMAAO, HCFI

With input from Dr Monica Vasudev

1401: New CDC COVID-19 school guidance

1.   The CDC has issued new guidelines for in-person learning, without recommendation for vaccinations for teachers first.

2.   Looking at elementary schools and COVID-19 cases in Atlanta early in the pandemic, the agency reported nine clusters of linked cases. Eight of these included at least one teacher. The trigger behind the spread is unclear, but in seven of these clusters, teachers were reported to have worked in close proximity to the students. Additionally, students were reported to have removed masks to eat lunch in the classroom, which may have a contribution in the spread.

3.   While the agency stated that there is little evidence of in-school transmission but opening up schools without vaccinating teachers is not without risk.

4.   Dr. Anthony Fauci, the NIAID Director had said that teachers are a priority group among essential personnel, adding that if they’re not vaccinated, it does not mean that we don’t open the school.


1402: What is known about the new home grown COVID-19 mutations in Maharashtra

Like California, new home-grown mutations are also occurring in many states in India. Each of them has RBM substitution mutation which can lead to a rise incases if there is a super spreader and virus appropriate behavior. The mutations will be a variant of concern for that particular country but not of global concern unless there are associated deletion mutations.

1.   Maharashtra has witnessed a rise in COVID-19 cases over the past week, with 5,210 new cases reported on Monday.

2.   Two new independent local variants of the virus have been found in samples in the Vidarbha region.

3.   Since February 15, over 2,400 cases have been recorded in Amravati district, and 500 new cases in Yavatmal district.

4.   E484K mutation of the virus in four samples from Amravati was detected.

5.    N440K mutation was also detected in one sample from Yavatmal. The N440K variant had been identified in Andhra Pradesh and some parts of north India in December last year.

6.    Officials stated that E484K and N440K variants had been identified in samples from Maharashtra, Kerala and Telangana.

7.    In India, more than 241 different mutations have been reported thus far, but the new ones identified in Maharashtra have been a cause for concern as their presence has been detected at a time when cases have increased significantly in those districts.

8.    In Maharashtra, the E484K mutation was first identified in four out of 12virus-infected blood samples from Amravati. In all the four cases, there was no travel history outside of the district, and they had not been in contact with each other, but their entire families tested positive for COVID-19.

9.    265 samples from Amravati, Yavatmal and Akola district have been sent to Pune’s BJ Medical College for genome sequencing.

10.  The samples have been taken from patients who died of COVID-19, asymptomatic patients, and those with mild and severe symptoms.

11.  Genome scientists at the Council of Scientific and Industrial Research noted that the N440K variant was able to evade antibodies generated by the body’s immune system.


1403:  Post-acute sequelae of SARS-CoV-2 infection or PASC. Dr Anthony Fauci has introduced a new acronym for long COVID. He stated that even patients with moderate infection can develop PASC. The symptoms include fatigue, gastrointestinal problems, brain fog, or an inability to focus, depression, anxiety, sleep difficulties, and impaired lung capacity in some extreme cases.

New symptoms may develop well after the time of infection, or they may evolve overtime and continue for months altogether. The symptoms can range from mild to incapacitating.

Dr Fauci citeda study from the University of Washington published online February 19 in JAMA Network Open wherein over 30% of the 177 participants reported symptoms that persisted for up to 9 months.


Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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