HOW I FOUND MY RHYTHM WHEN THE MUSIC STOPPED

At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.

….FULL ARTICLE

THE MAN IN A BLUE SARONG

I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.

….FULL ARTICLE

PATIENT “OWNERSHIP”

I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.

….FULL ARTICLE

Use the buttons below to scroll through more great articles from Kentucky Doc Magazine

MORE ARTICLES

Be Sociable, Share!

Share on Facebook Share on Twitter Share on Delicious Share on Digg Share on Google Bookmarks Share on LinkedIn Share on LiveJournal Share on Newsvine Share on Reddit Share on Stumble Upon Share on Tumblr

MORE ARTICLES

CONTACT INFORMATION

© Kentucky Doc Magazine - All rights reserved | Designed & Maintained by PurplePatch Innovations

MORE FROM ROCKPOINT PUBLISHING

KENTUCKY DOC MAGAZINE

HOME | FEATURE ARTICLES | COLUMN ARTICLES |  COMMUNITY NEWS  | DIGITAL ISSUES | ABOUT | CONTACT

spread. The first letter A is assigned to those mutants arising directly from the original China strain, B to those from the first Italian isolates. Subsequent extensions (ie: B.1.1) indicate the succeeding mutant variant from the immediate ancestor B.1 line. The UK virus designation B.1.1.7 indicates the 7th variant that was identified arising from the B.1.1 mutation lineage and the S. African strain B.1.351 is the 351st variant arising from the B.1 ancestor.


There is so much mutational activity that even this system has problems of this system had become too cumbersome for public discussion. In consensus, around Feb 2021; WHO, CDC and other research groups implemented a more useful labeling of current significant SARS-CoV-2 strains. Letters of the Greek alphabet have been assigned to the most significant variants. The Alpha variant was originally “UK”, the Beta was “South Africa”, Gamma was “Brazil”, Delta had no previous country of origin name but arose in Peru in Aug 2020 and is now the predominant virus in the world. There are currently at least 3 mutational spin-offs from the Delta SARS- CoV-2 stain (B.1.672.1) designated as subgroups AY, AY2,AY3. They have no mutations that make them more or less dangerous than the original Delta strain.


Mu is the latest added variant which was first noticed in Colombia and Ecuador in Jan 2021, but has minimally spread out of S. America and is decreasing as Delta is replacing it. Epsilon, Kappa, and Iota variants are also named but are of very little interest. Of note — there is no C, F, J, ,Q or V in the Greek alphabet. Non-English “fraternity” favorites you might recognize are Psi, Phi,Theta, Chi and Omega; which will probably be used in the not to distant future.


To help prioritize the importance of the variants the U.S. SARS-CoV-2 InterAgency Group (SIG) assigns each to one of 3 categories based on their genetic and clinical risk profiles.




Below are profiles of the variants with WHO or SIG assigned categories as of Sept 3.



In conclusion, more variants will arise every month around the world. One hopeful observation from the genetic studies of the variants is that increased mutations in transmissibility capabilities seems to diminish the number of mutations in genes that promote severe disease. The more deadly variants are at a competitive disadvantage with the highly contagious variants like Delta during viral surges. It seems that variants are unlikely to be both highly transmissible and highly lethal.



References


In the beginning of 2020 the world learned there was a “Novel Corona Virus” in China, which over 8 weeks became pandemic and the media added additional labels. Some of these were: Covid-19 virus, China Virus, Wuhan Virus, KungFu Virus. Eventually the scientific community settled on SARS-CoV-2. Early on the U.S. was infected with 2 strains, only slightly genetically different; one in New York City (directly from Europe) and the other on the West Coast (directly from China). By fall 2020 global viral proliferation had given rise to large clusters of mutated virus that had higher contagion ability and slightly higher morbidity/ mortality. The earliest of these became known as the UK and South African variants.  They were labelled B.1.1.7. and B.1.351 in the most popular system used by the scientific community. The media and even the CDC and WHO largely used the UK and South African monikers. Soon a Brazilian variant also joined the discussion. Having multiple systems for naming the virus has been confusing for everyone—the public, media, government agencies, and even the scientists studying the viruses. Some history of the nomenclature follows.


In traditional viral taxonomy, SARS-CoV-2 is a member of the Coronavirus subfamily, a single stranded RNA virus subfamily that primarily infects mammals and birds. Genus and “species” of virus are designated mostly by the species they infect or the disease they cause. Corona virus genomes are 26-32,000 nucleotide bases in length, with 9-12 genes. Mutations are very common during replication. Hundreds of mutant virus occur and are secreted in the mucus and breath from every patient infected, whether they are symptomatic or not.

BY TERRY CLARK, MD, FCAP

The vast majority of these are defective. Rarely, they can be more virulent.


As the Covid-19 outbreak progressed, numerous mutant clones rapidly evolved; only a few clinically important. A new system was needed to label the important ones. The popular method of labeling them by the country in which they first blossom into public notice is not necessarily accurate as to origin and has nothing do with their pathogenic properties. The most populated countries have multiple variants arising.


The Global Initiative on Sharing Avian Influenza Data (GISAID) monitors the mutant influenza strains that emerge globally every year. They help the manufacturers to modify flu vaccines to be effective. When the Covid-19 pandemic hit they undertook to create a database of all of the laboratories doing genomic sequencing of the SARS-CoV-2 isolates. Several different systems of identifying the variants have been used, but most prevalent in the literature is the alphabet-numeric system is called “Pango” (ie; B.1.1.7). There is a computer program (Pangolin, there are already 3 generations) used by participants in the GISAID data base. This identification algorithm, proposed around April 2020, attempts to trace the virus mutants along their evolutionary lines since the early