New Coronavirus News from 11 Jan 2022

What Is 'Flurona'? Cases of Co-Infections Increase Amid Peak Influenza Season and Omicron Variant Surge [Smithsonian, 11 Jan 2022]

By Elizabeth Gamillo

In the United States, most infections are being reported in young children and teens
As the flu season in the United States hits its peak, scattered cases of individuals testing positive for Covid-19 and the flu are emerging, reports Ed Cara for Gizmodo. Cases of so-called "flurona" refer to simultaneous infections of both SARS-CoV-2, the virus that causes Covid-19, and influenza. Flurona is not a new virus, nor is it an official medical term or diagnosis.

“Yes, it is possible to catch both diseases at the same time,” the World Health Organization (WHO) explains in a statement. “The most effective way to prevent hospitalization and severe Covid-19 and influenza is vaccination with both vaccines.”

Reports of co-infection in the U.S. have occurred since the pandemic began in 2020. For instance, a New York man was seen at a hospital for fever and a severe cough in late February 2020. At this time, the city had not reported any cases of Covid-19. After being swabbed, the man tested positive for influenza, and he was also swabbed for Covid-19. When the results came in few weeks later in early March, he found out he had also tested positive for Covid-19, reported Roxanne Khamsi for the Atlantic in November 2021.

By late summer 2020, experts cautioned of the possibility of a “twindemic” where both Covid-19 and flu cases could threaten to overwhelm hospitals with infected patients, per the Atlantic.
However, the rises of co-infection did not occur during the 2020 to 2021 flu season, possibly due to mask-wearing and social distancing, and overall, flu cases were actually lower than usual.

Still, more recently, experts anticipate more co-infection cases as the Omicron variant continues to surge and infect a record-breaking number of Americans during peak flu season, reports Nathan Place for the Independent.

More reported cases of flurona, or a dual infection of the flu virus and coronavirus, have already been reported in various parts of the globe. In the first week of January, Israel confirmed its first case of flurona when an unvaccinated pregnant woman with mild symptoms tested positive for both the seasonal flu and Covid-19, per the Times of Israel.

A growing number of co-infection cases in children are also being reported in the U.S., reports the New York Times’ Amelia Nierenberg. A teenager from Los Angeles tested positive for both Covid-19 and the flu last week after returning from a family vacation in Mexico. Hospitals in South Florida and in Houston, Texas, have also reported flurona cases in children and teens, per the Independent. Officials say this is no surprise since younger age groups are more susceptible to co-infection than adults.

Experts are still debating whether co-infection is more severe than only having Covid-19 alone, per the Independent. With more reports on the rise, doctors and public health experts are emphasizing that vaccines against Covid-19 and influenza are the best way to protect against cases of severe infection, reports Jennifer Hassan for the Washington Post.

Here’s a breakdown of what experts know so far:
Will a Co-Infection Make Individuals Twice as Sick or Worse?

“I expect to see plenty of co-infections (of flu and COVID-19) going forward, but I don’t see anything that suggests it makes COVID infections worse,” says Frank Esper, a physician at the Cleveland Clinic Children’s Center for Pediatric Infectious Diseases, to USA Today’s Adrianna Rodriguez. “Those are two viral pathogens that we actually have medicines for.”

While a dual infection could cause more complications, it could also trigger an even more robust defense response because immune system can simultaneously create antibodies for multiple pathogens, says Andrew Noymer, an epidemiologist who studies influenza at the University of California Irvine, to the New York Times.

Which Groups Are More Susceptible to a Co-Infection?

Immunocompromised individuals and children, especially those who are too young for Covid-19 vaccines, are more likely to develop flurona symptoms.

Children are more likely to get multiple infections at once, like walking Petri dishes, per the New York Times. Children generally experience co-infections more frequently than adults.

Despite the presence of two viruses in their systems, children don't seem to become much sicker.

Because children haven't been exposed to most common viruses yet, their immunity has not been built up against different viral strains of the flu, USA Today reports. However, this does not mean that children will be overwhelmed with flurona. Covid-19 cases in children have been milder than those in adults.

Unvaccinated adults are also more susceptible to co-infection. Individuals who refuse one vaccine might refuse other types of vaccines as well, making them more vulnerable to co-infections, as Saad B. Omer, director of the Yale Institute for Global Health, tells the New York Times.

What Are the Symptoms of a Coronavirus and Influenza Co-Infection?

Both Covid-19 and seasonal influenza infections affect the respiratory system. They also share comparable symptoms like fever, fatigue, coughing, a runny nose, a sore or scratchy throat, muscle and body aches, and even diarrhea, per the Washington Post.

How Can I Protect Myself and Others?

Respiratory viruses like influenza and Covid-19 are transmitted through droplets or aerosols.
These transmission methods occur when an infected individual coughs or sneezes. Droplets and aerosols can also be dispersed through speaking, singing, and breathing. To prevent infection, the WHO encourages getting vaccinated for both Covid-19 and the flu, practicing social distancing, wearing a well-fitted mask, and avoiding overly crowded or poorly ventilated places and settings.

BA.2 'stealth' variant makes up 80% of Kolkata's Omicron infections [Times of India, 11 Jan 2022]

BY Sumati Yengkhom

KOLKATA: Nearly 80% of Covid-positive samples sent for genome-sequencing by laboratories in the city have been found to contain the BA.2 sub-lineage of the Omicron variant, nicknamed the 'stealth version', as it cannot be picked up in RT-PCR tests and requires genome-sequencing.

Interestingly, almost none of those found infected with BA.2 had any immediate history of foreign travel; the other sub-lineage - BA.1 - has been detected in those who had travelled abroad in the recent past, said a senior health official.

From the original B.1.1.529 variant (first detected in South Africa), Omicron has now split into three sub-types: BA.1, BA.2 and BA.3. No instance of BA.3 has so far been identified in India. In Maharashtra and some other states, BA.1 is dominantly circulating in the community, rapidly replacing the Delta variant, as reported in Monday's TOI.

BA.2 cannot be identified by primers used in the RT-PCR test. The BA.1 sub-lineage carries the characteristic S-gene dropout mutation, which BA.2 does not. The absence of an S-gene mutation in an RT-PCR test is, therefore, indicative of an Omicron indication. But, to identify a BA.2 infection, genome-sequencing is a must.

Around 150 positive samples from the community have already been sequenced. While about 80% are Omicron-positive, all were found BA.2-positive, except for one or two samples. All these samples had a CT value below 30, indicating high viral load. These samples were sent for genome-sequencing between December 22 and 28.

'BA.2 reason for cluster infection'
The findings indicate that the BA.2 sub-lineage is dominantly circulating in the community in Kolkata and adjoining areas, from where most of the samples had been sent for genome-sequencing. "It is possible that BA.2 is causing the local cluster infection. Even as this sub-lineage is different from its other siblings, genetically it belongs to the same family and hence there is no significant difference in the clinical course of the disease," said immunologist Dipyaman Ganguly from the Indian Institute of Chemical Biology.

In the samples sent by one laboratory, 34 Covid-positive samples were found with BA.2. One sample was Omicron BA.1 and eight were Delta and Delta plus. Of the 17 Covid-positive samples sent by another lab, 14 were Omicron and belonged to the BA.2 lineage and the rest Delta. Findings on the 50 samples sent by the third lab showed that 35 were BA.2.

Omicron live updates
"The virus will keep mutating. Hence the need for genomic sequence surveillance," said Peerless Hospital microbiologist Bhaskar Narayan Chaudhuri.

The government, around the third week of December, had decided to send all positive samples with CT value under 30 for genome-sequencing to detect community transmission of Omicron. Accordingly, labs in Kolkata, Salt Lake and New Town started sending in samples. The health department had reversed the decision a week later when it was clear that community transmission of Omicron had begun.

"About 70% of our samples tested positive to Omicron, mostly of the BA.2 lineage. This was a week ago. Given the high transmissibility, presence of Omicron is likely to have increased a lot more," said Shelly Sharma Ganguly, AMRI Dhakuria microbiologist.

The health department has asked labs to send only those samples that have foreign travel history.

"Omicron is replacing Delta. Though there is an indication about the BA.2 subtype being more prevalent, we need a bigger sample size to draw a conclusion," said RN Tagore International Institute of Cardiac Sciences microbiologist Swatilekha Banerjee.