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The fusion peptide on the SARS-CoV-2 spike protein has a larger role in COVID-19 infection than previously thought, according to the results of a recent study published in Structure. Steven Van Doren, a molecular biologist at the University of Missouri College of Agriculture, Food and Natural Resources—alongside other researchers at the University of Missouri—discovered that the fusion peptide is a consistent feature on all SARS-CoV-2 viral spike proteins.1 Image credit: BillionPhotos.com | stock.adobe.com “Throughout the evolution of this virus, the fusion peptide endured despite all the mutations and variants that we kept on hearing about in the news,” Van Doren said in a press release. “It’s too critically important for infection for it to be modified.”2 The fusion peptide sits at the N terminus of the spike protein’s S2 summit. The spike protein is what binds the SARS-CoV-2 virus to the human host cell; the fusion peptide is what facilitates this bond, which leads to infection transmission.1 This could explain why “the fusion peptide is the most preserved part of the whole viral spike,” Van Doren said in the press release.2 During the study, investigators looked at how the fusion peptide, most likely folded with 42 residues (Ser816-Gly857)—a residue being an amino acid that characterizes a certain polypeptide or protein—punctures the host cell membrane lipid bilayer leading to cell fusion. The study aims to identify insertion mechanisms and measure disturbances in the host lipid bilayer using magnetic resonance.1,2 Advertisement At analysis, investigators discovered that the SARS-CoV-2 virus can effectively enter human cells via the endocytic pathway, which has a lower pH range (5 to 6.5) and low-calcium conditions (0.3 to 30 μM).1 The fusion peptide was also observed to prefer attaching to areas of negative charge (anionic) outside the host cell membrane, influencing viral transmission, infectivity, membrane fusion, and cell-cell fusion. Study authors note that different anionic residues may represent different viral strains. Finally, investigators discovered that the fusion peptide may insert itself deeply into a host membrane, despite appearing to only have shallow insertion.1 Authors note study limitations, including choice of lipid. The team used bilayered micelles (bicelles) to study the role of the fusion peptide. Bicelles have a simpler lipid composition that does not include cholesterol, anionic lipids, curvature-inducing head groups, and specific acyl chains.1 Ultimately, Van Doren noted in the press release that protein functionality and process remain a source of great interest in his research. “How proteins work has been something that has stuck with me for decades now—I’d say going on almost 40 years,” Van Doren said in the press release. “I love what protein molecules look like and what they can do.”2 Van Doren noted further that the recent novel findings around the SARS-CoV-2 spike protein’s role in COVID-19 infection could be applied to the vaccine setting. However, to this end, it will be important to more fully understand how the fusion peptide inserts itself into cells, which could help with identifying targets for the development of COVID-19 vaccines.1,2 “There may be many strategies for crossing membranes, but it’s conceivable that the fusion peptide work could help further development of more ways to cross cellular membranes, which could be useful to deliver therapeutics through cell membranes,” Van Doren said in the press release.2 References Van Doren SR, Scott BS, Koppisetti RK. SARS-CoV-2 fusion peptide sculpting of a membrane with insertion of charged and polar groups. Structure. August 24, 2023. Accessed on August 28, 2023. https://www.sciencedirect.com/science/article/abs/pii/S0969212623002782?dgcid=author Perrett C. Mapping the coronavirus spike protein could provide insight into vaccine development. University of Missouri. News Release. August 24, 2023. Accessed on August 28, 2023. https://showme.missouri.edu/2023/mapping-the-coronavirus-spike-protein-could-provide-insight-into-vaccine-development/

COVID-19 certainly didn’t take a vacation this summer. Virus levels in the US have been on the rise for weeks, but it’s hard to know exactly how widely it’s spreading. Federal data suggests that the current increases have stayed far below earlier peaks and notable surges. But judging by word of mouth among family, friends and coworkers, it can seem like everyone knows someone who’s sick with COVID-19 right now. “We have several folks down with COVID, unfortunately,” one health-focused nonprofit told CNN when seeking comment for this story. Rates of severe disease may be staying at relatively low levels, but experts agree that there are probably more infections than the current surveillance systems can capture. “There is more transmission out there than what the surveillance data indicates,” said Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists. “And we should be paying attention to it, because we are starting to see an increase.” SEE ALSO: First lady Jill Biden experiencing ‘mild symptoms’ after testing positive for COVID From 2020 to 2022, the University of Washington’s Institute for Health Metrics and Evaluation produced regular estimates of COVID-19 case rates and projections for trends. But the research institute paused that modeling in December. All of the measures that factored into the model had stopped being reported or had changed in some way, said Ali Mokdad, professor of health metrics sciences and chief strategy officer of population health at the University of Washington. “The surveillance system was not adequate anymore to capture changes in COVID-19,” he said. “We felt that the margin of error became really too big for us to make a prediction that we could stand by and defend.” Mokdad declined to quantify an estimate for current case counts, but he said he’s been getting lots of calls and questions about COVID-19 recently — similar to what he experienced around the end of last year. In mid-December, the US Centers for Disease Control and Prevention was reporting about 500,000 cases a week. And IHME estimates from that time suggest that the US was in one of the worst waves of the pandemic, second only to the Omicron surge. Two imperfect measures of transmission Tracking COVID-19 trends has always had its challenges. But the rise of rapid home tests — and general waning of public interest in testing at all — has all but erased the ability to grasp current case counts nationwide. The CDC officially stopped reporting aggregate COVID-19 case counts months ago, noting that data had become less representative of actual infections or transmission levels over time. As case counts started to become less reliable, some experts first pointed to hospitalization metrics as a reasonable substitute to gauge transmission. Hospitals were regularly testing all patients, whether they were coming in for COVID-related symptoms or for something else entirely, and they are required to report positive cases. The idea was that case rates in a hospital could serve as a proxy for case rates in the broader community. There were about 15,000 new hospital admissions for COVID-19 in the week ending August 19, according to CDC data — less than half of what the numbers were at this time last year and lower than they were for about 80% of the pandemic. But hospitals have shifted their testing practices, balancing changing federal requirements and recommendations with local risk assessments, which makes it difficult to compare data from different points in time. “When testing supplies first were readily available, we moved to testing everyone, including health care workers routinely, including anybody who was coming in the door for any reason,” said Nancy Foster, vice president of quality and patient safety for the American Hospital Association. “Anybody and everybody got tested.” MORE: Updated COVID-19 shot likely to be available mid-September Although hospitals are still required to report any positive cases, they’ve eased back on testing to be more in line with guidance around other infectious diseases. The focus is on those who are symptomatic, have been exposed or might be around other high-risk patients. “Hospital admissions is much more of an indication of severity at this point in time, than I think it is of generalized transmission,” Hamilton said. Many measures of COVID-19 and other public health surveillance rely on people to seek out clinical testing or medical treatment, and those behaviors have changed over the past few years. Wastewater surveillance offers a more consistent approach by monitoring the amount of virus shed in sewage systems. But interpreting that data can be complicated — and with COVID, wastewater levels can’t be directly translated to case counts. The amount of virus that an infected person sheds depends on a many factors, including the presence of antibodies from a vaccine or previous infection and the severity of the current infection. Data from Biobot Analytics, a biotechnology firm that has partnered with the CDC, shows that wastewater concentrations of the coronavirus are similar to what they were at the start of the first winter surge in 2020. But now that the vast majority of people in the US have some immunity to COVID-19 through vaccination, infection or both, those same viral concentrations could translate to a larger number of infected individuals with milder — but still contagious — infections. The upward trend is clear Even if the exact number of new infections isn’t clear, experts say, the rising trends in the data that is available are enough to raise alarm. “Surveillance data is across a continuum. We want to have multiple different types of data that tell us different kinds of things. When they’re all pointing in the same direction, that’s maybe a time to get even more concerned,” Hamilton said. And right now, many key measures are indicating an increase. Weekly hospital admissions have nearly doubled over the past month, including a 19% bump in the most recent week, CDC data shows. And a sample of laboratories participating in a federal surveillance program show that test positivity rates have tripled

Chances are, someone close to you or in your periphery has recently gotten COVID-19. Cases and hospitalizations are trending upward as new variants of the virus have emerged. Data show hospitalizations in the U.S. are not anywhere near the levels seen during the worst surges of the pandemic. (Credit: CDC) Still, with new variants come new concerns about the severity of symptoms, the effectiveness of the upcoming vaccines, and what fall and winter might look like if a surge is around the corner. Here’s what we know from health experts and current data. What are the dominant COVID-19 variants right now? New lineages of the Omicron variant that first popped up in November 2021 continue to emerge and spread nationally and globally. Omicron subvariant EG.5, which some health experts nicknamed “Eris,” is the dominant strain, accounting for an estimated 21.5% of cases in the country for the two weeks leading up to Sept. 2, according to the Centers for Disease Control and Prevention. Eris held about 18% of cases during the previous two weeks. FL.1.5.1 is the second-largest strain, holding 14.5% of infections in the U.S. as of Sept. 2. During the previous two weeks, FL.1.5.1 accounted for 9.5% of COVID infections. What about the new variant BA.2.86? A highly mutated variant called BA.2.86 has caught the attention of health experts around the globe. “We have not seen a new variant [in humans] with this many new spike mutations happening all at once since the emergence of the original Omicron,” Jesse Bloom, an evolutionary biologist at Fred Hutch Cancer Center, told NBC News in August. As of Aug. 30, there were 24 confirmed cases of BA.2.86 throughout the world, including three in the United States, one of whom tested positive at Dulles International Airport in Loudoun County, Virginia, through the CDC’s Traveler-based Genomic Surveillance. Ten others who tested positive for the variant were in Denmark, four were in Sweden, two were in South Africa, two were in Portugal, one was in Canada, one was in Israel and one was in the UK, the CDC said. “One of the reasons WHO and other viral evolution people were concerned about this is because it seemed to pop up in four different continents at once, and that suggests it’s widely distributed,” said Dr. Jesse Goodman, professor of medicine and infectious diseases at Georgetown University Medical Center. Outside of those confirmed cases, the CDC says wastewater samples taken from Ohio and New York have indicated the presence of the BA.2.86 variant. While the CDC and World Health Organization say they’re monitoring BA.2.86, it’s still too soon to know how well it can spread. “Detection across multiple continents suggests some degree of transmissibility,” the CDC said. “This is notable since scientists have not detected broad international spread of many other highly diverged lineages, which can arise in immunocompromised persons with prolonged infections.” Where do we stand with case rates and hospitalizations from COVID-19? Since most tests are now done at home and go unreported, individual cases of COVID-19 are harder to track. But health experts say they’ve noticed an uptick in patients with the virus. Goodman, who is a physician at three hospitals in the D.C. area, said he’s seen an increase in COVID-19 patients in the past several weeks. “I think just generally, and also talking to my colleagues, whereas a few months ago we weren’t seeing much, we didn’t have many COVID patients hospitalized. Now, we’re starting to see them,” he said. From Aug. 13-19, there were nearly 19% more patients hospitalized with COVID-19 in the U.S. than the previous week, at more than 15,000 new admissions. The Washington, D.C., region saw a significant jump in COVID hospitalizations during that time frame. Maryland reported 207 new COVID hospital patients, nearly 47% more than the 141 hospitalizations the previous week. Virginia reported a 26% increase of 298 hospitalizations. D.C., however, reported 35 new patients hospitalized, a slight decrease from the 41 patients the week before. Below, a map shows a county-by-county breakdown of the percentage change in hospitalizations from the week of Aug. 12 to Aug. 19. D.C. and Montgomery and Prince George’s counties saw a moderate increase, while other counties such as Arlington, Fairfax and Loudoun were in the “stable” range. (Credit: CDC) While hospitalizations are rising, they are still relatively low, with about four in every 100,000 people hospitalized in the country with COVID-19. “This [virus] is still being nasty and tricky. It’s still shifting just as fast as vaccines can be developed. And we are seeing an uptick in infection nationally, an uptick in emergency room visits and hospitalizations, but it is nothing to the kind of level that was experienced earlier in the COVID epidemic,” Goodman said. Deaths from COVID-19 are also rising, but remain low. From Aug. 20-26, 361 people died of COVID in the U.S., according to the CDC. The week before, 636 people died. Those numbers are drastically lower than the number of deaths seen at the height of the pandemic. (Credit: CDC) What are the symptoms of Eris, FL.1.5.1 and other variants? Symptoms of the variants that are currently circulating are the typical upper-respiratory and cold-like symptoms seen with most COVID cases, including: Sore throat Runny nose Cough Sneezing Fever Fatigue Muscle aches Headache “We’re seeing in healthy, young individuals, you know, COVID disease perhaps being somewhat milder because people have preexisting immunity from prior infection and vaccine,” Goodman said. But, Goodman says, there are still severe cases in which people get pneumonia and require oxygen, and other cases in which people show no symptoms at all. “It still seems to run the whole range, but with time we’ve generally seen the manifestations become milder,” he said. “But if you’re one of the people that gets severe COVID or is hospitalized, obviously, it’s no laughing matter and there’s still the issue of [long COVID], which I think is the concern.” Symptoms of the BA.2.86 variant remain unclear. “There’s no data on symptoms associated with infection

Infection control and prevention is crucial in health care. From infection preventionists to environmental hygienists, these professionals work tirelessly to ensure patients and staff remain safe from infectious diseases daily. A major part of their work is teaching others about the many and varied processes of controlling and preventing infections. Every person in infection and control is an educator. With that thought in mind, Linda Spaulding, RN, CIC, infection prevention consultant, InCo and Associates, International, Inc, announces today that Infection Control Today® is reviving the annual Infection Control Today®’s Educator of the Year Award™. The award was given from 2002 until 2010, and she was honored with it in 2003. The Infection Control Today®’s Educator of the Year Award™ recognizes the infection prevention and control professional who has excelled and is passionate about educating others on infectious disease. Recipients must have at least 15 years of experience in the field and have demonstrated quantifiable results and positive change. Formal rules are posted on the Infection Control Today®’s Educator of the Year Award™ webpage. Advertisement Nominees will be accepted from September 5, 2023, until November 1, 2023. The Winner will be notified by December 1, and announced on the Infection Control Today website on December 15, 2023, and in the January/February 2024 print publication. If you are interested in nominating someone, please go to The Infection Control Today®’s Educator of the Year Award™ webpage and fill out the form. We are thrilled to bring back this prestigious award and look forward to reading the nominations. Abbreviated Rules: NO PURCHASE NECESSARY. Contest begins on or about August 31, 2023, at 12:01 a.m. ET and ends on October 31, 2023, at 11:59 p.m. ET. Open only to legal U.S. residents who are 18 years of age or older. Subject to Official Rules. See Official Rules at [ADD LINK TO FULL RULES] for additional eligibility restrictions, prize descriptions, restrictions, and complete details. Odds of winning depend on the number of eligible entries received. Void where prohibited. Sponsor: MultiMedia Medical, LLC

Do you know an infection prevention and control professional whose exceptional dedication goes beyond ordinary efforts, actively empowering others to effect positive change within their sphere?Nominate the deserving individual for this year’s prestigious title of Infection Control Today‘s Educator of the Year by clicking the button below to complete the form. The nominee should possess a minimum of 15 years of distinguished experience in infection prevention and control and currently hold a pivotal role within the field. Demonstrating a commitment to education, they should excel in imparting knowledge with fervor and possess measurable achievements that highlight a positive transformative impact. Advertisement Submit a comprehensive Word document nomination, containing a maximum of 1,000 words, showcasing the nominee’s outstanding dedication to education with examples of: Educational Excellence: The nominee excels and is passionate about educating others. Provide at least two (2) compelling examples that highlight their exceptional teaching skills. Empowerment for Change: The nominee goes above and beyond to encourage others for positive change. Present at least two (2) instances that illustrate their commitment to fostering empowerment and transformation. Thank you for your submission! Abbreviated Rules: NO PURCHASE NECESSARY. Contest begins on or about August 31, 2023, at 12:01 a.m. ET and ends on October 31, 2023, at 11:59 p.m. ET. Open only to legal U.S. residents who are 18 years of age or older. Subject to Official Rules. See Official Rules at [ADD LINK TO FULL RULES] for additional eligibility restrictions, prize descriptions, restrictions, and complete details. Odds of winning depend on the number of eligible entries received. Void where prohibited. Sponsor: MultiMedia Medical, LLC