Lancaster Physician Fall 2021 - 19

FALL 2021
countries in South America and Europe being examples. We still
have much to learn about the nature and dynamics of COVID-19.
How are SARS-CoV-2 variants classified?
The Centers for Disease Control and Prevention (CDC) and the
World Health Organization (WHO) have classified variants of SARSCoV-2
by letters of the Greek alphabet. They have also subdivided
the variants by their clinical importance.
Variants of Interest (VOI) are those that carry mutations that have
been associated with enhanced binding of the spike protein, reduced
neutralization or killing by antibodies, reduced effectiveness of treatments,
a negative impact on diagnostic test accuracy, or potential
for an increase in transmissibility or disease severity. There are many
of these under study by the CDC, including the recently described
Lambda and Mu variants.
Variants of Concern (VOC) are those for which there is solid evidence
of increased transmissibility, more severe disease, a significant
reduction in neutralization by antibodies, reduced effectiveness of
treatments or vaccines, or diagnostic detection failures. The table on
page 17 outlines the current list of VOC.
Variants of High Consequence (VOHC) are those with clear
evidence that prevention measures or medical countermeasures
have significantly reduced effectiveness compared to prior variants.
Such variants could potentially render our current prevention and
treatment measures for COVID-19 useless. Fortunately, there are no
SARS-CoV-2 VOHC that have been identified.
What does the future hold?
Thus far, in the COVID-19 pandemic the major theme of variant
evolution for SARS-CoV-2 has been the development of more and
more contagious strains, culminating in the Delta variant that has
swept across the planet. In the background, however, are the variants
capable of immune evasion. These include the Beta (South Africa)
and Gamma (Brazil) variants, as well as the Mu variant. A hybrid
of Delta and one of these potentially vaccine resistant strains would
be a completely new threat to humanity. Such a variant of high
consequence could negate all of our progress in the battle against
this virus. While this has not occurred, it is after all just a matter of
mathematics and time.
Our ultimate and only defense against this draconian event is
herd immunity achieved through vaccination of a large percentage
of the population of the planet. When the virus cannot find another
susceptible host, we will have achieved control. We have done it before,
with measles, mumps, and whooping cough, controlling rather than
eradicating these pathogens by an aggressive national immunization
policy. Until we can apply the same control measures to COVID-19,
we must remain aggressive with public health maneuvers, continue
to increase our vaccination rates, and above all follow the science.
Danielle B. Cross, MD
Penn Medicine Lancaster General
Health announces Danielle B. Cross,
MD as Medical Director, Stroke
Program
Medical School: University of Pennsylvania
School of Medicine
Residency: NYU School of Medicine
Fellowship: UCSF School of Medicine
Board Certification: American Board of
Psychiatry and Neurology
Specialties and Clinical Expertise: Vascular
Neurology, Stroke and Stroke Recovery,
Neurointensive Care, TIA, General Neurology
Lancaster General Hospital is the only
hospital in Lancaster County to perform
mechanical thrombectomy, an advanced
stroke procedure. Lancaster General Hospital
is a Certified Primary Stroke Center by The
Joint Commission.
Remember how to spot the signs of stroke
using BE FAST (Balance, Eyes, Face, Arms,
Speech, Time). Visit LGHealth.org/Stroke to
learn more about the stroke warning signs.
LGHealth.org
LANCASTER 19 PHYSICIAN
Neuro_Cross_AD_2021_3.5625x9.875.indd 1
8/17/21 3:37 PM
http://www.LGHealth.org/Stroke http://www.LGHealth.org

Lancaster Physician Fall 2021

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