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COVID “Mega-variant” and eight criteria for a template to assess all variants

Daniel R. Lucey, MD, MPH, FIDSA
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Building on the Dec. 22  South African variant may be worse than UK variant: A template is needed for the variants to come post here, the following eight criteria are proposed to help create a template to assess the many variant SARS-CoV-2 viruses already found and those to come.

These eight criteria will need to be better quantified as more data becomes available after a variant is identified, and then determined whether it is a “variant of concern,” depending on assessment of these criteria (and likely more).

If all these possible criteria are met, then the term “mega-variant” is proposed.

The eight criteria are:

  1. More deadly: in adults and/or children (degree of increase to be quantified)
  2. More contagious (degree of increased transmissibility to be quantified)
  3. Re-Infections are frequent: by epidemiologic and/or virologic evidence
  4. Vaccine escape mutants (partial loss of vaccine efficacy to be quantified)
  5. Monoclonal antibody escape mutants
  6. Increased risk of “long-COVID”
  7. Increased risk of Multisystem Inflammatory Syndrome in Children: “MIS-C”
  8. In the future, when specific antiviral drugs (not antibodies or immune modulators) are proven to decrease mortality are found, then this #8 will be resistance to one or more of these (future) drugs


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