- Virological characteristics of the SARS-CoV-2 XBB variant derived from recombination of two Omicron subvariants Nature.com
- Identifying trajectories of the evolution of post-COVID-19 condition News-Medical.Net
- Profiling post-COVID-19 condition across different variants of SARS-CoV-2: a prospective longitudinal study in unvaccinated wild-type, unvaccinated alpha-variant, and vaccinated delta-variant populations The Lancet
- A retrospective analysis of clinical features of patients hospitalized with SARS-CoV-2 Omicron variants BA.1 and BA.2 | Scientific Reports Nature.com
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Tag Archives: subvariants
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A novel pan-sarbecovirus vaccine candidate neutralizes Omicron BQ.1.1 and XBB subvariants – News-Medical.Net
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- Synthetic multiantigen MVA vaccine COH04S1 and variant-specific derivatives protect Syrian hamsters from SARS-CoV-2 Omicron subvariants | npj Vaccines Nature.com
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- A new generation Mpro inhibitor with potent activity against SARS-CoV-2 Omicron variants | Signal Transduction and Targeted Therapy Nature.com
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BQ, XBB omicron subvariants pose serious threat to boosters
Evusheld injection, a new COVID treatment that people can take before becoming symptomatic, in Chicago on Friday, Feb. 4, 2022.
Chris Sweda | Tribune News Service | Getty Images
The omicron subvariants that have become dominant in recent months present a serious threat to the effectiveness of the new boosters, render antibody treatments ineffective and could cause a surge of breakthrough infections, according to a new study.
The BQ.1, BQ.1.1, XBB and XBB.1 omicron subvariants are the most immune evasive variants of Covid-19 to date, according to scientists affiliated with Columbia University and the University of Michigan. These variants, taken together, are causing 72% of new infections in the U.S. right now, according to data from the Centers for Disease Control and Prevention.
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The scientists, in a study published online Tuesday in the peer-reviewed journal Cell, found that these subvariants are “barely susceptible to neutralization” by the vaccines, including the new omicron boosters. The immune response of people who were vaccinated and had breakthrough infections with prior omicron variants was also weaker against the subvariants.
“Together, our findings indicate that BQ and XBB subvariants present serious threats to current COVID-19 vaccines, render inactive all authorized antibodies, and may have gained dominance in the population because of their advantage in evading antibodies,” the scientists wrote.
Although these subvariants are more likely to cause breakthrough infections, the vaccines have been shown to remain effective at preventing hospitalization and severe disease from omicron, the scientists wrote.
The study examined blood samples from people who received three or four shots of the original vaccines, those who received the new omicron boosters after three shots of the original vaccines, and individuals vaccinated with the original shots who also had breakthrough infections from the BA.2 or BA.5 subvariants.
For people who received the omicron boosters, antibodies that block infection were 24 times lower against BQ.1, 41 times lower against BQ.1.1, 66 times lower against XBB and 85 times lower against XBB.1 compared to their performance against the ancestral strain that emerged in Wuhan, China in 2019.
However, people who received the omicron boosters had modestly higher antibody levels against all of these subvariants compared with people who received three or four shots of the original vaccines, according to the study.
People who were vaccinated and had breakthrough infections had the highest antibody levels of any group in the study, though neutralization was also much lower against the subvariants than the ancestral strain.
The subvariants have evolved away from previous versions of omicron in dramatic fashion. BQ.1.1, for example, is about as different from omicron BA.5 as the latter subvariant is from ancestral Covid strain, according to the study.
“Therefore, it is alarming that these newly emerged subvariants could further compromise the efficacy of current COVID-19 vaccines and result in a surge of breakthrough infections, as well as re-infections,” the scientists wrote.
XBB.1, however, presents the biggest challenge. It is about 49 times more resistant to antibody neutralization than the BA.5 subvariant, according to the study. XBB.1, fortunately, is currently causing no more than 1% of infections in the U.S., according to CDC data.
BQ.1.1 and BQ.1 represent 37% and 31% of new infections respectively, while XBB is causing 4.7% of new infections, according to CDC data.
Antibodies ineffective
Key antibody drugs, Evusheld and bebtelovimab, were “completely inactive” against the new subvariants, according to the study. These antibodies are used primarily by people with weak immune systems.
Evusheld is an antibody cocktail used to prevent Covid in people with weak immune systems who don’t respond strongly to the vaccines. Bebtelovimab is used to prevent Covid from progressing to severe disease in organ transplant patients and other individuals who cannot take other treatments.
“This poses a serious problem for millions of immunocompromised individuals who do not respond robustly to COVID-19 vaccines,” the scientists wrote. “The urgent need to develop active monoclonal antibodies for clinical use is obvious.”
The FDA has already pulled its authorization of bebtelovimab nationwide because it is no longer effective against the dominant omicron variants in the U.S. Evusheld remains authorized as the only option for pre-exposure prophylaxis.
New Covid infections increased by about 50% to 459,000 for the week ending Dec. 7, according to CDC data. Covid deaths increased 61% to nearly 3,000 during the same week. Hospital admissions have plateaued at 4,700 per day on average after rising in November, according to the data.
White House chief medical advisor Dr. Anthony Fauci, in a press briefing last month, said U.S. health officials are hoping there’s enough immunity in the population from vaccination, infection or both to prevent the massive surge of infections and hospitalizations the U.S. suffered last winter when omicron first arrived.
New subvariants, family gatherings may bring more Covid-19 after holiday, but experts don’t expect severe surge
CNN
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As millions of Americans travel to gather with friends and family over the next few days, there’s a good chance that Covid-19 will follow.
Experts expect that Thanksgiving gatherings will stir up social networks and give new coronavirus subvariants fresh pockets of vulnerable people to infect. As a result, cases and hospitalizations may tick up after the holiday, as they have for the past two years.
Covid-19 is not unique in this regard. Thanksgiving gatherings have the potential to amp up the spread of other viruses too, notably respiratory syncytial virus, or RSV, and influenza, which are both already at high levels for this time of year.
“We have seen, in some regions, RSV numbers starting to trend downward. Flu numbers are still on the rise. And we are concerned that after holiday gathering, lots of people coming together, that we may see increases in Covid-19 cases as well,” Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said Tuesday on CNN.
But things have been relatively quiet on the Covid-19 front. Experts say it may not stay that way for long.
“Covid positivity is going up,” said Shishi Luo, associate director of bioinformatics and infectious disease at the genetic testing company Helix, which has been monitoring coronavirus variants. “It’s increasing fastest among 18- to 24-year-olds” in the Helix sampling.
It’s the first time test positivity in the Helix data has risen since July.
When test positivity increases, it means a greater proportion of Covid-19 tests are returning positive results, and it can be an indication that transmission is on the rise.
“We should expect more cases,” Luo said. “Whether they’re measured in how we measure cases right now, I don’t know, but I think in general, you should see more people who are sick. I definitely am.”
Increasing cases may not be picked up as quickly by official counts because people are mostly testing for Covid-19 at home and not reporting their results – if they test at all.
The BQ subvariants of Omicron have risen to dominate transmission in the US. BQ.1 and its offshoot BQ.1.1 are descendants of BA.5; they have five and six key mutations, respectively, in their spike proteins that help them evade immunity created by vaccines and infections. Because of these changes, they’re growing more quickly than BA.5 did.
For the week ending Nov. 19, the CDC estimates that BQ.1 and BQ.1.1 were causing about half of all new Covid-19 cases in the US. But so far, they’ve risen to predominance without much impact.
Covid-19 cases, hospitalizations and deaths have remained flat for the past four weeks. But it’s not gone: On average, more than 300 Americans die and 3,400 people are hospitalized each day with Covid-19, according to CDC data.
Nobody knows exactly what will happen with the BQ variants. Many experts say they feel hopeful that we won’t see the big waves of winters past – certainly nothing like the original Omicron variant, with its jaw-dropping peak of nearly a million new daily infections.
There’s reason for optimism on a number of fronts.
First, there’s the experience of other countries like the UK, where BQ.1 has outcompeted its rivals to dominate transmission even as cases, hospitalizations and deaths have fallen. Something similar happened in France and Germany, notes Michael Osterholm, an infectious disease expert who directs the Center for Infectious Disease Research and Policy at the University of Minnesota.
“Cases went up in France and Germany just before the subvariants came in. Then the subvariants came in, and cases actually dropped,” he said.
Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health, thinks our behavior and our social contacts might be bigger determinants of whether cases will rise this go-round than whatever variant is in the lead.
He thinks it’s likely that we’ll see a rise in cases that may peak around the second week in January – as it has in years past – but that it won’t have a big effect on hospitalizations and deaths.
Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health, says that’s probably because BQ.1’s advantages are incremental, not drastic.
“It’s probably got a bit more of a fitness advantage, so what we’re seeing is gradual replacement without a massive change in the total number of Covid-19 cases,” he said.
All that’s not to say that BQ.1 and BQ.1.1 won’t have any impact. They’ve shown marked resistance to the antibodies that are available to protect and treat people who are vulnerable to severe Covid-19 infections. From that standpoint, there’s good reason for people to be cautious if they have weakened immune systems or will be around someone who does.
But these subvariants will land at a time when population immunity is higher than ever, thanks to vaccines and infections. It’s a very different setting than the virus encountered when Omicron emerged a year ago, and that should also help dampen any coming wave, Pekosz says.
“With lots of people now being boosted and vaccinated and with people having some immunity from an Omicron infection, it’s also a very, very different sort of population landscape for a variant to emerge in,” he said. “All the signs are, I think, the best part of the scenario in terms of not seeing these massive increases in cases.”
If there’s reason to worry about BQ in the US, it could be this: Americans aren’t as well-vaccinated or boosted as other countries. CDC data shows that two-thirds of the population has completed the primary series of the Covid-19 vaccines, and only 11% of those who are eligible have gotten an updated bivalent booster. In the UK, 89% of the population over age 12 has completed their primary series, and 70% have been boosted.
New research indicates that a country’s vaccination rate matters more than any other single factor when it comes to the effects of variants on a population.
Scientists at Los Alamos National Labs recently completed a study delving into what drove the effects of 13 dominant variants of coronavirus as they transitioned from one to another in 213 countries. The study includes data up to the end of September and was published as a preprint ahead of peer review.
Among 14 variables that influenced the speed and height of new Covid-19 waves, a population’s vaccination rate was by far the most important.
The number of previous cases in a country, the percentage of people who wore masks, average income and the percentage of the population older than 65 ran a distant second, third, fourth and fifth, respectively.
How many other variants are in the mix when a new one rises is also an important factor, says senior study author Bette Korber, a laboratory fellow in the Theoretical Biology and Biophysics Group at Los Alamos.
She points to the Alpha variant, B.1.1.7, and how it behaved in the UK versus the US.
“When it came through England, it was just extremely fast, but it was much slower in the Americas,” Korber said.
By the time Alpha reached the United States, we were evolving our own variants out of California and New York “that were very distinctive and had a competitive edge compared to what it had to come up against in England,” Korber said, which probably slowed its roll here.
The CDC is tracking a soup of more than a dozen Omicron subvariants that are causing cases in the US, and that variety may end up helping dampen any wave over the winter.
But Korber isn’t making any predictions. She says it’s just too difficult to know what’s going to happen, pointing to Asia as the source of her uncertainty.
Asian countries have been contending with waves driven by the recombinant XBB, a subvariant that really hasn’t had much of a presence in the US. The BQ variants arrived later, but she says they look impressive against XBB, which is also highly immune-evasive.
“BQ is really making a stand there,” Korber said. “So I think it’s not really possible to be certain yet” what could happen in the US.
“To me, it’s a good time, when it’s possible, to wear masks,” she said. Masks protect the wearer as well as others around them. “And get the booster if you’re eligible and it’s the right moment for you,” especially as we gather around the table to feast with our friends and family.
“It’s a time to exercise a little additional caution to prevent that wave that we don’t want to see happening, or at least make it a smaller bump,” Korber said
Moderna says new booster increases protection against omicron subvariants
The data is encouraging because it shows that the bivalent booster shots, which were updated to match the BA.4 and BA.5 versions of the omicron variant and began to roll out in September, are providing protection against newer coronavirus variants ahead of a possible winter surge of cases.
Moderna also said a preliminary analysis with a small number of subjects showed that the antibodies generated by the bivalent booster lost some potency against the challenging and rapidly growing BQ.1.1 subvariant — but could still block it. BQ.1.1 makes up about a quarter of the cases in the United States, according to the Centers for Disease Control and Prevention.
“Evolution is a dangerous thing to bet against. The virus keeps surprising us, and we need to be ready to update the vaccine,” said Stephen Hoge, Moderna’s president. But he added that he was encouraged by the high antibody levels induced by the booster shot as the country heads into winter.
“I think we’re optimistic this BA.4/BA.5-containing bivalent is going to be sufficient to get us through,” Hoge said.
Moderna’s announcement will intrigue scientists thinking about future booster strategies because the makers of both messenger RNA coronavirus vaccines have now presented convergent results showing their bivalent shots trigger a stronger response than their original formulations.
But the news is somewhat of an artificial comparison to the general public because those original boosters are no longer available. The decision to switch was made over the summer to ensure enough supply to vaccinate people with the updated shots ahead of a potential winter surge of cases.
It is also unclear whether the data will help ignite public interest in the boosters. Only about 10 percent of people 5 and older in the United States have gotten a bivalent booster, according to CDC data.
To measure the effect of the additional shot, scientists compared the virus-blocking antibodies in the blood of 511 people, before and after the bivalent booster or the original one. What these kinds of laboratory experiments cannot predict is how well or how long the higher antibody levels will protect people against infections or severe illness. Most scientists expect the boosters will help shore up protection against the worst outcomes but will not provide as robust protection against infections.
Moderna reported that its bivalent booster created five to six times the level of antibodies compared with the older booster. That is a stronger advantage than the effects of a previous bivalent booster tuned to fight the BA.1 variant. But some scientists have questioned whether differences between the two groups of people that received each type of shot could be partially responsible for some of the advantage.
By contrast, Novavax, a latecomer in the vaccine race, presented data last week suggesting that a bivalent booster of its shot that included the omicron BA.1 subvariant did not offer an advantage over its original booster.
The company did not present data on a BA.4/BA.5-containing bivalent vaccine, but argued that its original shot could continue to offer protection, instead of updating the formula. It is unclear why there are divergent results. Novavax’s chief medical officer, Filip Dubovsky, said last week that the company’s shot may induce a broader response to the variants, which is then strengthened by repeated boosts of the older formulation. Unlike the widely used messenger RNA vaccines from Pfizer-BioNTech and Moderna, the Novavax shot is a protein-based vaccine with an added substance called an adjuvant that’s designed to rev the immune system.
Novavax has said it could update its shot if required by regulatory agencies.
“We’re kind of ready to respond to whatever is required,” Dubovsky said. “But we actually think we have a case that sticking with what we have now, and appears to be working now, is the way to go into the future.”
Omicron subvariants resistant to key antibody treatments are increasing
Two omicron subvariants that are resistant to key antibody treatments are on the rise in the U.S., according to data from the Centers for Disease Control and Prevention.
The subvariants BQ.1 and BQ.1.1 now represent 27% of infections in the U.S., a significant jump from the week prior when they made up about 16% of new cases, according to CDC data published Friday.
Omicron BA.5, though still the dominant variant, is diminishing every week. It now represents about 50% of infections in the U.S., down from 60% the week prior, according to the data.
President Joe Biden this week warned people with compromised immune systems that they were particularly at risk this winter because antibody treatments are not effective against emerging subvariants.
BQ.1 and BQ.1.1 are likely resistant to Evusheld and bebtelovimab, according to the National Institutes of Health.
Evusheld is an antibody cocktail administered as two injections that people ages 12 and older with moderately or severely compromised immune systems take to prevent Covid-19. Bebtelovimab is a monoclonal antibody taken to treat Covid after an infection.
Biden urged people with weak immune systems to consult their physicians on what precautions to take. Dr. Ashish Jha, head of the White House Covid task force, said the U.S. is running out of options to treat the vulnerable because Congress failed to pass more money for the nation’s Covid response.
“We had hoped that over time as the pandemic went along, as our fight against this virus went along, we would be expanding our medicine cabinet,” Jha told reporters this week. “Because of lack of congressional funding that medicine cabinet has actually shrunk and that does put vulnerable people at risk.”
It’s unclear how well the new boosters will protect against variants such as BQ.1 and BQ.1.1. Jha has said the boosters should offer better protection than the old shots because these subvariants are descended from BA.5, which is contained in the updated vaccines.
Two independent studies from Columbia and Harvard this week found that the omicron boosters did not perform much better than the old shots against BA.5. The Food and Drug Administration said the studies were too small to draw any definitive conclusions.
The CDC, the FDA and the White House Covid taskforce believe the new shots will prove more effective because they are better matched to the circulating variants than the first generation vaccines.
“It is reasonable to expect based on what we know about immunology and the science of this virus that these new vaccines will provide better protection against infection, better protection against transmission and ongoing and better protection against serious illness,” Jha told reporters in September.
Jha called for all eligible Americans to get the omicron booster and their flu shot by Halloween so that they are protected when families start gathering for the holidays.
Omicron subvariants show resistance, putting some people at risk
Emerging omicron subvariants are resistant to key antibody treatments for HIV patients, kidney transplant recipients and other immunocompromised people, making them particularly vulnerable to Covid this winter, the White House warned this week.
“With some of the new subvariants that are emerging, some of the main tools we’ve had to protect the immunocompromised like Evusheld may not work moving forward. And that’s a huge challenge,” Dr. Ashish Jha, head of the White House Covid task force, told reporters on Tuesday.
President Joe Biden on Tuesday cautioned the estimated 7 million adults in the U.S. who have compromised immune systems that they are particularly at risk, but he could offer little in the way of reassurance other than telling them to consult their physician about what precautions to take.
“New variants may make some existing protections ineffective for the immunocompromised,” the president said before getting his booster Tuesday. “Sadly, this means you may be at a special risk this winter. I urge you to consult your doctors on the right steps to protect yourself, take extra precautions.”
The message clashes with repeated White House assurances that the U.S. has all the vaccines and treatments it needs to fight Covid this winter as public health officials are expecting another surge.
While this may be true for the general population, it is not the case for people with weak immune systems. They include those with cancer, those who have had organ transplants, people living with HIV and individuals who are taking medicine for autoimmune diseases.
Evusheld is an antibody cocktail authorized by the Food and Drug Administration to prevent Covid in people ages 12 and older who have moderately or severely compromised immune systems. The drug is administered as two injections, prior to infection, every six months.
Evusheld, made by AstraZeneca, has helped fill a gap in protection for those with weak immune systems who cannot mount a strong response to the vaccines. The drug, plus several rounds of vaccination, has led to significant declines in hospitalization among this cohort over the past several months, according Camille Kotton, an infectious disease expert who specializes in treating people with weak immune systems.
“We’ve been in a sweet spot for maybe several months now as far as immunocompromised patients having good protection and then good treatment options,” said Kotton, a physician at Massachusetts General Hospital and a member of the Centers for Disease Control and Prevention’s independent vaccine advisory committee.
But more immune evasive omicron subvariants such as BA.4.6, BA.2.75.2, BF.7, BQ.1 and BQ.1.1 are resistant to Evusheld, according to the National Institutes of Health. Scientists at Columbia University, for example, found Evusheld had completely lost its effectiveness against BA.4.6.
And BQ.1 and BQ.1.1 are likely resistant to bebtelovimab, the monoclonal antibody developed by Eli Lily to prevent people with compromised immune systems who catch Covid from developing severe disease, according to NIH.
That leaves people with compromised immune systems increasingly vulnerable as these subvariants increase in circulation in the U.S. As omicron BA.5 declines, this swarm of newer subvariants collectively make up about 38% of infections in the U.S., according to CDC data.
Although Pfizer’s antiviral Paxlovid remains effective against the omicron subvariants, people who have had organ transplants often can’t take the pill because of the way it interacts with other drugs they need, Kotton said.
“I’m concerned that the near future will be a challenging time for immunocompromised patients,” said Kotton. “The monoclonal antibodies in Evusheld are going to provide less protection and bebtelovimab is going to provide ineffective treatment for several of the emerging variants.”
And help is not on the way at the moment. Kotton said she’s not aware of any monoclonal antibodies that are ready to replace the ones the subvariants are chipping away at. Jha acknowledged at the White House on Tuesday that the U.S. has dwindling treatment and prevention options for people with weak immune systems as Covid evolves. He blamed Congress for failing to pass $22.5 billion in funding for the nation’s Covid response due to Republican opposition.
“We had hoped that over time as the pandemic went along, as our fight against this virus went along, we would be expanding our medicine cabinet,” Jha told reporters. “Because of lack of congressional funding that medicine cabinet has actually shrunk and that does put vulnerable people at risk.”
Andrew Pekosz, a virologist at Johns Hopkins University, said finding ways to protect people with compromised immune systems is the most critical issue of the pandemic right now and it needs to be addressed quickly.
“What we need to really work on is getting new antibody treatments out of the lab and into clinics,” Pekosz said. “In the lab, scientists know what next-generation monoclonal antibodies look like.”
Kotton said people with compromised immune systems should stay up to date on their vaccines, which means getting the new booster that targets omicron BA.5. Those who have stayed up to date throughout the pandemic have received six shots by now.
Those starting from scratch would receive a three-dose primary series of Moderna or Pfizer with the older generation shots and then a new booster that targets omicron, according to CDC guidelines.
People with compromised immune systems should continue to exercise caution this winter, because the immune-resistant omicron subvariants could pick up in circulation as people gather for the holidays, Kotton said. But she noted that the group has been more diligent in wearing masks and practicing mitigation measures to avoid the virus than the rest of the population.
The bigger problem is that the general population has largely moved on and is no longer taking basic precautions that could reduce transmissions and protect the vulnerable — such as wearing masks, Kotton said.
“If we all were to mask more in public venues that would enhance the safety for them and allow them to have a higher likelihood of a safer return to many activities,” she said.
Jha was asked by NBC News on Tuesday whether Biden telling people with weak immune systems to consult their physicians about precautions is an indication that the burden of responsibility has shifted to the individuals instead of the broader community.
“As a society — as a caring society, we care about all Americans, particularly the most vulnerable Americans,” Jha said. “So it remains, I think, a collective responsibility for all of us to care about our fellow Americans who are immunocompromised.”
The CDC recommends that people in communities where the Covid risk level is moderate to self test and wear a high-quality mask before meeting indoors with someone who is at high risk of getting sick. Those who are at high risk should wear a high-quality mask when indoors in public.
When the Covid level is high, people in general should consider wearing high-quality masks and the vulnerable should consider avoiding indoor activities in public that aren’t essential, according to CDC. You can check your county’s Covid level at the CDC’s website.
Universal indoor masking may soon return in Los Angeles County as omicron subvariants surge
LOS ANGELES (KABC) — As COVID-19 cases continue to rise, Los Angeles County is getting closer to bringing back an indoor masking mandate.
The county is on the verge of moving into the CDC’s “high” level of community transmission as early as Thursday. Staying two weeks at that level would automatically trigger an indoor masking mandate.
A return of the mandate appears imminent as new omicron subvariants fuel a summer surge.
But how do people feel about it?
Like many residents, Roman Lomtadze says he’s not ready to go back to masking.
“I’m really not sure about it,” he said.
“I think they do work. But telling people that they must wear them? I think that’s where I’m starting to have a problem with that,” Lomtadze said.
Health officials report the highly transmissible omicron subvariants BA.4 and BA.5 now account for 40% of sequenced cases.
“That’s two and a half times higher than it was just two weeks earlier,” said L.A. County Public Health Director Barbara Ferrer. “Both BA.4 and BA.5 are of special concern because of their ability to evade prior immunity.”
This means people who were previously infected with other variants can get it again.
“This is real, and the county has indicated that we’re heading towards indoor masking again,” said L.A. Mayor Eric Garcetti.
L.A. County reported 100 COVID-19 deaths in the past week – the highest total in three months.
“More people have died this year from COVID than flu, than from homicides, than from car accidents combined. I think all of us want this to be done. We think that it’s done, but it’s still quite dangerous,” said Garcetti.
He said the goal of universal indoor masking is to knock down the spread. And if everyone participated, we wouldn’t have to do it for long.
“It’s for the safety of you but it’s also for the safety of others,” said Orian Gaston who is visiting from Texas.
“If everybody does it, then yes if it’s required,” said tourist Mark Freegard
“We’d be happy to wear a mask if that was the mandate and everybody was doing it,” said Freegard’s wife, Alison.
“You know it sucks,” said Clyde Hayes of Los Angeles.
“But we got to do what we got to do,” said Kayla Star of Los Angeles.
“We gotta do what we gotta do to get back to normal,” said Hayes.
The White House COVID-19 response team is urging eligible Americans to get caught up on their vaccines and boosters. Wednesday, the FDA authorized the Novavax COVID-19 vaccine for people 18 and older, making it the fourth vaccine to receive an emergency use authorization.
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New covid subvariants highly contagious, immune evasive, experts say
A rapidly spreading covid variant is highly contagious and can cause breakthrough infections, but it’s not more severe or dangerous than prior strains, local experts say.
The omicron subvariant — known as BA.5 — has “really taken off, nationally and locally,” said Dr. Lee Harrison, professor of infectious disease and epidemiology at the University of Pittsburgh.
“It is very, very infectious,” Harrison said. “There’s no doubt about it. In terms of immunity, it looks like even if you’ve had the previous omicron variants, there are enough differences in the BA.5 that you can get reinfected pretty easily.”
Nationally, the subvariant accounted for about 54% of sequenced strains, according to Centers for Disease Control and Prevention data, Harrison said. The related BA.4 subvariant constituted about 17% of sequenced strains.
“We’re seeing something very similar to the national trends,” Harrison said. “In Allegheny County, we’ve seen a very rapid increase recently in BA.4 and BA.5, with BA.5 being much more prevalent.”
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CDC data from the week ending July 2 indicates that BA.4 and BA.5 constituted about 59% of cases in the region, he said, and the majority of those were BA.5.
The new covid strain is the latest in a string of variants and subvariants that have emerged since the onset of the pandemic, said Dr. Amesh Adalja, a Pittsburgh-based infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security.
This BA.5 subvariant is “very similar” to the BA.4 subvariant, he said, but “clearly different” from earlier versions of the omicron variant.
As new subvariants have emerged, they’ve become more contagious, said Dr. Tom Walsh, an infectious disease specialist for Allegheny Health Network. The BA.5 subvariant, Walsh explained, is “a little more contagious and a little more immune-evasive,” meaning it’s more likely to cause breakthrough infections — or cases of covid-19 in fully vaccinated individuals.
The disease is now “approaching measles” in terms of how contagious it is, he said of BA.5.
Despite the contagious and immune-evasive nature of the variant, experts said fully vaccinated individuals are still likely safe from the worst outcomes.
“The vaccines are extremely effective when it comes to prevention of serious illness, hospitalization and death,” Adalja said.
Hospitalization numbers “are going up slightly,” Harrison said, but death numbers “are staying relatively flat.”
“What’s happened is the nature of people being admitted to the hospital has changed from earlier in the pandemic,” he said. “So, if they get hospitalized, they tend to be less severe than earlier on. Hospitalizations are going up, because we’re seeing a large number of infections. We still see very severe cases and we still see deaths, but compared to earlier in the pandemic, the severity in the hospital has shifted to being less severe.”
Most people admitted to Allegheny Health Network hospitals with the virus are either unvaccinated or they’re elderly with multiple health problems, Walsh said.
Inpatient and outpatient therapeutics that treat covid-19 are still effective against the latest subvariants, he said, and the same basic mitigation strategies that have been highlighted since the onset of the pandemic can still reduce risk of infection.
In general, Walsh said, omicron infections seem to cause “less severe disease” than prior variants.
Vaccine manufacturers are working to produce new vaccines that may be more effective against omicron and other variants, Walsh said. But creating a vaccine specifically targeting the variant that is currently dominant can be tricky, he said, as variants change so rapidly that a new variant could be taking over by the time that vaccine is ready to be administered.
The BA.5 subvariant won’t be the last new variant or subvariant of the coronavirus, Adalja said.
“BA.5 is the dominant strain of the virus right now. It will eventually get supplanted by something else,” he said. “There’s going to be one after this and one after that, too. That’s what the virus is going to do — it’s going to evolve to continue to be able to infect us.”
That’s why researchers are working on pan-coronavirus vaccines that would target “all of the variants and subvariants” and provide immunity for ever-mutating strains of the virus, Walsh said.
It’s unclear when updated vaccinations may be available, Walsh said, though some experts have suggested as early as this fall.
Already, a new variant is cropping up overseas. Scientists say the variant — called BA.2.75 — may be able to spread rapidly and get around immunity from vaccines and previous infection, according to The Associated Press. It’s unclear whether it could cause more serious disease than other omicron variants, including the globally prominent BA.5.
Julia Felton is a Tribune-Review staff writer. You can contact Julia at 724-226-7724, jfelton@triblive.com or via Twitter .