Home Immunity New omicron subvariants now dominant in US, raising fears of winter surge

New omicron subvariants now dominant in US, raising fears of winter surge

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By Rob Stein

Two new omicron subvariants have become dominant in the United States, raising concerns that they could fuel a new wave of COVID-19 infections, according to estimates released Friday by the Centers for Disease Control and Prevention.

The subvariants — called BQ.1 and BQ.1.1 – appear to be among the best able to evade immunity from vaccination and previous infections, and have now surpassed the BA.5 omicron subvariant that has dominated in the US since the summer.

“It’s a little oddly familiar,” says Dr. Jeremy Luban from the University of Massachusetts, which has been tracking variants since the start of the pandemic.

“This time last year, we were optimistic. We were coming out of the delta wave, and it was steadily decreasing, and we went to Thanksgiving to wake up to omicron. So there’s this sort of sense of deja vu from l last year,” Luban said.

BQ.1 and BQ.1.1, had rapidly gained ground in the United States in recent weeks. They officially surpassed BA.5 on Friday, accounting for about 44% of all new infections nationwide and nearly 60% in some parts of the country, such as New York and New Jersey, according to the CDC. estimates. BA.5 now accounts for around 30% of all new infections nationwide.

Recent laboratory studies report that novel mutations in the virus’ spike protein appear to make BQ.1 and BQ.1.1 up to seven times more “immune-evasive” than BA.5.

But even if new subvariants spike this winter, most experts believe any surge in infections won’t hit as hard as the pandemic’s first two winter surges.

“We hope that the amount of immunity that has been induced either by previous infection or by vaccination” will prevent most people from becoming seriously ill or dying, Dr. Anthony Fauci, the White House medical adviser, told NPR.

That said, a new study suggests that reinfection with the virus can still pose significant risks, both for short- and long-term complications, including an increased risk of hospitalization, long COVID symptoms, and even death.

“The risk of reinfection is certainly not insignificant,” says Ziyad Al-Aly, assistant professor of medicine at Washington University School of Medicine in St. Louis and author of the new study. “So going into the winter surge, people should do their best to try to avoid getting re-infected.”

“You are playing Russian roulette again,” he says. “You can dodge the bullet next time, but you might not.”

Since the newly dominant variants appear to be highly immune, many people can become reinfected.

“The bad news is that it’s likely that people who have been vaccinated and/or infected will still be infected” with these new subvariants, says Dr. Daniel Barouch, a virologist at Beth Deaconess Hospital in Boston, who studies the new strains.

The new strains become dominant as winter approaches and people will travel and congregate for the holidays, factors which had previously raised fears of another winter surge.

“The United States will see a winter increase in COVID infections”, predicts William Hanage, epidemiologist at Harvard TH Chan School of Public Health. “And I think if nothing else changes, BQ.1 and BQ.1.1 will probably be very big players.”

The key question is the magnitude of any winter surge that emerges.

“The question is whether this surge is going to be nationwide and whether the size of the surge and surge will be something like what we experienced with delta and omicron, or much smaller,” says Samuel Scarpino, vice president of pathogen surveillance for the Rockefeller Foundation.

“I think it’s quite worrying,” he adds.

Infections, and even hospitalizations, have already started to rise in some parts of the country.

A promising sign is that recent surges in other countries suggest that if the subvariants are involved in a new US surge, any upside may be short-lived. For example, while France experienced a surge involving the new subvariants, the increase in cases quickly receded.

Nevertheless, experts are urging more people to get one of the updated boosters, which target omicron for the first time.

“Hopefully more people will get their updated vaccine — the bivalent vaccine,” Fauci said. “It will dampen a real push and at worst we will have a sharp hit from a major push.”

While some Preliminary studies wondered if the new boosters are better than the original vaccine at protecting against omicron, others suggested they might be. Vaccine makers Pfizer and BioNTech recently released a statement saying their new booster stimulates much higher levels of antibodies that can neutralize the BA.5 omicron subvariant than the original vaccine.

Another concern is that these new subvariants are likely to render the latest monoclonal antibodies, including the one that people with weakened immune systems use to protect themselves, useless.

“Winter is going to be especially worrisome for immunocompromised people,” Harvard’s Hanage said.


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