October 18, 2022 – Move, there are BA. 5. Il new kids in town and no one knows yet if we worry.
But there are fears that the BQ. 1 and BQ1. 1 subvariants of the COVID-19 virus may be only a major risk in the U. S. And that XBB simply replaces the image of COVID globally.
At this point, infectious disease experts have predictions.
The worst-case scenario would be a sudden surge of one or more strains escaping our immune protections, just as a projected fall and winter surge hits the United States.
At the same time, we know much more about SARS-CoV-2 than when COVID first became a surname. Obligatory -gurgling- return to the mask, the obsessive washing of hands and the distance with the neighbors.
The CDC’s recent peak knowledge that the BQ. 1 and BQ. 1. 1 subvariants have reached about 12% of viral strains circulating in the United States, doubling last week, compared to just 1% a month ago.
“I don’t think we’ll panic, but I’m not worried,” says Hannah Newman, MPH. “I wouldn’t be surprised to see an increase in infections as we enter the breathing season and in light of the emergence of new subvariants. “
“We’re already seeing a COVID accumulation in some European countries, partly because of those circulating subvariants,” adds Newman, director of infection at Lenox Hill Hospital in New York City.
The emergence of BQ. 1 and BQ1. 1 in the U. S. The U. S. and XBB global review isn’t entirely unexpected, says Amesh Adalja, MD. Don’t be surprised. “
Better coverage compared to bivalent reinforcements?
An unanswered question is how well the new bivalent mRNA vaccine boosters work compared to express subvariants.
“The new booster is better suited to what’s circulating than the old one, but we don’t know what that means in real life,” says Adalja, a senior researcher at the Johns Hopkins Center for Health Security in Baltimore. This is a tricky questionto answer because no one plans to compare the two types of recall in a clinical trial.
Newman is more optimistic. ” Good news is that bivalent COVID reinforcement will provide some coverage opposite to those strains, and we want other people to roll up their sleeves and get it,” she says.
XBB subvariant, lately booming in Singapore, may be just a warning to the United States, says Eric Topol, MD, founder and director of the Scripps Research Translational Institute in La Jolla, California, and editor-in-chief of Medscape. WebMD sister for medicine. Professional.
For example, before the advent of XBB, the COVID reinfection rate in Singapore was 5%. Now it’s 17%. That means a lot of other people who have had an infection will be affected again,” Topol says. In addition, Singapore reports that 92% of its population is vaccinated and that its booster rate is double the rate of the United States.
“And despite that, they have a very giant wave, which will be bigger than any of the original Omicrons,” he says.
Fewer remedy options
The drug Paxlovid will continue to play a role in preventing more serious COVID outcomes, Adalja said. In fact, “Paxlovid acts in an absolutely different domain of the virus, apart from those mutations that elude immunity. “
Conversely, evidence suggests that monoclonal antibody remedies will not be effective against these new subvariants. “The ability to evade monoclonal antibody remedies is a fear for me, as it can leave our maximum vulnerable open to more serious outcomes,” Newman said. Says.
“If strains are able to evade immunity to antibodies and monoclonal antibodies are not effective, we can expect to see more severe symptoms in high-risk Americans who would otherwise gain advantages from those treatments,” he says.
In particular, the monoclonal antibody bebtelovimab and the monoclonal mixture Evusheld would possibly be less effective against the new subvariants, Adalja says.
Does inflamed mean protected?
Most other people who have had COVID-19 in the past 3 to 6 months will likely have antibody grades against them, at least as opposed to severe illness, Adalja says. This is one of the reasons why U. S. officials are not yet in the process of doing so. U. S. officials suggest that other people wait 3 months for a booster after infection and Canadian officials proposed 6 months.
“You will definitely be protected from serious diseases,” Adalja adds. How long you’re going to be protected, how evasive those variants of the immune formula are, and how immune they escape, that’s going to depend on whether you’re vulnerable. “to infection. “
After natural immunity declines, those evasive immunovariants can re-infect, but are more likely to rejoice in a mild case, Adalja says.
Newman agrees. ” There is a point of herbal immunity that is acquired with a recent infection. However, it fades over time. Keeping up with vaccines and boosters is the ultimate proven and effective for consistent protection.
What is known is that COVID will most likely be with us for a while, Adalja says. “I’m very frank about it, it would never happen. It devises a new normal,” he says.
He who is advancing in managing COVID as an outpatient disease.
The long term is uncertain
It’s hard to expect exactly what will happen this fall and winter based on the existing evidence, says Gregory Poland, MD, an internal medicine physician at the Mayo Clinic in Rochester, MN.
However, throughout the pandemic, what is in the UK and India has consistently signaled what is in the US. U. S. And those other countries are experiencing “significant increases in subvariants,” he says.
“Unfortunately, there is no crystal ball that predicts for sure what a long-duration wave would look like right now,” Newman says. “There will be the superiority of one variant over the other strains and the preventive measures that are taken. “
It is also involved in a convergence of COVID and flu during the winter.
“Prevention fatigue related to upcoming holiday gatherings may be potential for more widespread events,” Newman said.
One fear is the relatively low uptake of bivalent reinforcements among Americans, Topol says. “It’s going to be bad because in a few weeks we’re going to face a very big wave. “
The relaxation of pandemic protections and declining immunity as more Americans move more than 6 months away from their last vaccine also relate to the following, Topol says. “Our immune wall is coming out more and more holes. “
“We will see a wave even before BQ1. 1 goes into effect,” Topol predicts. “And then the two in combination can have a very bad December or January. “
SOURCES:
Hannah Newman, MPH, Director of Infection Control, Lenox Hill Hospital, New York.
Amesh Adalja, MD, Principal Investigator, Johns Hopkins Center for Health Security, Baltimore.
Eric Topol, MD, Founder and Director, Scripps Research Translational Institute, La Jolla, CA, Editor-in-Chief, Medscape.
Gregory Poland, MD, internal medicine physician, Mayo Clinic, Rochester, MN.
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