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Over the past six months, several new variants of COVID-19 have emerged and taken hold in the United States. Currently, two strains account for the majority of cases: HV. 1 and JN. 1. As the United States approaches peak respiratory virus season, those highly contagious omicron subvariants are causing a surge in infections across the country.
The HV.1 variant has been circulating in the U.S. since the late summer. It descended directly from EG.5, aka Eris, and is very similar to its parental strain. In October, HV.1 quickly overtook other variants, including EG.5 and XBB.1.16 or Arcturus, to become the leading variant in the country.
HV. 1 remained the dominant strain until mid-December, when it overtook JN. 1, an offshoot of BA. 2. 86, or Pirola. However, HV. 1 continues to spread and sicken large numbers of Americans. about one-fifth of infections nationwide.
In a two-week period ending December 23, JN. 1 accounted for 44% of COVID-19 cases, followed by HV. 1, which accounted for about 22% of cases, according to the most recent estimates from the US Centers for Health. Disease and Prevention.
All of the COVID-19 variants that have become dominant in the U.S. during the last year are descendants of omicron, which began circulating in November 2021.
The appearance of HV. 1 demonstrates how the SARS-CoV-2 virus, which causes COVID-19, will mutate and give rise to new highly contagious variants.
Experts say the updated COVID-19 vaccines, launched in September, still offer coverage against new strains, adding HV. 1 and JN. 1, but uptake has been low so far.
COVID-19 cases and hospitalizations are currently rising. In the last two weeks, average daily COVID hospitalizations in the U.S. increased by 17%, according to an NBC News analysis.
COVID-19 infections are expected to continue through this winter, as they have for the past three winter seasons, Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center, told TODAY. com.
Respiratory virus season has not yet peaked in the U. S. COVID-19 comes as flu and RSV activity remains high across much of the country. Here’s what we know so far about HV. 1.
HV. 1 is a member of the omicron family. ” You can think of HV. 1 almost as a grandchild of Omicron,” Schaffner says. HV. 1 is a sublineage of the omicron XBB. 1. 9. 2 and a direct descendant of EG. 5, according to the CDC’s SARS-CoV-2 lineage tree.
“The COVID virus family likes to mutate. We’ve all learned that now,” Schaffner says. Although HV. 1 is mutated, it’s still very close to existing omicron subvariants, Schaffner says.
For the most part, scientists are concerned about new variants like HV. 1, which closely resemble strains we’ve seen before, NBC News reported.
However, there are a few highly mutated strains that have set off alarm bells in the past. These include BA.2.86 or Pirola, which has an extra 36 mutations that differentiate it from XBB.1.5, and a new fast-growing variant called JN.1.
JN. 1 is a direct descendant of Pirola with an additional mutation, and has gained momentum in recent weeks, surpassing BA. 2. 86. However, there is no evidence that JN. 1 is more severe and does not pose a greater threat to the public. health, the CDC said in an update published Dec. 8.
As for HV. 1, it has grown after its first detection last summer. At the end of July, HV. 1 accounted for just 0. 5% of COVID-19 cases in the U. S. According to data from the CDC. Al Sept. 30, HV. . 1 accounted for 12. 5% of cases and was the dominant strain until November.
“One of the characteristics of this full circle of Omicron relatives is that they are highly transmissible,” Schaffner says.
Like the omicron subvariants, HV. 1 is highly transmissible, Dr. Priya Sampathkumar, an infectious disease specialist at the Mayo Clinic, tells TODAY. com.
Sometimes, mutations can enable a new variant to spread more effectively or quickly, per the CDC.
Right now, it appears that HV.1 could be better at spreading from person to person than previous strains, NBC News reported. The increased transmissibility of HV.1 likely explains how it became dominant so quickly in the U.S., Schaffner notes.
It also appears that HV. 1 would possibly also be better at evading past immunity to COVID-19, but not enough to cause concern, said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston. he told NBC News.
“The challenge is that people’s peak immunity has waned after outbreaks and our vaccination rate is still very low. . . it’s too early to draw conclusions about (avoided) immunity to HV. 1 after infection or vaccination,” Sampathkumar says.
Although more transmissible, HV. 1 appears to cause more severe illness or lead to more hospitalizations, Schaffer says.
An increase in COVID-19 activity is expected as it peaked toward the end of the summer and around the New Year, the CDC said.
What remains unclear is whether HV.1 could cause a major surge in COVID-19 cases in the coming weeks. “If there’s vast numbers of people getting infected, even if the disease for most people isn’t very severe, we will see an uptick in hospitalizations and deaths,” says Sampathkumar.
Health officials are intensively monitoring HV. 1, but low levels of testing make it more complicated, as it should be, to track new variants, experts say.
The symptoms caused by HV. 1 infection are similar to those caused by recent variants, Schaffner says, including:
Sore throat
Congestion or congestion
Rhinorrhea
Cough
Fatigue
Headache
Muscle aches and pains
Fever or chills
“Congestion, sore throat and dry cough seem to be the three most prominent symptoms right now,” says Schaffner.
Increasingly, doctors are reporting that COVID-19 symptoms seem to be concentrated in the respiratory tract, starting with a sore throat and continuing with congestion or runny nose, NBC News reported.
Coughing is not a major symptom, but it can persist. “It turns out that the virus causes a type of chronic bronchitis, so you can have a cough syndrome that lasts beyond the time you recover from other symptoms,” Schaffner says. .
“I haven’t heard of any other symptoms or any new symptoms that might raise alarm bells,” says Sampathkumar.
Another trend is that COVID-19 turns out to cause milder illness, likely because other people enjoy some prior immunity. “By milder, we mean it doesn’t require hospitalization, you would possibly feel quite dissatisfied for several days,” Schaffner says.
All COVID-19 tests — including PCR tests performed by a health care provider and rapid at-home antigen tests — will detect HV.1, says Schaffner.
Testing is a very important tool to protect yourself and others from COVID-19. The symptoms of HV. 1 and other COVID-19 variants can be very similar to those of other viruses, including respiratory syncytial virus (RSV), influenza, and rhinovirus, which cause the usual cold.
There’s no way to distinguish those viruses based on symptoms alone, Sampathkumar says.
“The way to distinguish (COVID-19) from RSV and influenza, both of which are gaining traction, is through testing,” Schaffner says.
Experts take inspiration from symptoms or who has been exposed to get tested, especially those in high-risk groups: people over 65, immunocompromised, or with underlying health conditions.
“We have treatments that can prevent more serious disease,” says Schaffner, but early detection is key. COVID-19 antivirals such as Paxlovid are effective against HV.1 and other variants, but they work best when within five days of symptom onset, TODAY.com previously reported.
Testing is down in the U. S. This is a worrying case, Schaffner says.
When the U.S. federal public health emergency for COVID-19 ended in May, so did the guarantee of free testing for many. Now, the cost of COVID-19 testing will vary depending on your health insurance plan.
However, each and every American can still request 4 at-home COVID-19 tests from the government, which will be delivered by mail via the U. S. Postal Service. U. S. To request your free tests, visit COVIDTests. passv.
According to Health, other uninsured people can still get free or inexpensive testing through in-network fitness centers and pharmacies.
If you still have a source of testing, make sure the expiration date and whether it has been extended through the U. S. Food and Drug Administration. U. S.
The updated COVID-19 vaccine is recommended by the CDC for everyone ages 6 months and older. It is now widely available at pharmacies, doctor’s offices and other locations around the U.S., says Schaffner.
The new boosters have been reformulated to target omicron XBB.1.5, which was the dominant COVID variant for most of 2023. While XBB.1.5 has since been overtaken by HV.1 and other variants, it is still closely related to these newer strains.
Updated vaccines appear to be a good option for newly circulating variants that make people sick, Andrew Pekosz, Ph. D. , a virologist at Johns Hopkins University, previously told TODAY. com.
“Laboratory studies suggest that the current booster will protect against severe illness caused by HV. 1,” Schaffner says. Vaccination also especially reduces the risk of being hospitalized or dying, according to the CDC.
As of Dec. 22, only about 18% of adults and 7% of children in the U.S. have gotten the new vaccine, according to the latest CDC data on vaccination trends.
The first phase of the vaccine rollout faced several obstacles, including sourcing delays, canceled appointments and insurance hurdles. Some parents were unable to get their children vaccinated early on, as some pharmacies and pediatricians’ offices struggled to obtain enough doses suitable for children. .
While many of those teething issues have been resolved, Schaffner says, adoption remains slow. “We have underutilized this updated vaccine, and we anticipate that COVID will intensify further in the winter season,” Schaffner says.
It’s not too late to take advantage of the new booster, Schaffner adds, and other people are getting vaccinated as soon as possible. While other people get the COVID-19 vaccine, they also get the seasonal flu vaccine, Sampathkumar adds.
The FDA has three legal vaccine features for 2023-2024: an mRNA shot from Moderna and Pfizer, and a non-mRNA protein shot from Novavax.
Insurance plans cover the updated booster, Schaffner says, and those without insurance can still get vaccinated for free, according to the CDC.
“We’re in a good situation because it’s been a long time since we’ve had a new variant that causes more severe disease or escapes coverage from newly available vaccines,” Schaffner says.
As winter and the holiday season approach, it is vital to take steps to protect yourself from COVID-19 and prevent transmission to others, especially the most vulnerable. These include:
Staying up to date with COVID-19 vaccines
Getting tested if you have symptoms
Isolation if you are positive for COVID-19
Avoid contact with others who are sick.
Improving ventilation or gathering outdoors
Washing your hands with soap and water frequently
Use a in crowded indoor spaces
CORRECTION (November 27, 2023, 10:30 a. m. ET): A previous edition of this article incorrectly stated that insurance must still reimburse the cost of 8 at-home COVID-19 tests per month. When the federal pandemic emergency ended in May 2023, insurance was no longer required to do so, but some insurers still reimburse the test charge. See your plan for more information.
This article was originally published on TODAY. com
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