The COVID-19 pandemic in the United States isn’t as bad as Europe, but it’s changing the U.S.
Several computer models are projecting that COVID infections will continue to recede at least through the end of the year. But researchers stress there are many uncertainties that could change that, such as as whether more infectious variants start to spread fast in the U.S.
The first sign of things to come is what’s happening in Europe. There have been rising infections in Italy, France and the U.K.
“In the past, what’s happened in Europe often has been a harbinger for what’s about to happen in the United States,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. We have to be prepared for what they are going to see in Europe, that’s what the bottom line message in this country is.
“We look around the world and see countries such as Germany and France are seeing increases as we speak,” says Lauren Ancel Meyers, director of the UT COVID-19 Modeling Consortium at the University of Texas at Austin. “That makes me stop and think.” It adds uncertainty about what we can expect during the next couple of months.
The U.S. experience might not be as similar to Europe’s, says an epidemiologist at the University of North Carolina who helps run the COVID-19 Scenario Modeling Hub.
That’s because it’s not clear whether Europe’s rising cases are related to people’s greater susceptibility to new subvariants they’ve not yet been exposed to. In addition, different countries have different levels of immunity.
“The bad news is that it’s likely that people who’ve been vaccinated and/or infected will still get infected” with these new subvariants, says Dr. Daniel Barouch, a virologist at Beth Deaconess Hospital in Boston who’s been studying the new strains.
It’s too early to say what the future holds, but Amy Kirby says the CDC is keeping an eye on it.
But infections and even hospitalizations have started rising in some of the same parts of New England, as well as some other northern areas, such as the Pacific Northwest, according to Dr. David Rubin, the director of the PolicyLab at Children’s Hospital of Philadelphia, which tracks the pandemic.
“We’re seeing the northern rim of the country beginning to show some evidence of increasing transmission,” Rubin says. The winter resurgence is beginning.
It’s not clear whether this gang of new variants will continue to run around together, each sharing a piece of the Covid-19 infection pie, or whether one will rise to outcompete the others, as has happened in previous surges.
An author of a new study says that the risk of being re-infected is not trivial. “So going into the winter surge now people should do their best to try to prevent getting reinfected.”
The White House hopes that the amount of immunity that has been put in place by previous infections or immunizations will protect most people from serious disease, according to Anthony Fauci.
Another crucial variable that could affect how the impact of a rise of infections is how many people get one of the new bivalent omicron boosters to shore up their waning immunity.
The Americans have taken a while to get the new boosters. The CDC data shows that only 15% of eligible Americans have had an updated booster. Among seniors – those age 65 and older – only about 1 in 3 have had an updated shot.
The current demand for the newest boosters is not very high. Less than 8 million people have gotten one of the new boosters since they became available over the Labor Day weekend even though more than 200 million are eligible.
Emerging new strains of Covid-19: Immunization, Health Communication, Public Health and Immunization in the United States, Europe, and UK
As the country trudges towards the end of its third pandemic year, NPR talked to experts on immunization, health communication and public health, to learn how we should all be thinking about COVID vaccines now.
In the United States, these are BQ.1, BQ.1.1, BF.7, BA.4.6, BA.2.75 and BA.2.75.2. The XBB variant in Singapore appears to be fueling a new wave of cases in other countries. Cases are also rising in Europe and the UK, where these variants have taken hold.
The Scrabble variant is thought of by Dr. Peter Hotez, co-direct of the Vaccine Development Centre at the Texas Children’s Hospital as the Q, X and B variant.
Lumped together, the variants accounted for almost 1 in 3 new Covid-19 infections nationwide last week, according to the latest estimates from the US Centers for Disease Control and Prevention.
The vaccine protects against the original strain of the coronavirus as well as the BA.4 and BA.5 subvariants.
Though they each descend from slightly different branches of the Omicron family tree, these new offshoots have evolved to share many of the same mutations, a phenomenon known as convergent evolution.
Some experts think this convergence means we’ve entered a new phase of the evolution of the virus, one that will see circulation of several variants at the same time.
The new strains are becoming dominant just as winter is approaching and people will be traveling and gathering for the holidays, factors that had already raised fears about another winter surge.
The Emergence of Omicron Diseases in the United States: a Scenario for the Evolution of New Infectious Sub-Langeages
“That’s because with convergent evolution, perhaps several different lineages can independently obtain similar transmissibility levels versus a single new variant taking over.
“This is what predominantly happens for most pathogens, such as the flu and RSV,” Grubaugh wrote in an email. “Now that the virus has adapted pretty well to human transmission, most of what is circulating has high fitness.”
Maria Van Kerkhove, the Covid-19 response technical lead for the World Health Organization, said Wednesday that the large mix of new variants was becoming more difficult for WHO to assess because countries were dialing back on their surveillance.
The Omicron subvariant is still the top ranked one in the US. According to the CDC it caused about 75% of new infections in the United States last week, but it was quickly outmatched by other new sub lineages.
“The projections vary a little, but generally, most people feel somewhere in the middle of November that they’ll wind up being a substantial proportion and have bumped BA.5 off as the dominant variant,” Fauci told CNN.
The result of genetic drift is that these are different from the other two. They have parts of their genomes that are related to the virus.
He said that the new population landscape with lots of people being boosted and immunized and having immunity from Omicron infections made it a very different type of variant to emerge. The signs are the best part of the scenario, in regards to not seeing the huge increases in cases.
If people would just get the shot, it would not completely escape the protection that you would get from vaccine.
Why vaccines and vaccines are needed to halt epidemics and protect high-risk populations: a case study of the Omicron wave
“It’s probably going to be significantly bigger than the BA.5 wave, at least that’s what I expect,” said Mark Zeller, a project scientist who monitors variants at the Scripps Research Institute. The Omicron wave was reached in January but he doesn’t think this winter’s surge will reach that height.
Many people who haven’t had an updated booster for vaccines, because they have genetic changes that could help them escape the immunity created by them, are at risk of reinfections and the development of breakthrough infections.
Crucially, some of the variants also appear to be impervious to the last lab-created antibodies available to ward off severe Covid-19 infections: an antibody treatment called bebtelovimab, which is made by Eli Lilly, and the combination of two long-acting antibodies in Evusheld, a shot made by AstraZeneca that helps keep people who are immunocompromised from getting sick in the first place.
People with immune function that is blunted by drugs, disease or age can benefit from the use of antibody therapies. These people are the same people that don’t respond well to vaccines.
“And the truth is that if we want monoclonals to protect high-risk people – which we do – then at this point, given the speed of viral evolution, the US government has to be a major player in that role,” Jha said. The market cannot care for it on its own.
“So even if we got money today, it would take us many months to bring a monoclonal into the marketplace, and we don’t have the money today anyway,” Jha told CNN.
It takes a lot of money to make an anti-viral and it may be only a few months before they are effective.
He says current realities require that the government continue to incentivize the production of new therapies, and he expects that the Biden administration will again try to ask Congress to pass more funding to do that.
Implication of the recombinant BQ subvariant for the immune-evasive response of the Asian countries to recent wave events
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. She says the Bq variant looks very impressive against XBB, which is highly immune-evasive.
We were optimistic this time of year last year. We went into Thanksgiving to wake up to omicron after coming out of the delta wave. So there is this sort of déjà vu feeling from last year,” Luban says.
Recent laboratory studies indicate that new mutations in the virus’s spike protein appear to make BQ.1 and BQ.1.1 as much as seven times more “immune-evasive” than BA.5.
A new study suggests that getting reinsured with the virus is riskier than previously thought, and poses a risk of long term injuries and even death.
“The question is whether this increase is going to be nationwide and whether the size of the increase and the 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.
One promising sign is that recent surges in other countries suggest that if the subvariants are involved in a new U.S. wave, any uptick could be short-lived. France experienced a surge in cases involving subvariants, but the increase in cases quickly disappeared.
Can the BQ vaccine protect against the omicron? The CDC’s opinion on Covid-19 and its phenomenology
While some preliminary studies have questioned whether the new boosters are any better than the original vaccine at protecting against omicron, others have suggested they may 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 last monoclonal antibody drugs useless, including one that people with compromised immune systems use to protect themselves.
“We have seen, in some regions, RSV numbers starting to trend downward. Flu numbers are still on the rise. Dr. Rochelle Walensky, the director of the US CDC, told CNN that they are concerned that there will be more Covid-19 cases after the holidays.
“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. In the Helix sampling, it is increasing fastest among 18 to 24 year olds.
It can be an indication of increased transmission when the proportion of tests that return positive results increases.
We should be expecting more cases, according to Luo. “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.”
People testing for Covid-19 at home and not reporting results may cause increasing cases to be missed by official counts.
Nobody knows exactly what will happen with the BQ variants. Many experts say they’re hopeful that there won’t be the big waves of winters past like the original Omicron variant, which had a peak of almost 1.5 million new infections a day.
Andrew Pekosz is a faculty member at the University of Maryland School of Public Health.
Bill Hanage thinks that our behavior and social contacts may be more important in determining whether cases will rise or not.
“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. If someone has weakened immune systems, there is a good reason for them to be cautious.
The scientists in Los Alamos completed a study into the effects of 13 dominant coronaviruses as they transitioned from one country to another. Prior to the peer review, the data was published as a preprint and included in the study.
The Rise of the Omicron Mask in a Cold, High-Redshift World, Explained by Alamos Korber
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.
A laboratory fellow in Los Alamos’ Theoretical Biology and Biophysics Group says that how many other variants are in the mix when a new one rises is important.
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 variety of Omicron subvariants being tracked by the CDC could help suppress any wave that might occur during the winter.
But Korber isn’t making any predictions. She says she is too uncertain to know what’s going to happen.
“To me, it’s a good time, when it’s possible, to wear masks,” she said. There are masks that protect the wearer and 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.
Korber said that it was time to take additional precautions to make sure that the wave did not happen.
Identifying the early Omicron subvariant and the Delta variant from Benin, West Africa: A sequence of 15 years after the COVID-19 detection
“I’m somewhat sceptical of this paper,” says Angela Rasmussen, a virologist at the University of Saskatchewan in Saskatoon, Canada. Rasmussen is not convinced that the analysis rules out contamination during sample preparation and sequencing, which is a familiar problem for researchers in the field.
They also sequenced five virus samples from Benin in West Africa that were collected between 22 August and 27 October 2021, months to weeks before Omicron was first detected. The genetic analysis of the evolutionary relationship between the early sequence and Omicron suggests that they are close ancestors.
The study analysed more than 13,000 virus samples that were taken from people who had COVID-19. These samples had not been sequenced at the time of collection. The team developed a rapid and specific test to identify the BA.1 Omicron subvariant and the Delta variant. This is a cool way of doing variant-specific surveillance, according to Joshua Levy, an applied mathematician at Scripps Research.
The researchers found that, by the end of December 2021, Omicron had replaced Delta as the dominant variant across Africa, starting in the south and moving up towards the west and east, before taking over in northern Africa.
Researchers who have reviewed the study and virus sequence from Benin, which were uploaded to a public repository, say that it’s probably false positives.
Levy says that many of the sequence from Benin appear to carry a number of different versions of Delta’s genetic code. It’s highly unlikely that this would have happened in a non-Delta sample.
Some observations were made because the viruses had to go through extensive re-imagination, which means either they were swapped with each other, or they wereContamination in the lab. Richard Neher thinks that recombination is unlikely and that it’s not really consistent with what we’ve seen so far in the evolution of SARS-CoV-2.
An alternative explanation that needs further investigation is that samples containing very small amounts of Delta variant were contaminated with Omicron, says Darren Martin, a computational biologist at the University of Cape Town in South Africa.
Drexler says he and his team used several techniques to ensure their sequencing was as robust as possible. They are re-checking their data carefully. We will handle this appropriately even if there has been a mistake.
Ultimately, the study points to the importance of genomic sequencing for tracking infectious diseases. Researchers in South Africa detected Omicron early and this paper highlights the strength of their genomic surveillance, says one of them, Tulio de Oliveira, a bioinformatician at Stellenbosch University’s Centre for Epidemic Response and Innovation, who helped to sound the alarm about Omicron.
Do Vaccines Fail? Hesitation in the United States, says Claire Hannan, the president of the Association of Immunization Managers
“That is very concerning,” says Claire Hannan, who helps immunization officials from all 50 states run vaccination programs as the executive director of the Association of Immunization Managers.
One way to address vaccine fatigue is to try and target efforts to the people who are at the highest risk. Only 35% of people over age 65 have gotten an updated booster. Three quarters of COVID deaths in the U.S. are among people in this age group.
“Personally, I am not a fan of needless suffering and death,” says Dr. Kelly Moore, CEO of Immunize.org, which does vaccination education and advocacy. A recent analysis from the Commonwealth Fund found that the vaccination campaign prevented more than 18 million hospitalizations and 3 million deaths in the U.S., and saved the country more than $1 trillion.
Now, the public health approach is changing. For instance, Hannan says, “the CDC is doing an initiative to put a number of single-dose vials in long-term care facilities that have the right storage equipment.” That way, even if one resident of the facility is ready for a booster, staff at the nursing home could get a single dose out of the pharmacy-grade fridge and vaccinate that person on the spot.
With the winter holidays upon us, it’s a good time to think about grandma. Lindsay was the first person in the U.S. to receive a COVID-19 vaccine in December 2020 as a critical care nurse, and now she’s vice president of public health advocacy at Northwell Health in New York. She says that everyone has a responsibility to their loved ones. Stay home if you’re sick. Take her to get her vaccine as a Christmas gift.
Baur has worked with community health workers who are out in Maryland pounding the pavement and talking to people about vaccination. “I don’t think that we or anybody else doing this work has found any particular message or fact or phrase that is kind of really changing hearts and minds,” Baur says.
Providers are still the best source for vaccine recommendations, she says. If providers recommend vaccines, it creates the opportunity for a discussion about it and the likelihood of someone thinking more carefully about it.
There are a lot of ways to combat vaccine hesitancy, including focusing on misinformation or politicization or trust in public health. Moore has decided to look at ways to improve the vaccination experience.
She says that about a quarter of adults are afraid of needles. “How many of the people who refuse to get the vaccine say they don’t want it, they don’t have time or it doesn’t work?” For how many of them is that really just an excuse?”
She says the Autism Society for America has been pioneering strategies to help families and kids with autism get vaccinated, since it can be especially stressful and upsetting for people with autism. They have some simple, low-cost ideas like putting on headphones, listening to your favorite music, or using a little plastic “shot blocker” to make the shot hurt less.
I recently tried a variation of this when I took my 7-year-old daughter, Noa, to get her bivalent booster. Kids have a higher fear of needles than adults. I bought an over-the-counter lidocaine patch (marketed for back pain) at the drugstore and cut it to fit her bicep. She had it on her arm for 30 minutes before we left. The immunizer could give her the vaccine if I had drawn an outline on her skin around the patch. Noa was happy and proud that she didn’t cry because the shot didn’t hurt. If we could use it for every shot in the future she asked.
The CDC Global Covid-19 Project: Does Travel Require a More Transparent Detection of a New Type of Influenza?
If there is a particular concern for us, that would be the ongoing infections and whether or not they are increasing in China. Pekosz doesn’t think testing people before they get on a plane will answer that question.
US health officials announced Wednesday that, starting January 5, travelers from China will be required to show a negative Covid-19 test result before flying to the country. Passengers from China who are going to the US will need to get tested in two days and present a negative test at their airline before boarding.
The CDC is increasing the number of airports in Los Angeles and Seattle that are part of the Genomic Survey Program to seven, with an additional 500 weekly flights from at least 30 countries covered.
Although the US testing will buy some time, it won’t prevent new Covid-19 cases from coming to the United States or new variant from emerging, according to Dr. Carlos Del Rio, an associate dean at the Grady Health System in Atlanta.
I don’t think we’ll see much benefit from the travel requirements. The most important thing we need to do right now is to have more transparency from the Chinese and to know what’s going on. This is about diplomacy.
“What we really need is to do a much better job of sequencing the viruses from individuals who are traveling from China so that we can aid in terms of understanding what kinds of variants are circulating there,” he said, adding that throughout the pandemic, Chinese officials have not been very transparent about their data on variants.
The more cases you have, the more likely it is that the virus will accumulate genes that will help it evade detection.
Source: https://www.cnn.com/2022/12/30/health/covid-variants-concern-new-year/index.html
The spread of Covid-19 has boosted circulation in the United States, and it may be increasing by the coming weeks, according to a researcher
GISAID said in an email to CNN on Wednesday that China’s Center for Disease Control and Prevention, and several regional centers in the country, “have noticeably increased the number of submissions of genome sequence and associated metadata from samples taken in recent days.”
Experts point out that the United States appears to be the site of XBB. 1.5 now that the Covid-19 threat has been raised. It was first detected in New York and Connecticut in late October, according to GISAID, a global effort to catalog and track variants of the coronavirus.
“For a few months now, we haven’t seen a variant that’s taken off at that speed,” said Pavitra Roychoudhury, director of Covid-19 sequencing at the University of Washington School of Medicine’s virology lab.
The genetics of XBB. 1.5 is allowing it to spread better, according to an email from a researcher.
Bedford has pegged its effective reproductive number – the number of new infections expected to be caused by each infected person – at about 1.6, roughly 40% higher than its next closest competitor.
“I expect it to drive increased circulation in the coming weeks,” Bedford wrote in an email. He pointed out that since more people are testing at home, they may not be counted in the numbers unless they seek medical care and get a lab test to confirm their results. I would look to hospitalizations in the vulnerable age groups as better indicator of wave, he wrote.
XBB.1.5: Implications for Covid-19 Vaccines and the Evolution of the Most Transducible Form of Omicron
Ho said Monday that XBB.1.5 was the same story in terms of antibody evasion as XBB.1, which means it has the potential to escape the protections of vaccinations and past infections. It is resistant to all current anti-retroviral treatments.
He said these levels of immune evasion could compromise the effectiveness of the Covid-19 vaccines. The journal Cell published his findings.
This is one of the important evolutionary changes that could be important to viral fitness. It has been confirmed by Yunlong Cao at Peking University.
We have more information on how well vaccines destroy XBB. 1.5, so we will start research to determine vaccine effectiveness against the new sublineage.
A level of immunity that may not prevent you from getting an STD, but may make a difference is what they offer. “I mean, right now, the most recent data we have shows that for those who have the bivalent vaccine, they have a three-fold lower risk of dying than those who don’t.”
Experts also note that although antibody treatments won’t work against this sublineage, other antivirals, such as Paxlovid and remdesivir, should still be effective.
Rapid tests continue to work, as do masks, and ventilation and filtration of indoor air, so even as the virus continues to evolve, there are still good ways to protect yourself from getting Covid-19.
The public was told to remain informed, but not alarmed, over the rapid growth of the new Omicron sublineage.
According to Van Kerkhout, XBB. 1.5 is the most transmissible form of Omicron to date, and has spread to at least 29 countries.
How Well Do We Expect New Diseases Around the World? A Quest for Real-World Measurement of the Severity of Asteroseismology in the 21st Century
“We do expect further waves of infection around the world, but that doesn’t have to translate into further waves of death because our countermeasures continue to work,” she said.
She said that the WHO hopes to publish a risk assessment of this sublineage in the next few days. Technical advisers for the group are looking at real-world data to assess severity.