What COVID-19 variants are going around in November 2022?

Authors: Nebraska Medicine November 1, 2022

There are currently more than 37,000 cases reported in the United States per day, with test positivity of 8.6%. When test positivity is above 5%, transmission is considered uncontrolled. There are more than 340 deaths per day, and hospitalizations have increased 8% over the last two weeks. 

What COVID-19 variant are we on?

Currently, the dominant variant nationwide is BA.5. “The original omicron variant is gone now,” says Dr. Rupp. “Currently subvariants of omicron are circulating, including BA.5, BA.4.6, BQ.1, BF.7 and BQ.1.1.” 
 

United States COVID-19 graphs through October 29, 2022.
Currently, BA.5 (dark green) is the dominant COVID-19 variant nationwide, followed by BA.4.6. Source: CDC Variant Proportions on November 1, 2022.

BA.5 variant dominating in Nebraska

BA.5 is also the dominant variant in Nebraska, making up 88% of cases. BA.4.6 is the next highest variant, with 6% of Nebraska cases.

Chart of COVID-19 variant data specific to Nebraska.
New COVID-19 variants displace older ones. In the last two weeks, Nebraska has seen an increase in omicron subvariants BA.5 (brown). Source: DHHS Nebraska on November 1, 2022. 

Which COVID-19 variant do I have? And do COVID-19 tests tell you the variant?

When you receive a COVID-19 test, you won’t find out which variant caused your infection. That’s because COVID-19 tests only detect the presence of the virus – they don’t determine the variant.

Genomic sequencing looks at the genetic code of the virus to determine which variant caused the infection.

Nebraska DHHS sequences test samples after a positive test is identified and reports the total percentage of each variant every two weeks. See the latest genomic surveillance report for Nebraska. Sequencing results are used by public health experts to understand variant trends in the community.

Will COVID-19 variants affect the vaccine?

The best way to prevent new variants is to slow the spread of the virus. The great news is that these proven public health strategies continue to work against new variants as well.

  • Get vaccinated
  • Choose outdoor activities over indoor activities whenever possible
  • Wash your hands often
  • Avoid close contact with others
  • Wear a mask in public places
  • Stay home if you’re sick or have symptoms of COVID-19

“We have a lot of disease out there. People should continue to be careful,” Dr. Rupp says. “Get your booster, try to avoid high-risk settings. If you can’t, then I think you should wear a mask.”

BA.4/BA.5 boosters, Novavax and vaccines for kids under 5

Everyone 5 years and up should get an updated COVID-19 booster, if eligible. These updated bivalent boosters offer protection against the latest omicron variants of BA.4 and BA.5, plus the original COVID-19 strain.

COVID-19 vaccines are now available for kids under 5. Now everyone ages 6 months and older can be vaccinated against COVID-19.

The Food and Drug Administration approved the Novavax vaccine July 19. As it uses a more traditional approach to vaccination and vaccine production than the mRNA vaccines already available, it may encourage some people who have not yet been vaccinated to accept vaccine. 

Novavax vaccines are available at the following Nebraska Medicine pharmacies:

As a community and nation, vaccination and booster dose rates need to increase. Evidence shows those vaccinated and boosted continue to be protected against severe disease, hospitalization, and death – even with the latest variants. Unfortunately, the United States is behind compared to other developed countries with only about 34% of those who are eligible to have received a booster actually getting the shot.

Yet Another Curveball in the COVID Mutation Nightmare

Authors: David Axe September 6, 2022 The Daily Beast

When the pharmaceutical industry scrambled to develop the first COVID vaccines back in 2020, it made sense that developers focused on the part of the virus that allows it to grab onto and infect our cells: the spike proteins.

The best vaccines contain a piece of the spike, or genetic data about the spike, either of which can spur an immune response. Not to be outdone, the virus has been mutating—with many of the changes occurring on that same spike.

But other parts of the virus are changing, too. Now, for the first time, a team of scientists has scrutinized these changes—and voiced a warning.

“With each major variant that has been identified, we are seeing mutations outside of [the] spike that we are trying to figure out,” Matthew Frieman, a University of Maryland School of Medicine immunologist and microbiologist and lead author of the new study, told The Daily Beast.

It’s possible the virus is accumulating non-spike mutations in an attempt to gain some advantage over our collective immunity as the COVID pandemic grinds toward its fourth year. These new mutations might not make the virus more infectious the way spike mutations do, but they could be associated with longer infections.

If this trend continues—and there’s no reason to believe it won’t—we might eventually need new antiviral drugs and new vaccine formulations that aren’t so specifically focused on the spike.

It’s possible the virus is accumulating non-spike mutations in an attempt to gain some advantage over our collective immunity as the COVID pandemic grinds toward its fourth year. These new mutations might not make the virus more infectious the way spike mutations do, but they could be associated with longer infections.

If this trend continues—and there’s no reason to believe it won’t—we might eventually need new antiviral drugs and new vaccine formulations that aren’t so specifically focused on the spike.

Vaccine developers weren’t wrong to focus their initial efforts on the spike protein, Frieman and his co-authors explained in their peer-reviewed study, which was published in Proceedings of the National Academy of Sciences and appeared online on Tuesday. “The spike protein is the immunodominant antigen,” they wrote. In other words, it’s the part of the virus most likely to produce a strong immune response.

Moreover, the major variants and subvariants of SARS-CoV-2—Delta then the various forms of Omicron including BA.4 and BA.5—have piled up mutations on the spike. As the spike evolves, the virus gets better and better at grabbing onto our cells despite the presence of antibodies.

That’s one reason why the vaccines have been getting somewhat less effective, and we’re seeing more and more breakthrough cases in vaccinated people. And it should come as no surprise that one of the leading contenders for the next dominant subvariant, a spinoff of Omicron called BA.4.6, features a particularly worrying mutation on the spike called R346T.

But there have been hints that non-spike mutations are becoming a bigger factor, too. Geneticists noted that BA.5, currently the dominant subvariant, doesn’t just have mutations along its spike—it features changes all across its structure.

There had to be a reason for those mutations, Frieman explained. “Viruses don’t do things by accident.” Instead, they try out small changes, over and over, until some combination of changes helps it survive and spread. The resulting variant or subvariant then outcompetes other forms of the pathogen until it becomes dominant—and the likely basis for the next set of mutations.

To understand the reason for, and effects of, the non-spike mutations, Frieman’s team cloned SARS-CoV-2 then started deleting the spike proteins and testing the resulting “deletion viruses” on mice, assessing how contagious the viruses were and how severe the infections were.

Their conclusion? “Mutations outside of [the] spike may be driving critical phenotypes of SARS-CoV-2 infection and disease.” That is to say, changes beyond the spike are beginning to define the virus.

For now, it seems the spike and non-spike mutations are working together. The spike mutations make the virus steadily more contagious. “Mutations in [the] spike have been identified in every major variant that then out-competes the previous variant,” Frieman explained.

Meanwhile, the non-spike mutations appear to prolong infection. This in turn gives the pathogen more time to mutate inside a particular person, and also spread to other people. “We hypothesize that this balance is critical for further evolution of SARS-CoV-2,” Frieman’s team wrote.

As the virus continues trying out mutations in order to stay ahead of our spike-focused immunity, it might further emphasize changes beyond the spike. BA.5, with its wide breadth of mutations, is a sign that’s already happening.

Take this as an urgent call for further study of non-spike mutations. “As more variants emerge, we will identify additional mutations outside of [the] spike that contribute significantly to viral replication, transmission and pathogenesis,” Frieman and his coauthors wrote.

Frieman said his goal is to scrutinize these non-spike mutations in order to “figure out what they do, how they do it [and] why they make the virus better at being a virus.” “Then we can use that information to make drugs,” including new antiviral therapies and vaccine formulations.

Speed matters. The Omicron variant and its rapid-fire subvariants, each coming just a couple months after the last, was a warning that our pharmaceutical research-and-development processes might be too slow. Note that the U.S. Food and Drug Administration just last week green-lit Omicron-specific vaccine boosters—a full 10 months after the initial Omicron variant first became dominant. “Omicron and its lineages”—another term for subvariants—“taught us a lesson for the need to be more agile in modifying the vaccine,” Ali Mokdad, a professor of health metrics sciences at the University of Washington Institute for Health, told The Daily Beast.

That problem could get worse if the rate of non-spike mutations accelerates. Our vaccine R&D is too slow even when it’s narrowly focused on the spike. What happens when it needs to broaden its scope to combat a virus that’s learning to mutate across its structure?

There’s another wrinkle. These accumulating mutations across the novel-coronavirus—on the spike and not on the spike—could start to mess with the polymerase chain-reaction tests we use to detect and track the virus.

PCR tests and sequencing use primers tailored for a certain range of viral characteristics. Too many mutations “can mess with the PCR test,” Niema Moshiri, a geneticist at the University of California-San Diego, told The Daily Beast.

Pay attention, but don’t panic. It’s really no surprise that SARS-CoV-2 is trying out mutations on different parts of the virus. That’s what viruses do—adapt. The trick for us, the novel-coronavirus’s host, is to adapt at least as quickly.

We did it before by rapidly developing vaccines and therapies targeting the most dangerous part of the virus. We can do it again as the virus finds new ways to evolve. It just takes political will… and money.

Unraveling the Interplay of Omicron, Reinfections, and Long Covid

Authors:  Liz Szabo AUGUST 26, 2022 KHN

The latest covid-19 surge, caused by a shifting mix of quickly evolving omicron subvariants, appears to be waning, with cases and hospitalizations beginning to fall.

Like past covid waves, this one will leave a lingering imprint in the form of long covid, an ill-defined catchall term for a set of symptoms that can include debilitating fatigue, difficulty breathing, chest pain, and brain fog.

Although omicron infections are proving milder overall than those caused by last summer’s delta variant, omicron has also proved capable of triggering long-term symptoms and organ damage. But whether omicron causes long covid symptoms as often — and as severe — as previous variants is a matter of heated study.

Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, is among the researchers who say the far greater number of omicron infections compared with earlier variants signals the need to prepare for a significant boost in people with long covid. The U.S. has recorded nearly 38 million covid infections so far this year, as omicron has blanketed the nation. That’s about 40% of all infections reported since the start of the pandemic, according to the Johns Hopkins University Coronavirus Research Center.

Long covid “is a parallel pandemic that most people aren’t even thinking about,” said Akiko Iwasaki, a professor of immunobiology at Yale University. “I suspect there will be millions of people who acquire long covid after omicron infection.”

Scientists have just begun to compare variants head to head, with varying results. While one recent study in The Lancet suggests that omicron is less likely to cause long covid, another found the same rate of neurological problems after omicron and delta infections.

Estimates of the proportion of patients affected by long covid also vary, from 4% to 5% in triple-vaccinated adults to as many as 50% among the unvaccinated, based on differences in the populations studied. One reason for that broad range is that long covid has been defined in widely varying ways in different studies, ranging from self-reported fogginess for a few months after infection to a dangerously impaired inability to regulate pulse and blood pressure that may last years.

Even at the low end of those estimates, the sheer number of omicron infections this year would swell long-covid caseloads. “That’s exactly what we did find in the UK,” said Claire Steves, a professor of aging and health at King’s College in London and author of the Lancet study, which found patients have been 24% to 50% less likely to develop long covid during the omicron wave than during the delta wave. “Even though the risk of long covid is lower, because so many people have caught omicron, the absolute numbers with long covid went up,” Steves said.

recent study analyzing a patient database from the Veterans Health Administration found that reinfections dramatically increased the risk of serious health issues, even in people with mild symptoms. The study of more than 5.4 million VA patients, including more than 560,000 women, found that people reinfected with covid were twice as likely to die or have a heart attack as people infected only once. And they were far more likely to experience health problems of all kinds as of six months later, including trouble with their lungs, kidneys, and digestive system.

“We’re not saying a second infection is going to feel worse; we’re saying it adds to your risk,” said Dr. Ziyad Al-Aly, chief of research and education service at the Veterans Affairs St. Louis Health Care System.

Researchers say the study, published online but not yet peer-reviewed, should be interpreted with caution. Some noted that VA patients have unique characteristics, and tend to be older men with high rates of chronic conditions that increase the risks for long covid. They warned that the study’s findings cannot be extrapolated to the general population, which is younger and healthier overall.

“We need to validate these findings with other studies,” said Dr. Harlan Krumholz, director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation. Still, he added, the VA study has some “disturbing implications.”

With an estimated 82% of Americans having been infected at least once with the coronavirus as of mid-July, most new cases now are reinfections, said Justin Lessler, a professor of epidemiology at the University of North Carolina Gillings School of Global Public Health.

Of course, people’s risk of reinfection depends not just on their immune system, but also on the precautions they’re taking, such as masking, getting booster shots, and avoiding crowds.

New Jersey salon owner Tee Hundley, 43, has had covid three times, twice before vaccines were widely available and again this summer, after she was fully vaccinated. She is still suffering the consequences.

After her second infection, she returned to work as a cosmetologist at her Jersey City salon but struggled with illness and shortness of breath for the next eight months, often feeling like she was “breathing through a straw.”

She was exhausted, and sometimes slow to find her words. While waxing a client’s eyebrows, “I would literally forget which eyebrow I was waxing,” Hundley said. “My brain was so slow.”

When she got a breakthrough infection in July, her symptoms were short-lived and milder: cough, runny nose, and fatigue. But the tightness in her chest remains.

“I feel like that’s something that will always be left over,” said Hundley, who warns friends with covid not to overexert. “You may not feel terrible, but inside of your body there is a war going on.”

Although each omicron subvariant has different mutations, they’re similar enough that people infected with one, such as BA.2, have relatively good protection against newer versions of omicron, such as BA.5. People sickened by earlier variants are far more vulnerable to BA.5.

Several studies have found that vaccination reduces the risk of long covid. But the measure of that protection varies by study, from as little as a 15% reduction in risk to a more than 50% decrease. A study published in July found the risk of long covid dropped with each dose people received.

For now, the only surefire way to prevent long covid is to avoid getting sick. That’s no easy task as the virus mutates and Americans have largely stopped masking in public places. Current vaccines are great at preventing severe illness but do not prevent the virus from jumping from one person to the next. Scientists are working on next-generation vaccines — “variant-proof” shots that would work on any version of the virus, as well as nasal sprays that might actually prevent spread. If they succeed, that could dramatically curb new cases of long covid.

“We need vaccines that reduce transmission,” Al-Aly said. “We need them yesterday.”

Omicron is considered a milder coronavirus, but scientists aren’t so sure

Authors: Melissa Healy August 13, 2022 la times

For more than two years, Cathy Baron and Sara Alicia Costa managed to duck the coronavirus. But despite their being fully vaccinated and boosted, the Omicron variant finally caught them.

Baron is an actress and dance instructor who lives in Santa Monica. Costa is an architect in Austin, Texas. Both are 40 and healthy. But the two friends saw two very different sides of the variant they expected to be gentler on its victims than earlier strains.

For Costa, the Omicron variant lived up to its reputation for mildness, causing headaches and “something like a crummy cold” for a couple of days. She was visiting Baron and surfing in Santa Monica a week after testing positive.

Baron’s illness was deeply chastening. She was flattened for several days with a high fever and debilitating muscle aches and was too exhausted to teach her pole dancing class for three weeks. Two months later, she’s still coping with fatigue, brain fog and episodic coughing fits. She hopes never to repeat the experience.

Baron and Costa are what scientists would dismiss as an “n of 2.” If their experience were a study, the sample size would be far too small to draw any conclusions, especially one as important as whether the Omicron variant really is less virulent than the SARS-CoV-2 variants that came before it.

And yet, their contrasting experiences are as telling as many of the research studies conducted to date that have tried to determine how dangerous Omicron really is.

“It’s an excellent question,” said Dr. Stanley Perlman, a University of Iowa virologist and a leading expert on coronaviruses. Many researchers think they know the answer, and “I think it’s true” that the Omicron variant is causing milder illnesses, he said. But the true picture is “not clear,” he cautioned.

Omicron arrived in the United States at a time when 60% of Americans had the protection of COVID-19 vaccines and roughly a third of Americans (including some who’d been vaccinated) had a past infection. Not only was there a high level of population immunity, those who did become ill had access to treatments that weren’t available to people sickened by the initial strain from Wuhan, China, or the Alpha and Delta variants that followed.

Perhaps these are the reasons why those infected with Omicron have tended to experience milder illnesses.

“It’s widely said that Omicron is inherently less pathogenic, but there is no real evidence for that,” said Dr. Christopher Chiu, a COVID-19 researcher at Imperial College London.

“Comparisons with Delta are like apples and oranges,” he said. “Delta was circulating at a time when many were still not vaccinated or previously infected. In contrast, Omicron is largely causing breakthrough infections in people who already have partial protection from immunity conferred by vaccines or infection.”

Since its earliest appearance in November, researchers have seen that compared with previous variants, Omicron was less likely to send infected people to the hospital or to their graves.

First in South Africa and later in communities across America, the new variant bucked expectations spawned by earlier surges. In the two to three weeks after Omicron cases spiked, hospitalizations and deaths rose as well — but more slowly, and they’d topped out at lower levels.

Still, as Americans have learned from hard experience, the Omicron variant is a highly capable killer. Just over 200,000 of the country’s COVID-19 deaths are likely attributable to some version of the Omicron variant, which arrived here around Thanksgiving and became dominant in January.

And don’t forget, Perlman added: It’s still killing some 400 people a day in the United States.

How much of Omicron’s supposed mildness should be credited to the protective effect of vaccines is not really known.

During June, the Centers for Disease Control and Prevention concluded that COVID-associated hospitalizations among unvaccinated adults were 4.6 times higher than they were among vaccinated people. But the picture is muddier than such data would suggest.

Americans’ immune profiles run the gamut, making it hard to slot people into neat categories and compare how they fared when infected by different variants. Those who’ve been vaccinated are experiencing various degrees of waning immunity, even if they’ve been boosted. The same goes for people who’ve recovered from infections. The readiness of their immune systems depends on how long ago they had the infection, what variant infected them, their vaccination status, and factors like age and the medications they take.

With so many variables to consider, it’s hard for researchers to draw a clean comparison between Omicron and its predecessors. But they’ve tried.

In one study published in Nature, scientists showed that Omicron was drawn to a wide range of human tissues. When observed in petri dishes, the variant established itself in cells that mimicked the upper airways of the respiratory system, though with less gusto than the Delta variant. In addition, Omicron was far less adept at infecting lower airway cells, including lung tissue, than either Delta or the original SARS-CoV-2 strain that left Wuhan.

And in studies that infected animals such as hamsters and genetically engineered mice, the Omicron variant caused less weight loss (a proxy of severe disease) and touched off less inflammation in the lungs than either Delta or the original strain.

Adding to the uncertainty is the fact that coronavirus testing was undergoing sweeping changes just as the Omicron variant took hold. As at-home testing ramped up and fewer new infections were reported to public health agencies, the relationship between cases on the one hand and hospitalizations and deaths on the other — a previously dependable measure of a variant’s ability to sicken — became less reliable.

The Omicron variant’s astonishing infectiousness and propensity to spin off new subvariants complicate the picture even more. In a recent meeting convened by the Food and Drug Administration, even experts from the agency shrugged when asked to compare the subvariants.

Collectively, those Omicron subvariants muscled Delta aside so quickly that doctors and researchers didn’t have time to collect groups of similar patients, genetically sequence the viruses that infected them, and compare how their illnesses proceeded.

That’s the kind of study that might shed light on the divergent experiences of Cathy Baron and Sara Alicia Costa. They’re a seemingly well-matched pair of healthy 40-year-old women, yet Omicron attacked one of them like a lion and treated the other like a lamb. With the experiences of hundreds or thousands of people thrown in, such research might reveal factors that nudge an Omicron infection in one direction or the other.

There is a more direct way to learn how Omicron compares to earlier variants in its ability to sicken and kill. Researchers could deliberately infect volunteers with different versions of the coronavirus and track their physiological responses to infection over the course of an illness.

Chiu and his colleagues at Imperial College London have just such an undertaking in mind. They are planning “human challenge” studies involving the Delta and Omicron variants to mirror one already conducted with the original version of the virus.

The resulting data could yield a clearer picture of exactly how Omicron behaves in healthy humans, and how a prior infection or different levels of vaccination affect an individual’s illness.

Chiu said a new study would seek to enroll people who gained immunity through vaccination, a past infection, or a combination of both. That would give them more insight into whether so-called hybrid immunity is an important bulwark against becoming sick in the Omicron era.

If research confirms that the Omicron variant is indeed milder than its predecessors, and that getting it confers some protection from future illness, some may conclude it’s time to let the virus spread.

Baron would take some convincing of that.

“When people say, ‘let’s just let it rip’ and allow ourselves to get infected over and over again — that’s scary to me,” she said. “I don’t want to just let it rip. I don’t want to get it again.”

Duration of Shedding of Culturable Virus in SARS-CoV-2 Omicron (BA.1) Infection

Authors: Julie Boucau, Ph.D. Caitlin Marino, B.S. Ragon Institute, Cambridge, MA

James Regan, B.S. Brigham and Women’s Hospital, Boston, MA Rockib Uddin, B.S.
Massachusetts General Hospital, Boston, MA Manish C. Choudhary, Ph.D.
James P. Flynn, B.S. Brigham and Women’s Hospital, Boston, MA Geoffrey Chen, B.A.
Ashley M. Stuckwisch, B.S. Josh Mathews, A.B. May Y. Liew, B.A. Arshdeep Singh, B.S.
Taryn Lipiner, M.P.H. Massachusetts General Hospital, Boston, MA Autumn Kittilson, B.S. Meghan Melberg, B.S. Yijia Li, M.D. Brigham and Women’s Hospital, Boston, MARebecca F. Gilbert, B.A. Zahra Reynolds, M.P.H. Surabhi L. Iyer, B.A. Grace C.Chamberlin, B.A. Tammy D. Vyas, B.S. Marcia B. Goldberg, M.D.Jatin M. Vyas, M.D., Ph.D.Massachusetts General Hospital, Boston, MAJonathan Z. Li, M.D.Brigham and Women’s Hospital, Boston, MA Jacob E. Lemieux, M.D., D.Phil. Mark J. Siedner, M.D., M.P.H.Amy K. Barczak, M.D.Massachusetts General Hospital, Boston, MA

July 21, 2022 N Engl J Med 2022; 387:275-277 DOI: 10.1056/NEJMc2202092

The B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a shorter incubation period and a higher transmission rate than previous variants.1,2 Recently, the Centers for Disease Control and Prevention recommended shortening the strict isolation period for infected persons in non–health care settings from 10 days to 5 days after symptom onset or after the initial positive test, followed by 5 days of masking.3 However, the viral decay kinetics of the omicron variant and the duration of shedding of culturable virus have not been well characterized.

We used longitudinal sampling of nasal swabs for determination of viral load, sequencing, and viral culture in outpatients with newly diagnosed coronavirus disease 2019 (Covid-19).4 From July 2021 through January 2022, we enrolled 66 participants, including 32 with samples that were sequenced and identified as the B.1.617.2 (delta) variant and 34 with samples that were sequenced and identified as the omicron subvariant BA.1, inclusive of sublineages. Participants who received Covid-19–specific therapies were excluded; all but 1 participant had symptomatic infection. This study was approved by the institutional review board and the institutional biosafety committee at Mass General Brigham, and informed consent was obtained from all the participants. Figure 1.Viral Decay and Time to Negative Viral Culture.

The characteristics of the participants were similar in the two variant groups except that more participants with omicron infection had received a booster vaccine than had those with delta infection (35% vs. 3%) (Tables S1 and S2 in the Supplementary Appendix, available with the full text of this letter at NEJM.org). In an analysis in which a Cox proportional-hazards model that adjusted for age, sex, and vaccination status was used, the number of days from an initial positive polymerase-chain-reaction (PCR) assay to a negative PCR assay (adjusted hazard ratio, 0.61; 95% confidence interval [CI], 0.33 to 1.15) and the number of days from an initial positive PCR assay to culture conversion (adjusted hazard ratio, 0.77; 95% CI, 0.44 to 1.37) were similar in the two variant groups (Figure 1A through 1C and S1 through S3, and Tables S3 through S5). The median time from the initial positive PCR assay to culture conversion was 4 days (interquartile range, 3 to 5) in the delta group and 5 days (interquartile range, 3 to 9) in the omicron group; the median time from symptom onset or the initial positive PCR assay, whichever was earlier, to culture conversion was 6 days (interquartile range, 4 to 7) and 8 days (interquartile range, 5 to 10), respectively. There were no appreciable between-group differences in the time to PCR conversion or culture conversion according to vaccination status, although the sample size was quite small, which led to imprecision in the estimates (Figure 1D and 1E).

In this longitudinal cohort of participants, most of whom had symptomatic, nonsevere Covid-19 infection, the viral decay kinetics were similar with omicron infection and delta infection. Although vaccination has been shown to reduce the incidence of infection and the severity of disease, we did not find large differences in the median duration of viral shedding among participants who were unvaccinated, those who were vaccinated but not boosted, and those who were vaccinated and boosted.

Our results should be interpreted within the context of a small sample size, which limits precision, and the possibility of residual confounding in comparisons according to variant, vaccination status, and the time period of infection. Although culture positivity has been proposed as a possible proxy for infectiousness,5 additional studies are needed to correlate viral-culture positivity with confirmed transmission in order to inform isolation periods. Our data suggest that some persons who are infected with the omicron and delta SARS-CoV-2 variants shed culturable virus more than 5 days after symptom onset or an initial positive test.

Natural Immunity From Omicron Strong Against Virus Subvariants: Study

Authors: Zachary Stieber via The Epoch Times, UL 18, 2022

The protection afforded by surviving COVID-19 was strong against the latest virus subvariants, including the one currently dominant in the United States, scientists in Qatar found.

People who were infected with Omicron, a variant of SARS-CoV-2, had 76.1 percent protection against symptomatic reinfection from BA.4 and BA.5 and 80 percent shielding from any reinfection, regardless of symptoms, according to the preprint study.

SARS-CoV-2, also known as the CCP (Chinese Communist Party) virus, causes COVID-19.

Omicron became the dominant virus strain in many countries in late 2021. Since then, a number of subvariants have taken hold. BA.5 is the strain currently dominant in the United States.

While protection from an Omicron infection provided robust shielding against reinfection, those who contracted a pre-Omicron strain had little protection, according to the Qatari scientists, who were led by Dr. Laith Abu-Raddad with Weill Cornell Medicine-Qatar.

Pre-Omicron infection provided just 15.1 percent effectiveness against symptomatic BA.4 and BA.5 reinfection and just 28 percent infection against any reinfection.

The scientists analyzed data from national COVID-19 databases.

Infections before Omicron were those that occurred before Dec. 19, 2021, when the variant wave started in Qatar.

Protection ‘Strong’

“Protection of a previous infection against BA.4/BA.5 reinfection was modest when the previous infection involved a pre-Omicron variant, but strong when the previous infection involved the Omicron BA.1 or BA.2 subvariant,” the scientists wrote.

Natural immunity has long been found to be superior to the protection from COVID-19 vaccines, and the new study is no exception. Vaccines provide little protection against Omicron infection and perform worse against infection and severe illness from the BA.4 and BA. 5 subvariants, studies have shown.

Natural immunity also waned against BA.4 and BA.5, highlighting how the subvariants are better at evading protection, the Qatari researchers found.

The group has been studying natural immunity for years and recently discovered that the protection from prior infection against severe disease showed no signs of waning, regardless of what strain infected the person.

Among the listed limitations for the new study was the young population of Qatar, where just 9 percent of residents are 50 years of age or older. That means the findings “may not be generalizable to other countries where elderly citizens constitute a larger proportion of the total population,” researchers wrote.

Some experts, including Abu-Raddad and U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky, continue recommending vaccination for people with natural immunity, pointing to studies that indicate one or more doses increase protection, but others say vaccination isn’t needed for people who survive COVID-19, since some research suggests the elevated protection is minimal and that the naturally immune are at higher risk of vaccine side effects.

VIRAL THREAT 

New Covid variant dubbed ‘Centaurus’ already ‘detected in 10 countries including UK and US’

Authors: Vanessa Chalmers U.S, Sun Jul 19 2022

BA.2.75, nicknamed Centaurus, was first detected and is spreading rapidly in India.

It is a relative of Omicon, the original strains of which were shown to be more mild Covid illness (BA.1 and BA.2).

Health chiefs, however, do not know how new versions of Omicron (BA.2.75, BA.4 and BA.5) compare.

But it is feared that Centaurus is even more infectious than Omicron strains that have come before it.

The UK has seen 18 cases to date, and is among roughly 10 countries where Centaurus has been detected.

Professor Susan Hopkins, Chief Medical Advisor at UKHSA said: “We are aware of a small number of cases of the emergent variant Omicron BA.2.75 in the UK.

“At this point, it is too early to draw conclusions about the relative transmissibility of this variant, or the illness it may cause, compared to the currently-dominant variants.

“UKHSA is monitoring the situation closely, as we do all data relating to SARS-CoV-2 variants in the UK and around the globe through our world-leading genomic surveillance systems.”

BA.2.75 appears to be spreading faster than other variants in India, Lipi Thukral, a scientist at the Council of Scientific and Industrial Research-Institute of Genomics and Integrative Biology in New Delhi, told MedicalXpress

The summer of subvariants

Authors: Tina Reed, July 9, 2022 Axios Vitals

As this summer heats up, so has the spread of the hot new version of COVID-19.

Why it matters: This subvariant of Omicron called BA.5 — the most transmissible subvariant yet — quickly overtook previous strains to become the dominant version circulating the U.S. and much of the world.

BA.5 is so transmissible — and different enough from previous versions — that even those with immunity from prior Omicron infections may not have to wait long before falling ill again.

What they’re saying: “I had plenty of friends and family who said: ‘I didn’t want to get it but I’m sort of glad I got it because it’s out of the way and I won’t get it again’,” Bob Wachter, chairman of the University of California, San Francisco Department of Medicine told Axios. “Unfortunately that doesn’t hold the way it once did.”

  • “Even this one bit of good news people found in the gloom, it’s like, ‘Sorry’,” Wachter said.

State of play: This week, the CDC reported BA.5 became the dominant variant in the U.S., accounting for nearly 54% of total COVID cases. Studies show extra mutations in the spike protein make the strain three or four times more resistant to antibodies, though it doesn’t appear to cause more serious illness.

  • Hospital admissions are starting to trend upward again, CDC data shows, though they’re still well below what was seen during the initial spread of Omicron.
  • It’s unclear whether that could be indicating an increase in patients in for COVID, or patients who happen to have COVID, Wachter said. “We’re up in hospitalizations around 20% but with a relatively small number of ICU patients,” Wachter said about COVID cases at UCSF.
  • In South Africa, the variant had no impact on hospitalizations while Portugal saw hospitalizations rise dramatically, Megan Ranney, academic dean at the Brown University School of Public Health told Axios.
  • “So the big unknown is what effect it’s going to have on the health care system and the numbers of folks living with long COVID,” she said.

Yes, but: “I’m certainly hearing about more reinfections and more fairly quick reinfections than at any other time in the last two and a half years,” Wachter said.

Zoom in: That is also largely the experience of the surge seen firsthand in New York City by Henry Chen, president of SOMOS Community Care, who serves as a primary care physician across three boroughs of the city.

  • With this particular variant, he said: “The symptoms are pretty much the same but a little bit more severe than the last wave. It’s more high fever, body ache, sore throat and coughing,” Chen said, adding his patient roster is mostly vaccinated.
  • But it is occurring among patients who’d gotten the virus only three or four months ago, he said.

The big picture: Another summertime wave of cases could prolong the pandemic, coming after many public health precautions were lifted and with available vaccines losing their efficacy against the ever-evolving virus.

The bottom line: The messaging isn’t to panic, but to understand the virus is likely spreading in local communities much more than individuals realize due to shrinking testing programs  and without the level of protection they might assume they have.

  • “If you don’t want to get sick, you still need to be taking at least some precautions,” Ranney said. “[COVID] is still very much among us.”

COVID Boosters Might Be Less Than 20% Effective After a Few Months: Study

An Italian review of COVID studies found that boosters restore vaccine effectiveness against omicron initially, but that protection falls off quickly

Authors: NBC News July 8, 2022

COVID booster shots appear to be less than 20% effective against infection with the omicron variant of the virus just a few months after the booster is given, a new study found this week.

The Italian study, which is a pre-print review and re-analysis of prior studies and has not been peer-reviewed, suggests boosters are effective in the short term to restore protection against the virus. But over just a few months, that wanes quickly.

“Booster doses were found to restore the VE [vaccine effectiveness] to levels comparable to those acquired soon after administration of the second dose; however, a fast decline of booster VE against Omicron was observed, with less than 20% VE against infection and less than 25% VE against symptomatic disease at 9 months from the booster administration,” the authors wrote in the paper released Wednesday.

It’s a crucial question to understand, given that boosters widely became available about 9 months ago in the United States, and that a new surge is now happening with the BA.5 variant of omicron — which appears to be better at reinfecting people than any past strain of the virus.

Overall, the researchers found that nine months after administration, two doses of a vaccine were less than 5% effective at stopping a symptomatic omicron infection, and three doses were no more than about 22% effective.

According to the CDC, less than a third of Americans have had a first booster dose at any point since they became available, and only about 5% of Americans have had a second booster dose.

This New ‘Ninja’ COVID Variant Is the Most Dangerous One Yet, Says Who?

Authors: David Axe Fri, July 8, 2022 Yahoo News

When Will People Realize That COVID is Here To Stay? Live With It!

The latest subvariant of the novel coronavirus to become dominant in Europe, the United States, and other places is also, in many ways, the worst so far.

The BA.5 subvariant of the basic Omicron variant appears to be more contagious than any previous form of the virus. It’s apparently better at dodging our antibodies, too—meaning it might be more likely to cause breakthrough and repeat infections.

Vaccines and boosters are still the best defense. There are even Omicron-specific booster jabs in development that, in coming months, could make the best vaccines more effective against BA.5 and its genetic cousins.

Still, BA.5’s ongoing romp across half the planet is a strong reminder that the COVID pandemic isn’t over. “We’re not done yet, by any stretch,” Eric Topol, founder and director of the Scripps Research Translational Institute in California, wrote on his Substack.

High levels of at least partial immunity from vaccines and past infection continue to prevent the worst outcomes—mass hospitalization and death. But globally, raw case numbers are surging, with serious implications for potentially millions of people who face a growing risk of long-term illness.

Equally worrying, the latest wave of infections is giving the coronavirus the time and space it needs to mutate into even more dangerous variants and subvariants. “The development of variants now is a freight train,” Irwin Redlener, the founding director of Columbia University’s National Center for Disaster Preparedness, told The Daily Beast.

In other words, unstoppable.

BA.5 first turned up in viral samples in South Africa in February. By May it was dominant in Europe and Israel, displacing earlier forms of the basic Omicron variant while also driving an increase in global daily COVID cases from around 477,000 a day in early June to 820,000 a day this week.

In late June, BA.5 became dominant in the United States. Cases haven’t increased yet—the daily average has hovered around 100,000 since May. But that could change in coming weeks as BA.5 continues to outcompete less transmissible subvariants.

Topol offered a concise explanation for BA.5’s ascendancy. Where the mutations that produced many earlier variants mostly affected the spike protein—the part of the virus that helps it to grab onto and infect our cells—BA.5 has mutations across its structure. “BA.5 is quite distinct and very fit, representing marked difference from all prior variants,” Topol wrote.

BA.5’s widespread mutations made the subvariant less recognizable to all those antibodies we’ve built up from vaccines, boosters and past infection. BA.5 has been able to slip past our immune systems, ninja-style, contributing to the rising rate of breakthrough cases and reinfections.

This comes as no surprise to epidemiologists who’ve warned for many months now that persistently high case-rates—which they largely attribute in part to a stubborn anti-vax minority in many countries—would facilitate ever more infectious and evasive variants and subvariant. The more infections, the more chances for significant mutations.

In that sense, BA5 might be a preview of the months and years to come. A year ago, we had a chance to block SARS-CoV-2’s main transmission vectors through vaccines and social distancing.

But we didn’t. Restrictions on businesses, schools and crowds have become politically toxic all over the world. Vaccination rates remained stubbornly low, even in many countries with easy access to jabs. In the U.S., for example, the percentage of fully vaccinated has stalled at around 67 percent.

The Massive Screwup That Could Let COVID Bypass Our Vaccines

So COVID lingers, 31 months after the first case was diagnosed in Wuhan, China. The longer the virus circulates, the more variants it produces. BA.5 is the all but inevitable result of that tragic dynamic.

The situation isn’t entirely hopeless. Yes, BA.5 seems to reduce the effectiveness of the best messenger-RNA vaccines. Vaccine-maker Moderna published data indicating that a booster shot it’s developing specifically for Omicron and its offspring works only a third as well against BA.5 compared to earlier subvariants.

But vaccines, boosters and past infection still offer meaningful, if reduced, protection against BA.5. “Even a boost of the original genome, or a recent infection, will [produce] some cross-protective antibodies to lessen the severity of a new Omicron subvariant infection,” Eric Bortz, a University of Alaska-Anchorage virologist and public-health expert, told The Daily Beast.

The more additional jabs you get on top of your prime course, the better protected you are. Arguably the best protection results from two prime jabs of the mRNA vaccines from Pfizer or Moderna plus a couple boosters. “Get your damn fourth shot!” Redlener said.

The problem, in the United States, is that only people 50 years old or older or with certain immune disorders qualify for a second booster. And the U.S. Food and Drug Administration won’t say whether, or when, it might authorize second boosters for younger people. “I have nothing to share at this time,” an FDA spokesperson told The Daily Beast when asked about boosters for under-50s.

It’s an obvious bureaucratic screw-up. As many as a million booster doses are about to expire in the U.S., all for a want of takers. “A profound waste, which should be made available to all people, age under-50 who seek added protection,” Topol wrote.

To be fair, Pfizer and Moderna are both working on new boosters that they’ve tailored specifically for Omicron subvariants. On June 30, an FDA advisory board endorsed these variant-specific boosters. The FDA announced it might approve them for emergency use for some Americans as early as this fall.

But there’s a risk these jabs will show up too late, especially if they’re highly optimized for just one recent subvariant and thus ineffective against future subvariants. “Variant-chasing is a flawed approach,” Topol wrote. “By the time a BA.5 vaccine booster is potentially available, who knows what will be the predominant strain?”

Fortunately, there are fallbacks. Masks and voluntary social-distancing, of course. Post-infection therapies including the antiviral drug paxlovid also help. “This is not a time to abandon non-pharmaceutical intervention,” Redlener stressed.

But voluntary mask-wearing and paxlovid are bandaids on a festering global wound. The surge in BA.5 infections creates the conditions for the next major subvariant—BA.6, if you will. It might be even worse.

It’s looking more and more likely that COVID will be with us, well, forever. “COVID is becoming like the flu,” Ali Mokdad, a professor of health metrics sciences at the University of Washington Institute for Health, told The Daily Beast.

That is, endemic. An ever-present threat to public health. The big difference, of course, is that COVID is much more dangerous than today’s flu. And it keeps mutating in ways that make it even worse.