Ed Yong: Why BA.5 Feels Different

[Nevilledog]

Link to tweet

https://www.theatlantic.com/health/archive/2022/07/ba5-omicron-variant-covid-surge-immunity-reinfection/670485/

No paywall
https://archive.ph/tTMXT

Well, here we go again. Once more, the ever-changing coronavirus behind COVID-19 is assaulting the United States in a new guise—BA.5, an offshoot of the Omicron variant that devastated the most recent winter. The new variant is spreading quickly, likely because it snakes past some of the immune defenses acquired by vaccinated people, or those infected by earlier variants. Those who have managed to avoid the virus for close to three years will find it a little harder to continue that streak, and some who recently caught COVID are getting it again. “People shouldn’t be surprised if they get infected, and they shouldn’t be surprised if it’s pretty unpleasant,” Stephen Goldstein, a virologist at the University of Utah, told me.

That doesn’t mean we’re about to have a surge on the scale of what we saw last winter, or that BA.5 (and its close cousin BA.4) will set us back to immunological square one. Goldstein told me that he takes “some level of comfort” in the knowledge that, based on how other countries have fared against BA.5, vaccines are still keeping a lot of people out of hospitals, intensive-care units, and morgues. The new variant is not an apocalyptic menace.

But it can’t be ignored, either. Infections (and reinfections) still matter, and by increasing both, BA.5 is extending and deepening the pandemic’s ongoing burden. “We will not prevent all transmission—that is not the goal—but we have to reduce the spread,” Maria Van Kerkhove, an infectious-disease epidemiologist at the World Health Organization, told me. “It’s not over, and we are playing with fire by letting this virus circulate at such intense levels.”

The age of Omicron began shortly after Thanksgiving, as the new variant swept through the U.S., ousting its predecessor, Delta. That initial version of Omicron, now known as BA.1, was just the first of a mini-dynasty of related variants that have since competed against one another in a grim game of succession. BA.2 took over from BA.1, and caused a surge in the spring. BA.4 and BA.5 are spreading even more quickly: First detected in South Africa in January and February, they have since displaced BA.2 all over the world, leading to surges in both cases and hospitalizations. In the U.S., BA.5 now accounts for about 54 percent of all COVID infections, and BA.4, about another 17 percent. (Most of this article will deal with BA.5 alone because it already seems to be outcompeting its cousin.) Hospitalizations have risen to their highest level since March.

*snip*

[SheltieLover]

1. Keep masking!

😷

[Hugin]

2. Due to the pollen/dust/smoke...

I was all spring. It’s like wearing a hat or dark glasses in the Sun now.

I have to be careful not to develop a surgeon’s tan I guess.

[Nevilledog]

3. But also a way to never be mistaken for a MAGAt

[SheltieLover]

6. This!👆

[SheltieLover]

5. Lol

[Ms. Toad]

4. Should we keep trying to prevent infection?

{Trevor Bedford, a virologist at the Fred Hutchinson Cancer Research Center} expects BA.5 to infect 10 to 15 percent of Americans over the next few months. Of course, it doesn’t have to. The Biden administration, other political leaders, and many media figures have promoted laxer COVID policies, on the grounds that vaccines are still reducing the risk of death and hospitalization. But this stance is foolish for several reasons.

Even if the infection-fatality ratio for COVID—the risk that an infected person will die—falls to the level of seasonal flu, rare events stack up when the virus is allowed to spread unchecked. Bedford estimates that in such a scenario, COVID could still plausibly kill 100,000 Americans every year, “which is a lot!” he said. “It’s not like in the peak of the pandemic, but it’s a major health burden.” That burden is still mainly borne by the elderly; low-income workers; Black, Latino, and Indigenous Americans; and immunocompromised people. The entire Omicron dynasty may well have arisen from chronic infections in immunocompromised patients, in whose bodies the virus can evolve more rapidly, which suggests a self-interested case for preventing infections in this group, along with the more obvious moral rationale.

Death isn’t the only outcome that matters, either. Even without sending people to the hospital, infections can lead to the persistent and in many cases disabling symptoms of long COVID—a risk that vaccines seem to lower but not fully avert. “I’m not worried about dying from COVID, but I’m personally cautious because of worries about long COVID,” Bedford told me. “I’m not a hermit, but I’m taking mitigation measures to try not to get sick.” And even “mild” infections can still be awful. Dan Barouch, an infectious-disease specialist at Harvard Medical School, told me that friends and colleagues have “felt pretty terrible at home, sometimes for weeks, but weren’t sick enough to go to the ICU and get intubated. There’s a lot of time missed from school and work.” Waves of sick employees are still disrupting sectors that were already reeling from the Great Resignation—including the health-care system. An exodus of experienced colleagues and untenable levels of burnout have trapped health-care workers in a chronic state of crisis, which persists even when hospitalization numbers are low, and deepens whenever the numbers climb.

Preventing infections still matters, and vaccines are still a crucial means of doing so. After a frustrating delay, Omicron-specific boosters are on the way, and the FDA has recommended that these include components of BA.4 and BA.5. The updated shots won’t be ready until October at the earliest, by which time new variants could have arisen. But “even if we don’t nail the match exactly,” Goldstein said, these boosters should expand people’s antibody repertoire, leaving them better defended against not just the Omicron dynasty but also other variants that could follow. Still, “it’s important not to overpromise the efficacy of Omicron-specific boosters,” Barouch said. In terms of preventing infections, clinical data suggest that they’ll be modestly better than current vaccines, but not substantially so. And even if we get the long-desired shots that protect against all coronaviruses, it may be difficult to persuade Americans to get them.

Vaccines were never going to end the pandemic on their own. They needed to be complemented by other protective measures such as masks, better ventilation, rapid tests, and social support like paid sick leave, which were either insufficiently deployed or rolled back. And with stalled COVID funding jeopardizing supplies of tests, treatments, and vaccines, the U.S. will continue its long streak of being underprepared for new variants. . . . The virus is likely now locked with the human immune system in a perpetual evolutionary arms race. A variant emerges to circumvent our existing immunity, then vaccines and infections gradually rebuild our defenses … until another variant emerges. This is exactly what happens with flu, but the coronavirus seems to be changing even more quickly. The big uncertainty is whether the next variants will erode immunity to the small degrees that scientists expect (as BA.5 is doing) or whether they’ll do something dramatic and unexpected (as BA.1 did). This is what “living with COVID” means—a continual cat-and-mouse game that we can choose to play seriously or repeatedly forfeit.

https://archive.ph/tTMXT#selection-859.1049-1021.712

[Hugin]

7. +1

The whole story.