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  • A new virus variant and lagging vaccinations may mean the US is in for a severe flu season

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    The United States may be heading into its second severe flu season in a row, driven by a mutated strain called subclade K that’s behind early surges in the United Kingdom, Canada and Japan.Last winter’s season was extreme, too. The U.S. had its highest rates of flu hospitalizations in nearly 15 years. At least 280 children died of influenza, the highest number since pediatric death numbers were required to be shared in 2004.Now, with a new variant in the mix, experts say we’re on track for a repeat. And with flu vaccinations down and holiday travel on the way, they worry that things may look much worse in the weeks ahead.The good news: Early analysis shows that this season’s flu shots offer some protection against being hospitalized with this variant, especially for kids. The bad news is that many Americans appear to be skipping their flu vaccines this year. New data from prescription data company IQVIA shows that vaccinations are down compared to where they usually are at this point in the year.A new playerFlu activity is low but rising quickly in the United States, according to the latest FluView report from the U.S. Centers for Disease Control and Prevention.Most of the flu viruses identified this season have been an A strain called H3N2, and half of those have come from subclade K, a variant that was responsible for a rougher-than-normal flu season this summer in the Southern Hemisphere.That variant wasn’t a major player when scientists decided which strains should be in the annual flu shots, so the vaccines cover a related but slightly different group of viruses.”It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case,” said Dr. Richard Webby, director of the World Health Organization Collaborating Center for studies on the ecology of influenza in animals and birds at St. Jude Children’s Research Hospital.Early analysis by the U.K. Health Security Agency shows that subclade K has seven gene changes on a key segment of the virus. Those mutations change the shape of this region, making it harder for the body’s defenses to recognize.”That’s the predominant thing that our immune system targets with antibodies, and that’s also pretty much what’s in the vaccine,” said Dr. Adam Lauring, chief of the Division of Infectious Diseases at the University of Michigan Medical School.UKHSA scientists found that the current flu vaccines are still providing decent protection against subclade K viruses. Vaccination cut the odds of an emergency department visit or hospitalization for the flu by almost 75% in children. The effectiveness for adults, even those over 65, was lower, about 30% to 40% against needing to visit the hospital or ER.But the scientists offer a caveat: These results are from early in the season, before the protection from seasonal flu vaccines has had time to wane or wear off. The findings are posted in a recent preprint study, which means it was published ahead of scrutiny from outside experts.Still, some protection is better than no protection, and while subclade K is expected to dominate the season, it won’t be the only flu strain circulating. No one gets to pick what they’re exposed to. Lauring said his daughter has just recovered from the flu, but it was a B-type strain.At the same time this new variant has emerged, flu vaccinations appear to be down in the U.S. According to IQVIA, about 64% of all flu vaccinations were administered at retail pharmacies, which administered roughly 26.5 million flu shots between August and the end of October. That’s more than 2 million fewer shots than the 28.7 million given over the same time frame in 2024.”I’m not surprised,” said Dr. Jennifer Nuzzo, who directs the Pandemic Center at Brown University’s School of Public Health. Vaccine skepticism expressed by leaders of the US Department of Health and Human Services has “injected chaos into the whole vaccination system,” she said.”There’s been a lot of attention on really non-issues,” like vaccine ingredients and separating shots, that she thinks “at the best, left people confused but possibly at the worst have left people worried about getting vaccinated,” she added.Flu vaccinations have also fallen in Australia, where subclade K was the predominant virus this year. As a result, flu hit a record, with more than 443,000 cases. Flu season in the Southern Hemisphere typically runs from May to July, so infectious disease experts often look to those countries for a preview of what might be on the way to North America.”What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming,” said Dr. Earl Rubin, director of the infectious disease division at the Montreal Children’s Hospital in Canada.’This is the time we start to see the rise’It’s difficult to say whether subclade K actually makes a person sicker than other flu strains, but if it drives more cases, it will certainly drive hospitalizations too, Rubin said.”When you look at severity, the more cases you have, if the same percentage get hospitalized, obviously you’re going to have more hospitalization if you have more cases. So it sometimes will look like the severity is also worse,” he said.Lab testing data has begun to show an uptick in flu cases.”This is the time we start to see the rise,” said Dr. Allison McMullen, a clinical microbiologist at BioMerieux, which makes the BioFire test, a popular diagnostic tool for respiratory pathogens.The company anonymously compiles its test results into a syndromic surveillance tool, which can offer a glimpse of what bugs are making people sick at any given time. At the beginning of the month, less than 1% of tests were positive for type A flu. Now it’s 2.4% – still low numbers but going up briskly, which aligns with the CDC trend.”We’re going to start seeing heavy holiday travel before we know it,” McMullen added. “With the rising cases that we’re seeing the U.K. and Japan, it can definitely be a bellwether for what we’re going to see in North America.”Signals are also rising in wastewater, said Dr. Marlene Wolfe, an assistant professor of environmental health at Emory University. In October, 18% of samples in the WastewaterSCAN network — an academically led wastewater monitoring program based at Stanford University, in partnership with Emory — were positive for type A flu, Wolfe said. In November, that number had risen to 40%.”Flu is something where, when it’s not in season, we don’t detect it very frequently in wastewater,” Wolfe said. COVID, on the other hand, can be detected pretty much all the time, which makes it challenging to know if it’s going up or down, she said.The scientists can set a threshold for when they can declare that a specific area is in flu season, Wolfe says. So far, just four of the 147 sites they monitor in 40 states have reached that threshold. Those sites are in the Northeast — in Maine and Vermont — in Iowa and in Hawaii.”I am concerned, I guess, that we could have a big flu season this year based on what we’re seeing in other parts of the world, and particularly Europe and elsewhere,” Michigan’s Lauring said.”It’s not too late. Go and get your flu shot,” Lauring advised. “And be alert that it’s out there.”

    The United States may be heading into its second severe flu season in a row, driven by a mutated strain called subclade K that’s behind early surges in the United Kingdom, Canada and Japan.

    Last winter’s season was extreme, too. The U.S. had its highest rates of flu hospitalizations in nearly 15 years. At least 280 children died of influenza, the highest number since pediatric death numbers were required to be shared in 2004.

    Now, with a new variant in the mix, experts say we’re on track for a repeat. And with flu vaccinations down and holiday travel on the way, they worry that things may look much worse in the weeks ahead.

    The good news: Early analysis shows that this season’s flu shots offer some protection against being hospitalized with this variant, especially for kids. The bad news is that many Americans appear to be skipping their flu vaccines this year. New data from prescription data company IQVIA shows that vaccinations are down compared to where they usually are at this point in the year.

    A new player

    Flu activity is low but rising quickly in the United States, according to the latest FluView report from the U.S. Centers for Disease Control and Prevention.

    Most of the flu viruses identified this season have been an A strain called H3N2, and half of those have come from subclade K, a variant that was responsible for a rougher-than-normal flu season this summer in the Southern Hemisphere.

    That variant wasn’t a major player when scientists decided which strains should be in the annual flu shots, so the vaccines cover a related but slightly different group of viruses.

    “It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case,” said Dr. Richard Webby, director of the World Health Organization Collaborating Center for studies on the ecology of influenza in animals and birds at St. Jude Children’s Research Hospital.

    Early analysis by the U.K. Health Security Agency shows that subclade K has seven gene changes on a key segment of the virus. Those mutations change the shape of this region, making it harder for the body’s defenses to recognize.

    “That’s the predominant thing that our immune system targets with antibodies, and that’s also pretty much what’s in the vaccine,” said Dr. Adam Lauring, chief of the Division of Infectious Diseases at the University of Michigan Medical School.

    UKHSA scientists found that the current flu vaccines are still providing decent protection against subclade K viruses. Vaccination cut the odds of an emergency department visit or hospitalization for the flu by almost 75% in children. The effectiveness for adults, even those over 65, was lower, about 30% to 40% against needing to visit the hospital or ER.

    But the scientists offer a caveat: These results are from early in the season, before the protection from seasonal flu vaccines has had time to wane or wear off. The findings are posted in a recent preprint study, which means it was published ahead of scrutiny from outside experts.

    Still, some protection is better than no protection, and while subclade K is expected to dominate the season, it won’t be the only flu strain circulating. No one gets to pick what they’re exposed to. Lauring said his daughter has just recovered from the flu, but it was a B-type strain.

    At the same time this new variant has emerged, flu vaccinations appear to be down in the U.S. According to IQVIA, about 64% of all flu vaccinations were administered at retail pharmacies, which administered roughly 26.5 million flu shots between August and the end of October. That’s more than 2 million fewer shots than the 28.7 million given over the same time frame in 2024.

    “I’m not surprised,” said Dr. Jennifer Nuzzo, who directs the Pandemic Center at Brown University’s School of Public Health. Vaccine skepticism expressed by leaders of the US Department of Health and Human Services has “injected chaos into the whole vaccination system,” she said.

    “There’s been a lot of attention on really non-issues,” like vaccine ingredients and separating shots, that she thinks “at the best, left people confused but possibly at the worst have left people worried about getting vaccinated,” she added.

    Flu vaccinations have also fallen in Australia, where subclade K was the predominant virus this year. As a result, flu hit a record, with more than 443,000 cases. Flu season in the Southern Hemisphere typically runs from May to July, so infectious disease experts often look to those countries for a preview of what might be on the way to North America.

    “What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming,” said Dr. Earl Rubin, director of the infectious disease division at the Montreal Children’s Hospital in Canada.

    ‘This is the time we start to see the rise’

    It’s difficult to say whether subclade K actually makes a person sicker than other flu strains, but if it drives more cases, it will certainly drive hospitalizations too, Rubin said.

    “When you look at severity, the more cases you have, if the same percentage get hospitalized, obviously you’re going to have more hospitalization if you have more cases. So it sometimes will look like the severity is also worse,” he said.

    Lab testing data has begun to show an uptick in flu cases.

    “This is the time we start to see the rise,” said Dr. Allison McMullen, a clinical microbiologist at BioMerieux, which makes the BioFire test, a popular diagnostic tool for respiratory pathogens.

    The company anonymously compiles its test results into a syndromic surveillance tool, which can offer a glimpse of what bugs are making people sick at any given time. At the beginning of the month, less than 1% of tests were positive for type A flu. Now it’s 2.4% – still low numbers but going up briskly, which aligns with the CDC trend.

    “We’re going to start seeing heavy holiday travel before we know it,” McMullen added. “With the rising cases that we’re seeing the U.K. and Japan, it can definitely be a bellwether for what we’re going to see in North America.”

    Signals are also rising in wastewater, said Dr. Marlene Wolfe, an assistant professor of environmental health at Emory University. In October, 18% of samples in the WastewaterSCAN network — an academically led wastewater monitoring program based at Stanford University, in partnership with Emory — were positive for type A flu, Wolfe said. In November, that number had risen to 40%.

    “Flu is something where, when it’s not in season, we don’t detect it very frequently in wastewater,” Wolfe said. COVID, on the other hand, can be detected pretty much all the time, which makes it challenging to know if it’s going up or down, she said.

    The scientists can set a threshold for when they can declare that a specific area is in flu season, Wolfe says. So far, just four of the 147 sites they monitor in 40 states have reached that threshold. Those sites are in the Northeast — in Maine and Vermont — in Iowa and in Hawaii.

    “I am concerned, I guess, that we could have a big flu season this year based on what we’re seeing in other parts of the world, and particularly Europe and elsewhere,” Michigan’s Lauring said.

    “It’s not too late. Go and get your flu shot,” Lauring advised. “And be alert that it’s out there.”

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  • COVID surges nationwide with highest rates in Southwest as students return to school

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    COVID-19 rates in the Southwestern United States reached 12.5% — the highest in the nation — according to new data from the U.S. Centers for Disease Control and Prevention released this week. Meanwhile, Los Angeles County recorded the highest COVID levels in its wastewater since February.

    The spike, thanks to the new highly contagious “Stratus” variant, comes as students across California return to the classroom, now without a CDC recommendation that they receive updated COVID shots. That change in policy, pushed by Health and Human Services Secretary Robert F. Kennedy Jr., has been criticized by many public health experts.

    The COVID-19 virus, SARS-CoV-2, mutates often, learning to better transmit itself from person to person and evade immunity created by vaccinations and previous infections.

    The Stratus variant, first detected in Asia in January, reached the U.S. in March and became the predominant strain by the end of June. It now accounts for two-thirds of virus variants detected in wastewater in the U.S., according to the CDC.

    The nationwide COVID positivity rate hit 9% in early August, surpassing the January post-holiday surge, but still below last August’s spike to 18%. Weekly deaths, a metric that lags behind positivity rates, has so far remained low.

    In May, RFK Jr. announced the CDC had removed the COVID vaccine from its recommended immunization schedule for healthy children and healthy pregnant women.

    The secretary argued it was the right move to reverse the Biden administration’s policy, which in 2024, “urged healthy children to get yet another COVID shot, despite the lack of any clinical data to support the repeat booster strategy in children.”

    That statement promptly spurred a lawsuit from a group of leading medical organizations — including the American Academy of Pediatrics, the American College of Physicians and the American Public Health Assn. — which argued the “baseless and uninformed” decision violated federal law by failing to ground the policy on the recommendation of the scientific committee that looks at immunization practices in the U.S.

    The Advisory Committee on Immunization Practices has been routinely recommending updated COVID vaccinations alongside the typical yearly flu vaccination schedule. In its update for the fall 2024-spring 2025 season, it noted that in the previous year, a COVID booster decreased the risk of hospitalization by 44% and death by 23%.

    The panel argued the benefit outweighed isolated cases of heart conditions and allergic reactions associated with the vaccine.

    The panel also acknowledged that booster effectiveness decreases as new COVID strains — for which the boosters were not designed — emerge. Nevertheless, it still felt that most Americans should get booster shots.

    The CDC estimates that only about 23% of adults and 13% of children received the 2024-25 COVID booster — even with the vaccine recommendation still in place. That’s compared to roughly half of adults and children who received the updated flu shot in the same time frame.

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    Noah Haggerty

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  • A new COVID variant, HV.1, is now dominant. These are its most common symptoms

    A new COVID variant, HV.1, is now dominant. These are its most common symptoms

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    As the United States enters respiratory virus season and health officials roll out updated COVID-19 vaccines, a new COVID variant HV.1 has emerged and is currently sweeping the country.

    The new omicron subvariant has rapidly overtaken other strains, including EG.5 aka Eris, to become the dominant variant in the U.S. As of late October, HV.1 is responsible for more than a quarter of all COVID-19 cases, and health officials are monitoring the new variant amid concerns of a winter COVID-19 surge.

    HV.1 accounted for an estimated 25.2% of new COVID-19 cases during the two-week period ending Oct. 28, according to the latest data from the U.S. Centers for Disease Control and Prevention.

    After HV.1, the next most common variant in the U.S. was EG.5, which made up 22% of cases, followed by FL.1.5.1 or “Fornax,” and XBB.1.16 or “Arcturus.” (Globally, EG.5 is still the dominant strain, according to the World Health Organization.)

    All of the most prevalent COVID-19 strains in the U.S. are offshoots of omicron, which first emerged in November 2021.

    Although COVID-19 cases and hospitalizations have been trending downward after a late summer surge, HV.1 is continuing to pick up speed around the country.

    Cases are expected to increase again this winter as was the case the past three years, Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, tells TODAY.com.

    As HV.1 spreads, many are curious if the new subvariant is more contagious or severe, whether it could cause different symptoms, and if the new COVID-19 vaccines will provide protection. Here’s what we know about HV.1 so far.

    What is HV.1, the new COVID variant?

    HV.1 is part of the omicron family. “You can almost think of HV.1 as a grandchild of omicron,” says Schaffner. HV.1 is a sublineage of omicron XBB.1.9.2 and a direct descendent of EG.5, according to the CDC’s SARS-CoV-2 lineage tree.

    “The COVID family of viruses likes to mutate. We’ve all learned that by now,” says Schaffner. While HV.1 is mutated, it’s still very close to the existing omicron subvariants, Schaffner explains.

    For the most part, scientists are not concerned about new variants like HV.1, which look very similar to strains we’ve already seen before, NBC News reported.

    However, there are a few highly mutated strains which have set off alarm bells. These include BA.2.86 or Pirola, which has an extra 36 mutations that differentiate it from XBB.1.5., and a newer variant called JN.1, which has one more mutation than Pirola.

    Fortunately, neither BA.2.86 nor JN.1 are common in the U.S. right now, according to the CDC — JN.1 is so rare that it makes up fewer than 0.1% of SARS-CoV-2 cases.

    As for HV.1, it rapidly gained steam after it was first detected this past summer. In late July, HV.1 accounted for just 0.5% of COVID-19 cases in the U.S., CDC data show. By Sept. 30, HV.1 made up 12.5% of cases, and by November, it was the dominant strain.

    Is HV.1 more transmissible?

    “One of the characteristics of this entire omicron family is that they are highly transmissible,” says Schaffner. 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 slightly 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 appears that HV.1 could also be slightly better at escaping prior immunity to COVID-19, but not enough to cause alarm, Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, told NBC News.

    Although it is more transmissible, HV.1 does not appear to produce more severe disease or lead to more hospitalizations, Schaffer says.

    What are HV.1 symptoms?

    The symptoms caused by infection with HV.1 are similar to those caused by recent variants, says Schaffner, which include:

    • Sore throat

    • Congestion or stuffiness

    • Runny nose

    • Cough

    • Fatigue

    • Headache

    • Muscle aches

    • Fever or chills

    “Congestion, sore throat and dry cough seem to be the three most prominent symptoms right now,” says Schaffner.

    Increasingly, doctors report that COVID-19 symptoms appear to follow a pattern of being concentrated in the upper respiratory tract, starting with a sore throat and followed by congestion or a runny nose, NBC news reported.

    Coughing isn’t typically a primary symptom, but it can persist. “The virus seems to produce a kind of a chronic bronchitis, so that you can have a cough syndrome that lasts beyond the period where you’ve recovered from other symptoms,” says Schaffner.

    Another trend is that COVID-19 seems to be causing milder infections, likely because people have some prior immunity. “By milder, we mean it doesn’t require hospitalization even though you can feel quite miserable for several days,” says Schaffner.

    Do COVID-19 tests detect HV.1?

    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 crucial tool to protect yourself and others from COVID-19. The symptoms of HV.1 and other COVID-19 variants can look very similar to other viruses, including respiratory syncytial virus (RSV), influenza and rhinovirus, which usually causes the common cold.

    “The only way to distinguish (COVID-19) from RSV and flu, both of which are now gaining steam, is by testing,” says Schaffner.

    Experts encourage anyone who has symptoms to get tested, especially those in high-risk groups — people over the age of 65, who are immunocompromised or who have 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 has significantly diminished in the U.S. in the last year, which is concerning, says Schaffner.

    When the U.S. federal public health emergency for COVID-19 ended in May, so did the guarantee of free testing for many people.

    However, every American can still get COVID-19 tests for free or low-cost right now. One way is to order four free at-home COVID-19 tests from the government, which will be delivered by mail via the U.S. Postal Service. To order your free tests, go to COVIDTests.gov.

    In addition, all health insurance plans are required to reimburse eight at-home COVID-19 tests per month, according to the Centers for Medicare & Medicaid Services. State Medicaid programs are also required to cover at-home tests, and Medicare beneficiaries and uninsured individuals can access free tests provided by Health & Human Services at thousands of community health centers, clinics and pharmacies.

    If you still have a stockpile of tests sitting around, remember to check the expiration date and whether it’s been extended by the U.S. Food and Drug Administration.

    Does the new COVID-19 vaccine protect against HV.1?

    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, Eris, Fornax and Arcturus, it is still closely related to these newer strains.

    The updated vaccines seem to be well-matched to the variants currently circulating and making people sick, Andrew Pekosz, Ph.D., virologist at Johns Hopkins University, previously told TODAY.com.

    “Laboratory studies indicate that the updated booster will protect against serious disease caused by HV.1,” says Schaffner. Vaccination also significantly lowers the risk of becoming hospitalized or dying, per the CDC.

    However, only 23 million Americans or 4.5% of the population had received the updated shots by Oct. 27, Reuters reported.

    The first phase of the new booster rollout hit several speed bumps, including supply delays, high demand, cancelled appointments and insurance obstacles. Some parents have been unable to get their kids vaccinated as some pharmacies and pediatrician’s offices have struggled to secure enough child-size doses.

    Although many of these initial issues have been resolved, says Schaffner, uptake is still slow. “We’ve underutilized this updated vaccine, and we anticipate that COVID will once again increase even more during the winter season,” says Schaffner.

    It’s not too late to take advantage of the new booster, Schaffner adds, and people should get the shot as soon as they can.

    The FDA has authorized three vaccine options for 2023-2024: one mRNA shot each from Moderna and Pfizer, and a protein-based non-mRNA shot from Novavax.

    Insurance plans should cover the updated booster, says Schaffner, and those without insurance should still be able to get the shot for free, according to the CDC.

    “We’re in a good place because for a considerable time now, we have not had a new variant that causes more severe disease or evades the protection of currently available vaccines,” says Schaffner.

    How to protect yourself from HV.1

    As the winter and holiday season approaches, it’s important 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

    • Isolating if you are testing positive for COVID-19

    • Avoiding contact with sick people

    • Improving ventilation or gathering outdoors

    • Washing your hands with soap and water frequently

    • Wearing a mask in crowded, indoor spaces

    This article was originally published on TODAY.com

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  • How Bad Could BA.2.86 Get?

    How Bad Could BA.2.86 Get?

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    Since Omicron swept across the globe in 2021, the evolution of SARS-CoV-2 has moved at a slower and more predictable pace. New variants of interest have come and gone, but none have matched Omicron’s 30-odd mutations or its ferocious growth. Then, about two weeks ago, a variant descended from BA.2 popped up with 34 mutations in its spike protein—a leap in viral evolution that sure looked a lot like Omicron. The question became: Could it also spread as quickly and as widely as Omicron?

    This new variant, dubbed BA.2.86, has now been detected in at least 15 cases across six countries, including Israel, Denmark, South Africa, and the United States. This is a trickle of new cases, not a flood, which is somewhat reassuring. But with COVID surveillance no longer a priority, the world’s labs are also sequencing about 1 percent of what they were two years ago, says Thomas Peacock, a virologist at the Pirbright Institute. The less surveillance scientists are doing, the more places a variant could spread out of sight, and the longer it will take to understand BA.2.86’s potential.

    Peacock told me that he will be closely tracking the data from Denmark in the next week or two. The country still has relatively robust SARS-CoV-2 sequencing, and because it has already detected BA.2.86, we can now watch the numbers rise—or not—in real time. Until the future of BA.2.86 becomes clear, three scenarios are still possible.

    The worst but also least likely scenario is another Omicron-like surge around the world. BA.2.86 just doesn’t seem to be growing as explosively. “If it had been very fast, we probably would have known by now,” Peacock said, noting that, in contrast, Omicron’s rapid growth took just three or four days to become obvious.

    Scientists aren’t totally willing to go on record ruling out Omicron redux yet, if only because patchy viral surveillance means no one has a complete global picture. Back in 2021, South Africa noticed that Omicron was driving a big COVID wave, which allowed its scientists to warn the rest of the world. But if BA.2.86 is now causing a wave in a region that isn’t sequencing viruses or even testing very much, no one would know.

    Even in this scenario, though, our collective immunity will be a buffer against the virus. BA.2.86 looks on paper to have Omicron-like abilities to cause reinfection, according to a preliminary analysis of its mutations by Jesse Bloom, a virologist at the Fred Hutchinson Cancer Center, in Washington, but he adds that there’s a big difference between 2021 and now. “At the time of the Omicron wave, there were still a lot of people out there that had never been either vaccinated or infected with SARS-CoV-2, and those people were sort of especially easy targets,” he told me. “Now the vast, vast majority of people in the world have either been infected or vaccinated with SARS-CoV-2—or are often both infected and vaccinated multiple times. So that means I think any variant is going to have a very hard time spreading as well as Omicron.”

    A second and more likely possibility is that BA.2.86 ends up like the other post-Omicron variants: transmissible enough to edge out a previous variant, but not transmissible enough to cause a big new surge. Since the original Omicron variant, or BA.1, took over, the U.S. has successively cycled through BA.2, BA.2.12.1, BA.5, BQ.1, XBB.1.5—and if these jumbles of numbers and letters seem only faintly familiar, it’s because they never reached the same levels of notoriety as the original. Vaccine makers track them to keep COVID shots up to date, but the World Health Organization hasn’t deemed any worthy of a new Greek letter.

    If BA.2.86 continues to circulate, though, it could pick up mutations that give it new advantages. In fact, XBB.1.5, which rose to dominance earlier this year, leveled up this way. When XBB.1.5’s predecessor was first identified in Singapore, Peacock said, it wasn’t a very successful variant: Its spike protein bound weakly to receptors in human cells. Then it acquired an additional mutation in its spike protein that compensated for the loss of binding, and it turned into the later-dominant XBB.1.5. Descendents of BA.2.86 could eventually become more transmissible than the variant looks right now.

    A third scenario is that BA.2.86 just fizzles out and goes away. Scientists now believe that highly mutated variants such as BA.2.86 are probably products of chronic infections in immunocompromised patients. In these infections, the virus remains in the body for a long time, trying out new ways to evade the immune system. It might end up with mutations that make its spike protein less recognizable to antibodies, but those same mutations could also render the spike protein less functional and therefore the virus less good at transmitting from person to person.

    “Variants like that have been identified over the last few years,” Bloom said. “Often there’s one sample found, and that’s it. Or multiple samples all found in the same place.” BA.2.86 is transmissible enough to be found multiple times in multiple places, but whether it can overtake existing variants is unclear. To do so, BA.2.86 needs to escape antibodies while also preserving its inherent transmissibility. Otherwise, Bloom said, cases might crop up here and there, but the variant never really takes off. In other words, the BA.2.86 situation basically stays where it is right now.

    The next few weeks will reveal which of these futures we’re living in. If the number of BA.2.86 cases starts to go up, in a way that requires more attention, we’ll know soon. But each week that the variant’s spread does not jump dramatically, the less likely BA.2.86 is to end up a variant of actual concern.

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    Sarah Zhang

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  • WHO names Eris a COVID variant of interest. Here’s what you need to know.

    WHO names Eris a COVID variant of interest. Here’s what you need to know.

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    The World Health Organization has upgraded COVID-19 variant EG.5 to a variant of interest, or VOI, from a variant under monitoring, or VUM, as it continues to become more prevalent around the world.

    The variant — which has been nicknamed Eris by some media, following the Greek-alphabet designation used for other variants — has been found in 51 countries, with most sequences, 30.6%, stemming from China, said the WHO.

    Other countries that have submitted at least 100 sequences to a central database include the U.S., the Republic of Korea, Japan, Canada, Australia, Singapore, the United Kingdom, France, Portugal and Spain, the WHO said in a statement.

    Eris is a descendent lineage of XBB.1.9.2, which is an omicron subvariant. It was first detected on Feb. 17 and designated as a VUM on July 19.

    Its latest designation means it’s more prevalent than it was, has a growth advantage over earlier variants and merits closer monitoring and tracking.

    Here’s what you need to know about Eris.

    Eris is spreading around the world

    The strain is increasing in global prevalence, accounting for 17.4% of cases sequenced in the week through July 23, up from 7.6% four weeks earlier. The WHO has been tracking COVID data on a 28-day basis, largely because countries have cut back on testing and surveillance as they emerge from the pandemic, meaning the agency has far less data than it did during the pandemic.

    It’s already dominant in the U.S.

    Eris has become dominant in the U.S., according to projections made by the Centers for Disease Control and Prevention, although a shortage of data is hampering the agency’s efforts to surveil the illness.

    The CDC said last week it was unable to publish its “nowcast” projections, which it releases every two weeks, for where EG.5 and other variants are circulating for every region, because it did not have enough sequences to update the estimates.

    “Because nowcast is modeled data, we need a certain number of sequences to accurately predict proportions in the present,” CDC representative Kathleen Conley told MarketWatch.

    “For some regions, we have limited numbers of sequences available and therefore are not displaying nowcast estimates in those regions, though those regions are still being used in the aggregated national nowcast,” she said.

    It is estimated that EG.5, an omicron subvariant, accounted for 17.3% of COVID cases in the U.S. in the two-week period through Aug. 5. That was up from an estimated 11.9% in the previous period and was more than any other variant.

    For more, see: New Eris COVID variant is dominant in the U.S., but a shortage of data is making it hard to track

    It’s no riskier than earlier variants

    The public-health risk is deemed to be low at the global level, lining up with the risk posed by XBB.1.16 and other currently circulating VOIs, according to the WHO statement. But it’s likely more infectious.

    “While EG.5 has shown increased prevalence, growth advantage, and immune escape properties, there have been no reported changes in disease severity to date,” said the WHO.

    That growth advantage and immune-escape properties mean Eris may cause a rise in case incidence over time and become dominant in some countries or even the world, according to the WHO.

    It has the same symptoms as other strains

    The Eris variant causes the same symptoms as seen with other strains of COVID, such as sore throat, runny nose, cough, congestion, fever, fatigue, body aches and a possible loss of taste or smell.

    The best defense against Eris is vaccination

    Like earlier strains of COVID, the best protection is to be vaccinated with any of the vaccines developed by Pfizer Inc.
    PFE,
    -0.03%
    and German partner BioNTech SE
    BNTX,
    -0.32%    ,
    Moderna Inc.
    MRNA,
    -1.01%
    or Novavax Inc.
    NVAX,
    +9.83%

    The vaccines that will be made available in the fall will be designed to protect against all subvariants of XBB, including Eris.

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  • New ‘Eris’ COVID variant is dominant in the U.S., but a shortage of data is making it hard to track

    New ‘Eris’ COVID variant is dominant in the U.S., but a shortage of data is making it hard to track

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    A new variant of COVID-19 dubbed EG.5 has become dominant in the U.S., according to projections made by the Centers for Disease Control and Prevention, although a shortage of data is hampering the agency’s efforts to surveil the illness.

    The CDC said on Friday it was unable to publish its “Nowcast” projections for where EG.5 and other variants are circulating for every region, which it releases every two weeks, because it did not have enough sequences to update the estimates.

    “Because Nowcast is modeled data, we need a certain number of sequences to accurately predict proportions in the present,” CDC representative Kathleen Conley said in a statement to CBS News.

    “For some regions, we have limited numbers of sequences available, and therefore are not displaying nowcast estimates in those regions, though those regions are still being used in the aggregated national nowcast.”

    It is estimated that EG.5, an omicron subvariant, accounted for 17.3% of COVID cases in the U.S. in the two-week period through Aug. 5. That was up from an estimated 11.9% in the previous period and more than any other variant.

    But the data are based on sequencing from just three regions; Region 2, comprising New Jersey, New York, Puerto Rico and the U.S. Virgin Islands; Region 4, comprising Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee; and Region 9, comprising Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands and Republic of Palau.

    The next most common variants are XBB.1.16, accounting for 15.6% of cases, and XBB.2.3, accounting for 11.2% of cases.

    All are subvariants of XBB, which COVID vaccines in the fall will be designed to protect against.

    The symptoms of EG.5, which Twitter users have nicknamed “Eris,” are similar to early variants, and it’s not deemed to be more virulent than early variants. It may be more infectious, however, as has been the pattern with new strains. Symptoms include a cough, fever, chills, shortness of breath, fatigue and a loss of taste or smell.

    The World Health Organization said last week that EG.5 increased in prevalence globally to 11.6% in the week through July 30 from 62% four weeks earlier.

    The variant is for now a variant under monitoring, or VUM, for the agency, which is a less serious designation than a variant of interest, or VOI, according to its weekly epidemiological update.

    The WHO is monitoring two VOIs, XBB.1.5 and XBB.1.6.

    It is tracking seven VUMs and their descendent lineages, namely BA.2.75, CH.1.1, XBB, XBB.1.9.1, XBB.1.9.2, XBB.2.3 and EG.5.

    CDC data show that hospital admissions with COVID started to rise again in July after being flat or falling for several months. But the number of deaths continues to decline with 81.4% of the overall population in the U.S. having had at least one vaccine dose.

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  • Will We Get Omicron’d Again?

    Will We Get Omicron’d Again?

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    In COVID terms, the middle of last autumn looked a lot like this one. After a rough summer, SARS-CoV-2 infections were down; hospitalizations and deaths were in a relative trough. Kids and workers were back in schools and offices, and another round of COVID shots was rolling out. Things weren’t great … but they weren’t the most terrible they’d ever been. There were vaccines; there were tests; there were drugs. The worst winter development the virus might produce, some experts thought, might involve the spawning of some nasty Delta offshoot.

    Then, one year ago this week, Omicron appeared. The first documented infection with the variant was identified from a specimen collected in South Africa on November 9, 2021; by December 1, public-health officials had detected cases in countries all around the globe, including the United States. Twenty days later, Omicron had unseated Delta as America’s dominant SARS-CoV-2 morph. The new, highly mutated variant could infect just about anyone it encountered—even if they’d already caught a previous version of the virus or gotten several shots of a vaccine. At the beginning of December, and nearly two years into the pandemic, researchers estimated that roughly one-third of Americans had contracted SARS-CoV-2. By the middle of February this year, that proportion had nearly doubled.

    Omicron’s arrival and rapid spread around the world was, and remains, this crisis’s largest inflection point to date. The variant upended scientists’ expectations about SARS-CoV-2’s evolution; it turned having COVID into a horrific norm. Now, as the U.S. approaches its Omicronniversary, conditions may seem ripe for an encore. Some experts worry that the emergence of another Greek-letter variant is overdue. “I’m at a loss as to why we haven’t seen Pi yet,” says Salim Abdool Karim, an epidemiologist at the Centre for the AIDS Programme of Research in South Africa. “I think there’s a chance we still will.”

    A repeat of last winter seems pretty unlikely, experts told me. But with a virus this unpredictable, there’s no guarantee that we won’t see disaster unspool again.

    Read: The worst pediatric care crisis in decades

    A lot has changed since last year. For one thing, population immunity to SARS-CoV-2 is higher. Far more people have received additional doses of vaccine, many of them quite recently, with an updated formula that’s better tailored to the variants du jour. Plus, at this point, nearly every American has been infected at least once—and most of them with at least some subvariant of Omicron, says Shaun Truelove, an epidemiologist and a modeler at Johns Hopkins University. These multiple layers of protection make it more challenging for the average SARS-CoV-2 spin-off to severely sicken people. They also raise transmission obstacles for the coronavirus in whatever form it takes.

    Omicron does seem to have ushered in “a different phase of the pandemic,” says Verity Hill, an evolutionary virologist at Yale. The variants that took over different parts of the world in 2021 rose in a rapid succession of monarchies: Alpha, Beta, Gamma, Delta. But in the U.S. and elsewhere, 2022 has so far been an oligarchy of Omicron offshoots. Perhaps the members of the Omicron lineage are already so good at moving among hosts that the virus hasn’t needed a major upgrade since.

    If that’s the case, SARS-CoV-2 may end up a victim of its own success. The Omicron subvariants BQ.1 and BQ1.1 appear capable of spreading up to twice as fast as BA.5, according to laboratory data. But their takeover in the U.S. has been slow and halting, perhaps because they’re slogging through a morass of immunity to the Omicron family. That alone makes it less likely that any single Omicron subvariant will re-create the sudden surge of late 2021 anytime soon. In South Africa and the United Kingdom, for instance, different iterations of Omicron seem to have triggered just modest bumps in sickness in recent months. (That said, those countries—with their distinct demographics and vaccination and infection histories—aren’t a perfect bellwether for the U.S.)

    For an Omicron 2021 redux to happen, SARS-CoV-2 might need to undergo a substantial genetic makeover—which Abdool Karim thinks would be very difficult for the virus to manage. In theory, there are only so many ways that SARS-CoV-2 can scramble its appearance while retaining its ability to latch onto our cells; by now, its options should be somewhat slimmed. And the longer the Omicron line of succession persists, the tougher it may be to upend. “It’s just getting harder to compete,” Hill told me.

    But the world has gotten overconfident before. Even if SARS-CoV-2 doesn’t produce a brand-new version of itself, low uptake of the bivalent vaccine could allow our defenses to wither, driving a surge all the same, Truelove told me. Our transmission-dampening behaviors too are slacker than they’ve been since the pandemic’s start. This time last year, 50 to 60 percent of Americans were regularly wearing masks. The latest figures, many of them several months old, are closer to 30 percent. “The more opportunities you give the virus to get into somebody,” Hill said, “the more chances you give it to get the group of mutations that could help it take off.” Immunocompromised people who remain chronically infected with older variants, such as Alpha or Delta, could also become the sites of new viral offshoots. (That may be how the world got Omicron to begin with.)

    Going on probability alone, “it seems more likely that we’ll keep going with these subvariants of Omicron rather than dealing with something wholly brand-new,” says Maia Majumder, an epidemiologist at Boston Children’s Hospital. But Lauren Ancel Meyers, an infectious-disease modeler at the University of Texas at Austin, warns that plenty of uncertainty remains. “What we don’t have is a really data-driven model right now that tells us if, when, where, and what kind of variants will be emerging in the coming months and years,” she told me. Our window into the future is only getting foggier too as fewer people submit their test results—or take any test at all—and surveillance systems continue to go offline.

    It wouldn’t take another Omicron-type event to hurl us into disarray. Maybe none of the Omicron subvariants currently jockeying for control will surge ahead of the pack. But several of them might yet drive regional epidemics, Majumder told me, depending on the local nitty-gritty of who’s susceptible to what. And as winter looms, some of the biggest holes in our COVID shield remain unpatched. People who are immunocompromised are losing their last monoclonal-antibody treatments, and although powerful drugs exist to slash the risk of severe disease and death, useful preventives and treatments for long COVID remain sparse.

    Read: The end of Evusheld

    Our nation’s capacity to handle new COVID cases is also low, Majumder said. Already, hospitals around the country are being inundated with other respiratory viruses—RSV, flu, rhinovirus, enterovirus—all while COVID is still kicking in the background. “If flu has taken over hospital beds,” says Srini Venkatramanan, an infectious-disease modeler at the University of Virginia, even a low-key wave will “feel like it’s having a much bigger impact.”

    As the country approaches its second holiday season with Omicron on deck, this version of the virus may “feel familiar,” Majumder pointed out. “I think people perceive the current circumstances to be safer than they were last year,” she said—and certainly, some of them are. But the fact that Omicron has lingered is not entirely a comfort. It is also, in its way, a reminder of how bad things once were, and how bad they could still get.

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    Katherine J. Wu

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  • CDC identifies new COVID variants that accounted for 11.4% of new cases in week ending Oct. 15

    CDC identifies new COVID variants that accounted for 11.4% of new cases in week ending Oct. 15

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    The Centers for Disease Control and Prevention said a new COVID variant dubbed BQ.1 and a descendant called BQ.1.1 have gained traction in the U.S., accounting for 11.4% of new cases across the nation in the week ending Oct. 15.

    The two variants are lineages of BA.5, the omicron subvariant that remains dominant but has shrunk to account for just 67.9% of circulating variants, the agency said in a Friday update. The CDC had previously combined BQ.1 and BQ.1.1 with BA.5 cases because the numbers of the new variants were so small. BQ.1 was first identified by researchers in early September and has been found in the U.K. and Germany, among other places.

    New York and New Jersey currently have the highest proportion of BQ.1 and BQ.1.1 infections, at about 20% of overall cases, according to CDC estimates.

    “When you get variants like that, you look at what their rate of increase is as a relative proportion of the variants, and this has a pretty troublesome doubling time,” Anthony Fauci, President Joe Biden’s chief medical adviser, said in an interview with CBS News. 

    Adding to concerns, the variant seems “to elude important monoclonal antibodies,” he added.

    Fauci is confident that Moderna
    MRNA,
    +3.92%    ,
    as well as Pfizer
    PFE,
    +1.84%
    and German partner BioNTech
    BNTX,
    +2.45%    ,
    will be able to update boosters to target the new subvariant. “The somewhat encouraging news is that it’s a BA.5 sublineage, so there are almost certainly going to be some cross-protections that you can boost up,” he said.

    So far, only 14.8 million people living in the U.S. have taken advantage of the new bivalent boosters that were authorized by the Food and Drug Administration in late August. That’s equal to about 7% of the 209 million who were initially eligible.

    The FDA authorized the Pfizer booster for use in people aged 12 and older and the Moderna booster for adults aged 18 and older. Last week, the FDA added children aged 5 to 11 to the Pfizer program and children aged 6 through 17 to the Moderna one.

    Experts are concerned that the low number of vaccinations is due to a sense that the pandemic is over and no longer poses a major risk for most people. U.S. cases are steadily declining and now stand at their lowest level since mid-April; however, the true tally is likely higher than the official count, because many people are testing at home, where data are not being collected.

    The daily average for new cases stood at 37,649 on Sunday, down 19% from two weeks ago, according to a New York Times tracker.

    The daily average for hospitalizations was down 5% to 26,475, while the daily average for deaths was down 8% to 374.

    But cold weather is expected to bring a new wave of cases, and hospitalizations are rising again in much of the Northeast, the Times tracker is showing.

    “That’s the thing that’s so frustrating for me and for my colleagues who are involved in this, is that we have the capability of mitigating against this. And the uptake of the new bivalent vaccine is not nearly as high as we would like it to be,” said Fauci.

    Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • Moderna and Gavi, the Vaccine Alliance, which is supplying vaccines to low- and middle-income countries, have agreed to cancel remaining orders under their 2022 COVID-19 vaccine agreement given “sufficient supply.” The biotechnology company has supplied Gavi with nearly 70 million doses of COVID-19 vaccines, in addition to facilitating the donation of more than 100 million doses. Moderna and Gavi said they will create a new framework that enables Gavi to buy up to 100 million COVID-19 vaccine doses in 2023. 

    • The World Health Organization, the Food and Agriculture Organization of the United Nations, the United Nations Environment Program and the World Organization for Animal Health on Monday launched a new initiative that aims to address health threats to humans, animals, plants and the environment. The One Health Joint Plan of Action “aims to create a framework to integrate systems and capacity so that we can collectively better prevent, predict, detect, and respond to health threats,” the four agencies said in a statement.

    • China is doubling down on its zero-COVID strategy as a historic Communist Party congress opens in Beijing, BBC News reported. Zero COVID was a “people’s war to stop the spread of the virus,” said President Xi Jinping as he kicked off the meeting. There is increasing public fatigue over lockdowns and travel restrictions, and Beijing has come under strict security measures ahead of the congress, sparking frustration in the city, including a rare and dramatic public protest on Thursday criticizing Xi and his strategy.

    In a rare display of defiance, two banners were unfurled from a highway overpass in Beijing condemning Chinese President Xi Jinping and his strict COVID-19 policies. The protest took place days before the expected extension of Xi’s tenure.

    • Airline stocks rallied Monday after data showed that on Sunday, more people flew than on any other day since before the pandemic. Data from the Transportation Security Administration showed that 2.495 million travelers went through TSA checkpoints on Sunday, which is just above the previous 2022 high of 2.490 million on July 1 and the most since Feb. 11, 2020, which was exactly one month before the World Health Organization declared COVID-19 a global pandemic. In comparison, the day with the fewest travelers since the start of the pandemic was April 12, 2022, with 87,534 people traveling. And in 2019, there were 116 days of more travelers than Sunday, while the average for that year was 2.306 million. The U.S. Global Jets ETF
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    +2.02%
     was up 2.2%.

    Here’s what the numbers say:

    The global tally of confirmed cases of COVID-19 topped 624.7 million on Monday, while the death toll rose above 6.56 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 96.9 million cases and 1,065,118 fatalities.

    The Centers for Disease Control and Prevention’s tracker shows that 226.2 million people living in the U.S., equal to 68.1% of the total population, are fully vaccinated, meaning they have had their primary shots. Just 110.8 million have had a booster, equal to 49% of the vaccinated population, and 25.6 million of those who are eligible for a second booster have had one, equal to 39% of those who received a first booster.

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