New COVID variants like XBB, BQ.1 and BQ.1.1 are emerging globally, sparking new concerns as they begin to spread and adding to the growing list of emerging variants, but why are all of these variants suddenly arising now and is one variant worse than the others?
New COVID variants like XBB, BQ.1 and BQ.1.1 are emerging globally, sparking new concerns as they begin to spread and adding to the growing list of emerging variants, but why are all of these variants suddenly arising now and is one variant worse than the others?
Chicago's top doctor said seasonal shifts could play a role in the rise in new variants.
"The way COVID, like any other virus, mutates, creates new variants is by spreading," Chicago Department of Public Health Commissioner Dr. Allison Arwady said Tuesday. "Every time there's a new COVID infection, there is an opportunity for the virus to mutate just a little bit in the genetics of it. And when we start to see more COVID infections happening, we also start to see more variants.That's just how it works. So the fact that we're heading into colder weather, it doesn't surprise me at all that we would see more mutations."
When it comes to the severity of the new variants, Arwady said the rapid rate of increase is worrisome, but it's not all bad news.
"These are all subvariants of omicron," she said. "And so, I don't like to see new variants at all, but the one I would be really worried about is a variant emerging that is not part of omicron because that is the real question in terms of major lack of predictability."
BQ.1.1 and BQ.1 are among the newer variants to emerge but are already rising above other recent variants like BF.7 in their spread, according to the Centers for Disease Control and Prevention.
CDC data shows BQ.1 and BQ.1.1 each make up 5.7% of recent cases, as of Oct. 15. That's just under BA.4.6's 12.2%. Though BA.5 continues to dominate, making up 67.9%, that number is significantly below the more than 80% seen in recent months.
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Beyond their ability to spread quickly, Dr. Eric Topol, founder of the Scripps Research Translational Institute, told TIME that BQ.1.1 is "riddled with troublesome mutations" that could "pose a threat to our immune system's response."
Another concern is whether the new variants can evade treatment from monoclonal antibodies, like Evusheld, which is used to prevent infections in those who are immunocompromised and not generating enough response from the vaccine.
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The U.S. Food and Drug Administration earlier this month updated its information for health care providers to state that those receiving the treatment could be at an "increased risk for developing COVID-19 when exposed to variants of SARS-CoV-2 that are not neutralized by Evusheld."
Still, Arwady said the new bivalent COVID vaccines could play a role in curbing a possible surge associated with the recent omicron subvariants.
"We're not in quite as stable place as we were six weeks ago... but the best news is everything is still omicron," she said. "And so getting your fall 2022 vaccine should give us that extra protection we're going to need... remember that the updated variant is specifically good for the BA.4, BA.5, which is more than 80% of what we're seeing right now."
The White House last week said eligible Americans should get the updated COVID-19 boosters by Halloween to have maximum protection against the coronavirus by Thanksgiving and the holidays, as it warned of a “challenging” virus season ahead.
Dr. Ashish Jha, the White House COVID-19 coordinator, said the U.S. has the tools, both from vaccines and treatments, to largely eliminate serious illness and death from the virus, but stressed that's only the case if people do their part.
“We are not helpless against these challenges," he said. “What happens this winter is up to us.”
Still, it remains unclear whether those new bivalent boosters will protect against infection in general, with studies still underway even as Americans get the shots.
Germany's health minister warned at the end of September that the country is seeing a steady rise in COVID-19 cases as it goes into the fall, and urged older people to get the new COVID booster shots. Other European countries such as France, Denmark and the Netherlands are also recording an increase in cases, Karl Lauterbach told reporters in Berlin.
“We are clearly at the start of a winter wave,” he said.
Despite vaccine uptake, Arwady said she is still anticipating a surge in the coming months.
"I would be the happiest person alive if we made it through this winter staying at a low COVID 19 level, but I don't think it's likely to happen," she said. "So, you know, I think we're likely to see some increase in COVID cases and probably some increase in COVID hospitalizations and deaths."
