A version of the omicron variant dubbed "stealth omicron" is being monitored by scientists and health experts around the world, and has now been detected in both Illinois and in Wisconsin, according to health officials.
According to officials at Northwestern University, the first case of the BA.2 omicron subvariant was detected in Illinois Monday.
The case was discovered by Northwestern Medicine's Center for Pathogen Genomics and Microbial Evolution, according to a press release.
The first case in Wisconsin was also reported on Monday, according to Milwaukee County health officials.
This version of the coronavirus is widely considered stealthier than the original version of omicron because particular genetic traits make it somewhat harder to detect on PCR tests.
Chicago's top doctor said the city is "keeping an eye on" the omicron subtype.
"There's nothing that we've seen at this point that is raising a high level of concern but please rest assured we're watching it and we'll let you know if there's anything to be interested or concerned about," Chicago Department of Public Health Commissioner Dr. Allison Arwady said Tuesday.
Here's what we know about "stealth omicron" so far.
What is 'stealth omicron' exactly?
According to Arwady, BA.2 is not a new variant, but rather a "subvariant" of omicron.
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"It's still omicron," she said. "It's just... sort of certain letters point one versus certain letters point two. It's a slight variation in terms of what is being picked up, but I want to be really clear it has not even been classified as a variant of interest yet... this isn't even a new variant, it's just considered a slightly different flavor of the kernel and we've seen that before."
For now, the original version, known as BA.1, and BA.2 are considered subsets of omicron. But global health leaders could give it its own Greek letter name if it is deemed a globally significant “variant of concern.”
"Every time there's a new variant, first of all, we will get a name," Arwady said. "So if this is something we have to worry about, nobody will call it the 'stealth something,' it would get a Greek letter name."
BA.2 has several key mutations, with the most important of those occurring in the spike protein that studs the outside of the virus. Those mutations are shared with the original omicron, but BA.2 also has additional genetic changes not seen in the initial version.
It's unclear how significant those mutations are, especially in a population that has encountered the original omicron.
According to initial data from the United Kingdom, BA.2 may be slightly more transmissible than the initial omicron variant, but scientists caution that it's too early to make a definitive conclusion, according to LiveScience.
The quick spread of BA.2 in some places, including Denmark, raises concerns it could take off.
“We have some indications that it just may be as contagious or perhaps slightly more contagious than (original) omicron since it’s able to compete with it in some areas,” said Dr. Wesley Long, a pathologist at Houston Methodist in Texas, which has identified three cases of BA.2. “But we don’t necessarily know why that is.”
An initial analysis by scientists in Denmark shows no differences in hospitalizations for BA.2 compared with the original omicron. Scientists there are still looking into this version's infectiousness and how well current vaccines work against it.
It's also unclear how well treatments will work against it.
Doctors also don’t yet know for sure if someone who’s already had COVID-19 caused by omicron can be sickened again by BA.2. But they’re hopeful, especially that a prior omicron infection might lessen the severity of disease if someone later contracts BA.2.
The two versions of omicron have enough in common that it’s possible that infection with the original mutant "will give you cross-protection against BA.2,” said Dr. Daniel Kuritzkes, an infectious diseases expert at Brigham and Women’s Hospital.
Scientists will be conducting tests to see if antibodies from an infection with the original omicron "are able to neutralize BA.2 in the laboratory and then extrapolate from there,” he said.
“Thus far, we haven’t seen it start to gain ground” in the U.S., said Dr. Wesley Long, a pathologist at Houston Methodist in Texas, which has identified three cases of BA.2.
Why is it harder to detect?
The original version of omicron had specific genetic features that allowed health officials to rapidly differentiate it from delta using a certain PCR test because of what’s known as “S gene target failure.”
BA.2 doesn't have this same genetic quirk. So on a COVID test, according to Dr. Wesley Long, a pathologist at Houston Methodist in Texas, BA.2 looks like delta.
“It's not that the test doesn't detect it; it's just that it doesn't look like omicron,” he said. "Don’t get the impression that ‘stealth omicron’ means we can’t detect it. All of our PCR tests can still detect it.”
How can you protect yourself?
Doctors advise the same precautions they have all along: Get vaccinated and follow public health guidance about wearing masks, avoiding crowds and staying home when you’re sick.
“The vaccines are still providing good defense against severe disease, hospitalization and death,” Long said. “Even if you’ve had COVID 19 before — you’ve had a natural infection — the protection from the vaccine is still stronger, longer lasting and actually ... does well for people who’ve been previously infected.”
The latest version is another reminder that the pandemic hasn't ended.
“We all wish that it was over," Long said, ”but until we get the world vaccinated, we’re going to be at risk of having new variants emerge.”