The latest subvariant of the new coronavirus to become dominant in Europe, the United States and elsewhere is also, in many ways, the worst yet.
The BA.5 sub-variant of Omicron’s base variant appears to be more contagious than any previous form of the virus. It’s also apparently better at dodging our antibodies, meaning it might be more likely to cause breakthrough and repeat infections.
Vaccines and boosters remain the best defense. There are even Omicron-specific booster shots in development that, in the coming months, could make the best vaccines more effective. effective against BA.5 and its genetic cousins.
Yet the ongoing antics of BA.5 over half the planet are a stark reminder that the COVID pandemic is not over. “We’re not done yet, far from it,” wrote Eric Topol, founder and director of the Scripps Research Translational Institute in California, on his Substack.
High levels of at least partial immunity to vaccines and past infections continue to prevent the worst outcomes – mass hospitalization and death. But globally, the raw number of cases is rising, with serious implications for potentially millions of people who face increasing risk of long-term illness.
Equally worrying, the latest wave of infections gives the coronavirus the time and space it needs to mutate even more. dangerous variants and sub-variants. “Variant development is now a freight train,” Irwin Redlener, founding director of Columbia University’s National Disaster Preparedness Center, told The Daily Beast.
In other words, unstoppable.
BA.5 first appeared in viral samples in South Africa in February. In May, it dominated in Europe and Israel, replacing earlier forms of the base variant of Omicron while driving global daily COVID cases up from around 477,000 per day in early June to 820,000 per day this week. .
At the end of June, BA.5 became dominant in the United States. Cases have yet to rise – the daily average has hovered around 100,000 since May. But that could change in the coming weeks, as BA.5 continues to outperform less transmissible subvariants.
Topol offered a concise explanation of BA.5’s ascendancy. Where the mutations that produced many earlier variants mainly affected the spike protein – the part of the virus that helps it latch on and infect our cells – BA.5 has mutations on the other side its structure. “BA.5 is quite distinct and very responsive, representing a marked difference from all previous variants,” Topol wrote.
The widespread BA.5 mutations made the subvariant less recognizable to all those antibodies we’ve built from vaccines, boosters, and past infections. BA.5 managed to bypass our immune system, like a ninja, contributing to the increased rate of breakthrough cases and re-infections.
This comes as no surprise to epidemiologists who have been warning for many months now that persistently high case rates – which they largely attribute to a stubborn anti-vax minority in many countries – would facilitate variants and increasingly infectious and evasive subvariants. The more infections there are, the greater the risk of significant mutations.
In this sense, BA5 could be a preview of the months and years to come. A year ago, we had the good fortune to block the main transmission vectors of SARS-CoV-2 through vaccines and social distancing.
But we didn’t. Restrictions on businesses, schools and crowds have become politically toxic around the world. Vaccination rates have remained stubbornly low, even in many countries with easy access to injections. In the United States, for example, the percentage of fully immunized people has stagnated at around 67%.
So COVID persists, 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 almost inevitable result of this tragic dynamic.
The situation is not entirely hopeless. Yes, BA.5 seems to reduce the effectiveness of the best messenger RNA vaccines. Vaccine maker Moderna has released data indicating that a booster shot it is developing specifically for Omicron and its progeny works only one-third as well against BA.5 compared to previous subvariants.
But vaccines, boosters, and past infections still provide significant, albeit reduced, protection against BA.5. “Even a boost of the original genome, or a recent infection, [produce] certain cross-protective antibodies to mitigate 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 extra jabs you get on top of your primary run, the better protected you are. Arguably the best protection results from two main injections of the mRNA vaccines from Pfizer or Moderna plus a few boosters. “Get your fucking fourth shot!” said Redler.
The problem in the United States is that only people aged 50 or older or with certain immune disorders can get a second booster. And the U.S. Food and Drug Administration won’t say if, or when, it might allow second boosters for young people. “I have nothing to share at this time,” an FDA spokesperson told The Daily Beast when asked about boosters for those under 50.
This is an obvious bureaucratic error. No less than a million booster doses are about to expire in the United States, all for lack of takers. “A profound waste, which should be made available to all people under the age of 50 who seek additional protection,” Topol wrote.
To be fair, both Pfizer and Moderna are working on new boosters they made specifically for Omicron sub-variants. On June 30, an FDA advisory board approved these variant-specific boosters. The FDA has announced that it may approve them for emergency use for some Americans as early as this fall.
But there is a risk that these jabs appear too late, especially if they are highly optimized for a single recent sub-variant and therefore ineffective against future sub-variants. “Variant research is the wrong approach,” Topol wrote. “By the time a booster of the BA.5 vaccine is potentially available, who knows which strain will be predominant?”
Fortunately, there are workarounds. Masks and voluntary social distancing, of course. Post-infection therapies, including the antiviral drug paxlovid, are also helpful. “Now is not the time to give up on non-pharmaceutical interventions,” Redlener stressed.
But voluntary mask-wearing and paxlovid are band-aids to a festering global wound. The resurgence of BA.5 infections creates the conditions for the Next major subvariant—BA.6, if you will. It may even be worse.
It seems more and more likely that COVID will be with us, well, still. “COVID is becoming like the flu,” Ali Mokdad, professor of health measurement sciences at the University of Washington Institute of Health, told The Daily Beast.
That is to say, endemic. A permanent threat to public health. The big difference, of course, is that COVID is far more dangerous than today’s flu. And it keeps mutating in ways that make it even worse.