If you’re like the majority of Americans — estimated to be over 60 percent of them, according to government data – you have already had COVID-19.
And if you’re like most of those Americans, you’ve had it pretty recently — during the massive Omicron wave that swept the US over the winter holidays.
The question now is whether you’re ready to get infected again – this time by a new subvariant that not only bypasses some of your existing immunity, but may also be more resistant to major treatments.
Two mutants that fit that description, BA.4 and BA.5, are now taking off in the US – and experts say they will soon replace the earlier versions of Omicron (BA.2 and BA.2.12.1). causes hundreds of thousands of new (and usually not reported) infections every day for weeks.
“The next chapter of the pandemic…is a story of immune system escape,” said Dr. Eric Topol, founder of the Scripps Translational Institute, recently. predicted†
And experts say the US isn’t doing enough to keep up.
Once reinfection was rare; some scientists even suspected that natural immunity to a previous case of COVID would protect most people from ever getting infected again. Vaccination also blocked more than 90% of infections.
But Delta broke that immunity wall and Omicron BA.1 broke it, pushing the infection rate — including breakthrough infections — to record highs.
BA.4 and BA.5 have subsequently evolved to evade the massive amount of immunity brought about by the original Omicron – and in the past month their share of US cases has been about doubling every seven days, indicating exponential growth. At the same time, reinfection rates appear in the US to get up† By July BA.4 and BA.5 likely to be nationally dominant†
The implications of Omicron’s faster-than-expected evolution — from a new variant evading previous immunity to a rapid succession of subvariants evading the immunity gained even from previous versions of Omicron — are only just beginning to emerge.
The good news is that overall, COVID is now less deadly than ever before. Despite the increased number of cases, there are now fewer US COVID patients in intensive care units than at any point in the pandemic and the national death rate (about 300 per day) is as low as it has ever been. Acquired immunity, multiple rounds of vaccinations and improved treatment options help – a lot.
But there is also worrying news. The latest research suggests that beneficial mutations in the spike proteins of BA.4 and BA.5 could negate some of the progress we’ve made against serious diseases. Among those preliminary findings:
Combined with declining vaccine protection and disappointing booster intake in the elderlyThe virus’s new trajectory — toward greater transmissibility, evasion and potentially pathogenicity — could affect vulnerable Americans in the coming months.
Portugal, for example, is currently experiencing a major BA.5 wave, and Deaths from COVID once again approach winter’s Omicron heightsalthough 87% of the Portuguese population is fully vaccinated – 20 points higher than in the US In contrast, the official number of COVID deaths in South Africa is remained fairly flat during that country’s recent BA.4 peak (although excess deaths had risen sharply† In South Africa, only 5% of the population is over 65; in Portugal that number is 23%. The US – where seniors represent 16% of the population – is demographically much more like Portugal. Even minor setbacks in protecting the immunocompromised and the elderly can have a real impact.
The same goes for a “new normal” that involves regular reinfection – and that seems to be where the US is heading. Dying isn’t the only downside of COVID. For starters, long COVID is real — and the more often the virus infects you, the more chances it has of causing lingering symptoms.
Then there are all the usual downsides of getting sick: missing school, missing work, losing pay, juggling childcare, canceling events and spreading the virus to other more vulnerable people. Each of these problems becomes much more problematic when it happens on a large scale over and over again – unlike the more modest and manageable scale of, say, the flu, which is far less contagious than COVID and just tends to re-infect us. every few years†
Americans already recognize how disruptive and potentially dangerously regular reinfections would be. According to the latest Yahoo News/YouGov polla significant majority (61%) say it would be a very (29%) or somewhat major problem (32%) “if you become infected with the coronavirus several times a year in the future” – while only a quarter or so ( 27%) say it is not a very big problem (17%) or no problem at all (10%).
So far, few Americans — just 28% — think they’re likely to be re-infected that often, and experts say it’s still possible to narrow the odds, which are now increasing rapidly, to better meet expectations. comply. But they also say that the US is lagging far behind.
Last week, Moderna announced that its lead candidate for a fall booster shot is based in part on Omicron BA.1 (which is now extinct in the US) rather than BA.4 and BA.5 (which account for 13% of falls and climbs). represent). Like the New York Times put itthe “make the virus evolve so fast that it goes faster than” [our] ability to adapt vaccines, at least as long as the United States depends on human clinical trials for results.” A faster method — likely based on data from lab and mouse or other animal experiments — may be needed to ensure boosters remain effective.
Next-generation vaccines may also be needed to minimize infections. Like dr. Deepta Bhattacharya, professor of immunology at the University of Arizona, wrote Monday in the New York Times: “Vaccines received through the nose or in the mouth position memory cells and antibodies near the sites of infection and offer potential ways to prevent symptoms and maybe even infections altogether† Some of these vaccines are now in clinical trials and could be available soon.”
Meanwhile, Bhattacharya continued, “groups of researchers are also exploring individual vaccines that could work against all versions of the novel coronavirus. These vaccines, which must be variant-resistant, make it difficult for the virus to outperform the immune system. They have big promise shown in animal experiments. Some are entering clinical trials and could be available in the next few years.”
Improving ventilation would also help. “If we get waves every few months, we need to do something *sustainable* to reduce transmission,” said COVID expert Prof. Christina Pagel recently. tweetedreferring to the “a once-in-a-decade opportunity” that “now exists to make sustainable improvements in public and private indoor air quality”†
“It’s not just about masks – especially if they’re impractical in restaurants/pubs/gyms,” says Pagel, who is based in the UK, added† “We have solutions!”
But the US is not funding Operation Warp Speed for next-generation vaccines or air quality improvements. Instead, Republicans in Congress are blocking a modest $10 billion in new COVID spending, forcing the White House save money for testing so the US is willing to buy the bare minimum this fall, such as existing pills and vaccines.
That combination of impediment and lack of ambition represents what topol and others have described as “COVID complacency”. But if the sudden emergence of BA.4 and BA.5 tells us anything, it’s that COVID hasn’t grown complacent with us.
New versions of the virus will never bring the US back to square one. But they will continue to make our way out of the pandemic more disruptive and even more dangerous than necessary — unless we do more to keep up.