The wave of COVID infections caused by BA.5 sub-variants has peaked.Daily new cases, hospitalizations and deaths worldwide is falling.
But the SARS-CoV-2 virus is almost certain to survive. Another wave is all but inevitable as new variants and sub-variants mutate, vie for dominance and find new avenues of transmission.
How fast and how bad this wave came may come down to a genetic competition between the different mutations of the new coronavirus.If we’re lucky, a mild form of the virus will win out — and buy us time to prepare for a response worse It is almost certain that the virus will emerge sooner or later.
if we were unluckythe worse comes faster.
Nothing is taken for granted in the scientific world. “What we’ve learned from this pandemic is to expect the unexpected,” University of Florida epidemiologist Cindy Prins told The Daily Beast.
BA.5 is a fork of the base Omicron variant that still dominates when epidemiologists start looking for possible versions of COVID back BA.5. They have identified two main possibilities.
The most likely possibility is another form of Omicron, a variant that our immune system recognizes and knows how to beat. The worst is some brand new variant that might slip through our antibodies. A Pi, Rho or Sigma variant, if you will.
Either outcome is possible. The only thing the experts didn’t expect was that COVID would… go away. “This virus always finds a way to survive,” John Swartzberg, professor emeritus of infectious diseases and vaccinology at the UC Berkeley School of Public Health, told The Daily Beast. “I don’t see any indication that it will not continue to do so.”
BA.5 is the third major subvariant of Omicron, itself the third major variant of the virus, after Alpha and Delta. BA.1, the baseline Omicron, became dominant late last year, replacing the Delta form.
BA.1 is not as deadly as Delta, mainly due to widespread immunity to vaccines and past infections. The deadliest day for BA.1 on February 9 was 13,000, but not as high as the deadliest day for Delta on January 20 at 18,000.
But BA.1 is method More contagious than Delta. Some epidemiologists describe it as the most contagious respiratory virus they have ever seen. BA.1 drove a record wave of infections, with new cases reaching nearly 4.1 million globally on January 19.
“But if we get Pi, Rho or Sigma, be prepared for possible disaster.“
The BA.1 wave resulted in two smaller surges of cases as the new Omicron sub-variant took over. BA.1 cases subsided in February; BA.2 brought them back to life in March. BA.2 infections eased in May. BA.5 gets them back on their feet in June.
The BA.5 surge peaked on July 20 with 1.6 million new cases and 4,500 deaths on July 27.Infections and deaths are now falling almost all places that are not japan.
By our pre-pandemic standards, the relative decline of COVID masks still-pervasive pain. “This is a good reflection of what we’ve faced over the past few years, where we could be facing over 120,000 known new infections per day, over 43,000 hospitalisations per day (5,000 in ICU) and 450 deaths per day Case [in the U.S.] And be in the mindset where we’re thinking, ‘This is not bad, we’re seeing worse,'” University of South Carolina epidemiologist Anthony Alberg told The Daily Beast.
The suspended sentence is temporary. If the past 32 months are any guide, the next wave of COVID will form this winter. The only variable is the form of the virus. Is the next major form of SARS-CoV-2 the fourth major subvariant of Omicron? Or a whole new variant?
The distinction is important. All Omicron sublineages have certain key mutations, especially around the virus’s spike protein, the part of the pathogen that helps it grab onto and infect our cells.
By now, billions of people have antibodies that recognize these mutations, whether they come from one of the safe and effective vaccines or from past infections. Even as infection rates rise, it is over the past two years that a steady increase in immunity has kept the death rate down. Since last winter, many people have contracted the new coronavirus — some for the second or third time. Most have mild cases.
If another offspring of Omicron dominates the next few months, this trend should continue.there will be perhaps Cases will continue to surge for weeks.but death possible Only a slight increase.
Our antibodies are ready, says Edwin Michael, an epidemiologist at the University of South Florida Center for Global Health Infectious Diseases, who has built sophisticated computer models to simulate the COVID pandemic.
“Naturally acquired immunity is durable, estimated at 2.5 years in our model, so new infections mostly occur in those who have lost vaccine-induced immunity, which decays faster,” Michael told The Daily Beast. “This results in a steady but small rise and fall in cases, with fluctuations or fluctuations that become progressively smaller in size over time until a clear endemic plateau is reached.”
But if we get Pi, Rho or Sigma, be prepared for possible disaster.
The new variant of the virus has become dominant through radical mutations that dramatically alter the way the pathogen behaves and give it an edge over its predecessors. With every new variant, it’s possible that it has changed so much that our antibodies no longer recognize it. “Regardless of vaccination status and prior infection, this major genetic shift would greatly improve its ability to infect humans,” said Ahlberg.
Epidemiologists call this “immune evasion.” It’s a nightmare scenario when it comes to viruses.
Michael modeled a proliferation of a major immune escape variant. How bad it gets depends on whether the new variant evades vaccine-induced antibodies, natural antibodies from past infections, or both. “If immune avoidance works similarly for the two forms of immunity, then depending on the exact rate and intensity at which escape occurs, you get significantly large repeating waves,” Michael said.
There is reason to believe that another Omicron sublineage is most likely to emerge. Geneticists scrutinizing virus samples have noticed four forms of Omicron vying for dominance in recent weeks. BA.5, of course. There are also BA.5.2, BA.2.75 and BA.4.6.
Christian Anderson, director of infectious disease genomics at the Scripps Research Translational Institute in California, told The Daily Beast that BA.5.2 is a slightly mutated form of BA.5 that may not have enough advantages over its predecessor. “So I think we’re going to see BA.2.75 or something completely different take over.”
This “completely different thing” has yet to show up in virus monitoring, which means BA.2.75 may have a head start.
If there is a wildcard, it might be BA.4.6, which is a subvariant of BA.4 and a close relative of BA.5. “We know very little about the structure of .4.6,” Swartzberg said. Although BA.4.6 is just another Omicron sub-variant, it may be mutated due to significant immune escape. “We hope to have a new Omicron sub-variant that is very successful in evading immunity [that] This could be a serious problem for us. “
“Be careful with your wishes,” Swartzberg quipped.
Still, as long as Omicron and its descendants dominate, the next wave of COVID is likely to be a fairly small one. This gives us time to prepare for the next wave – with time, it becomes more and more likely that some immune-evading variants will eventually emerge.
No one was expecting a new round of massive lockdowns, even as a highly immune-evasive new form of COVID raged around the world. Instead, our best tool against Pi, Rho or Sigma may be a new formulation of Moderna and Pfizer’s messenger RNA vaccine.
mRNAs are inherently flexible. It is a plug-and-play delivery system for generating tiny fragments of genetic material that trigger a specific immune response. Change the genetic material, and you change the vaccine — and the antibodies it induces.
Current mRNA vaccines are designed for Alpha variants, although they are still effective against Delta and Omicron. Anticipating the imminent arrival of immune escape variants, Pfizer and Moderna are working on new “multivalent” vaccine formulations with broader efficacy against a wider range of SARS-CoV-2 variants.
But these new recipes aren’t quite ready yet. Massachusetts-based Moderna and New York-based Pfizer have both conducted large trials of their multivalent vaccines, but the FDA is still reviewing the data.
Whether and when the FDA approves a new vaccine cocktail—a prerequisite for health agencies in many other countries to do so—may depend on whether and when immune-escape variants emerge. The new vaccine could be approved by the FDA in about a month, Swartzberg said.
Clearly, regulators prefer to work on new formulations without the pressure of a surge in infections and deaths. They might have figured this out if the next wave was the BA.2.75 wave and not possibly worse.