POST 242. March 24, 2022. CORONAVIRUS. “How worried should people be about the BA.2 variant? Will vaccines protect against it? What if someone contracted a previous variant — could they become reinfected? Is BA.2 milder than previous versions, and if so, should people try to get it? Could BA.2 cause another surge in the US, and is it time for restrictions to be put back into place?”
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“An even more transmissible version of the Omicron variant of the coronavirus known as BA.2 now accounts for about 30 percent of new cases in New York City, health officials said on Friday.
The subvariant is more transmissible than BA.1, the Omicron version that drove a sudden spike in cases and hospitalizations in New York last December and disrupted the city’s path to economic recovery.
Dr. Ashwin Vasan, who started this week as the city’s new health commissioner, said that he and others were watching closely to see if New York was on the verge of experiencing a wave of BA.2 cases like those taking place in parts of Europe and Asia, including Hong Kong. But as of this week, he said, there is no cause for immediate alarm…
Officials will continue to monitor cases and hospitalization rates, Dr. Quinn said. But she noted that BA.2 “does not appear to cause more severe illness” than BA.1, and she and Dr. Vasan said they believed hospitals would be prepared if there were any significant increase in severe illness.
BA.1 is responsible for the majority of cases in the United States, but the share of BA.2 cases is growing, reaching about 23 percent, according to estimates published Friday by the Centers for Disease Control and Prevention.
Epidemiologists are not yet sure whether BA.2 will drive a new spike in virus cases and related hospitalizations. BA.1 proved to be intrinsically less severe than prior variants, causing less damage in the lungs, and researchers in Britain and Denmark have found that BA.2 does not carry a higher risk of hospitalization. Vaccines were also effective at reducing severe illness from BA.1, particularly among those who received a booster shot, and researchers in Britain and Qatar have found the same for BA.2.
But though 77.4 percent of New York City residents are fully vaccinated, just 36.1 percent have received an additional vaccine dose.
“It’s essential that New Yorkers go and get boosted when they’re eligible,” Dr. Vasan said.” (A)
“On Tuesday, the University of Washington’s Institute of Health Metrics and Evaluation, said their model does not predict a new surge in Covid-19 cases “similar to what we have seen in parts of Europe,” said Ali Mokdad, a professor of global health at IHME, on Twitter. Instead, he said, their models suggests that after the end of March there would be a steady further decline in Covld-19 transmission in the US…
Adrian Esterman, an epidemiologist at the University of South Australia, pegged the basic reproduction number for BA.2 at around 12. “That makes it pretty close to measles, the most contagious disease we know about,” he wrote on Twitter on March 10.
Though BA.2 is more contagious, it does not appear to cause more severe disease. And though it escapes some of the immune protection created by vaccinations and prior infections, it doesn’t seem to do so any more than BA.1.
Hanage says that at a population level, Omicron is much more manageable than Delta was, but it is not harmless.
“The reason why Omicron BA.2 and BA.1 are a problem at all are the sheer numbers of infections they cause,” Hanage said.” (B)
“Top U.S. infectious disease official Dr. Anthony Fauci said at a Washington Post event on Tuesday that he does not believe there will be a major surge soon, “unless something changes dramatically.”
Still, Fauci noted that cases in the United States generally lag around three weeks behind the United Kingdom, “so if we are going to see an uptick, we should start seeing it within the next week or so.”
Daniel Kuritzkes, chief of division of infectious diseases at Boston’s Brigham and Women’s Hospital, said there was no evidence yet that the rise of BA.2 is pointing to an increase in cases.
“I think the one concern and where people need to remain vigilant is that as we have relaxed many restrictions around masking and gathering, there is a potential opportunity for BA.2 or any variant to gain a foothold,” Kuritzkes said.” (C)
“The proportion of Covid-19 cases due to BA.2 is rising in the United States, too. The US Centers for Disease Control and Prevention now estimates that 35% of new coronavirus cases are due to this subvariant. At the same time, restrictions are being lifted, and not a single US state requires mask mandates anymore (though masks are still required in some settings, including airports, public transportation, hospitals, nursing homes, and some schools and workplaces).
How worried should people be about the BA.2 variant? Will vaccines protect against it? What if someone contracted a previous variant — could they become reinfected? Is BA.2 milder than previous versions, and if so, should people try to get it? Could BA.2 cause another surge in the US, and is it time for restrictions to be put back into place?
To help us with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”
CNN: What do we know about BA.2, and how worried should we be about it?
Dr. Leana Wen: With any new variant or subvariant, we need to ask three questions: Is it more contagious? Does it cause more severe disease? And does it evade the protection of our vaccines?
BA.2 is related to BA.1, which is the original Omicron subvariant that led to the huge surge in cases over the winter here in the United States and across Europe. BA.1 swept through communities because of how contagious it is. BA.2 appears to be even more contagious than BA.1. The UK Health Security Agency estimates that BA.2 is growing 80% faster than BA.1. Here in the US as well, BA.2 appears to be on its way to overtaking BA.1 to become the dominant variant.
The good news is that BA.2 does not seem to cause more severe illness than BA.1. Researchers from the UK and Denmark have found BA.2 causes a level of hospitalization that’s comparable to that of BA.1, which is less likely to result in severe illness than the previously dominant Delta variant.
In addition, the vaccines we have are still effective. While vaccination may not protect as well against infection with BA.1 and BA.2, the effectiveness in that regard is partially restored with a booster dose, and the vaccines continue to provide very good protection against severe illness due to both Omicron subvariants.
What all of this says to me is that public health experts should follow the rise of BA.2 in the US closely, but that most people should not be worried. It’s likely that the US will see an increase in Covid-19 cases in the coming weeks, as this is the pattern we’ve seen before — that we lag behind the UK and Europe by a few weeks, so the increase they are seeing could be mirrored here. However, most people who are vaccinated, and in particular if they are boosted, are unlikely to become severely ill due to BA.2. Our government officials should prepare for what could be coming and increase the availability of tests and treatments, and continue to urge people to get vaccines and boosters. But I don’t think this is something that the general public should be overly concerned about at this time.” (D)
“The Biden administration is warning that the United States will soon run out of monoclonal antibodies and other COVID-19 treatments if Congress doesn’t sign off on additional funding.
White House Press Secretary Jen Psaki told reporters Tuesday the “consequences are dire” without more money being provided to these programs.
“Fewer monoclonal antibodies sent to states, an inability to purchase additional treatments, fewer tests available to Americans, less surveillance for future variants, and a risk of running short on vaccines,” Psaki listed as possible outcomes.
America’s monoclonal antibodies supplies could expire as early as June, she added. The treatments can help protect people who are at high risk of developing a serious illness from the virus.
The administration’s push for millions more in COVID-19 funding comes as virtually all 50 states and the Centers for Disease Control and Prevention have eased masking rules and other requirements as cases and deaths decline…
An administration official also told reporters Tuesday that the administration is canceling plans for the additional purchase of monoclonal antibodies due to the lack of funding. Governors will also be alerted that the number of monoclonal antibody treatments sent from the federal government will be slashed by 30 percent starting next week…
The House is expected to vote on a new bill that would provide $15 billion for COVID testing, treatment and vaccines. However, the proposal is likely to stall in the Senate. Republicans have argued that any COVID funding should be redirected from other stimulus programs.(E)
“The U.S. could soon see Covid-19 cases rise again and vulnerable people are likely to need a fourth vaccine dose, one of President Joe Biden’s top health advisers warned as the White House calls for more money to fight the pandemic.
Anthony Fauci, the longtime head of the National Institute of Allergy and Infectious Diseases and a Biden adviser, said U.K. officials are already warning him of an increase there driven by the BA.2 sub-variant, easing restrictions and waning protection from vaccines, and that the U.S. tends to be a few weeks behind case curves in the U.K.
“We have all three of those factors right now in this country,” Fauci said in an interview Thursday. “I would predict that we are going to see a bit of an increase, or at least a flattening out and plateauing of the diminution of cases. And the question is how do we deal with that.”..
Without new funding, “a lot of things are going to stop. It really will be a very serious situation,” Fauci said. “It just is almost unconscionable.”…
The U.S. has not ordered enough shots to give all Americans a fourth dose if needed, officials said earlier this week. Fauci said that the data aren’t entirely clear, but that protection against hospitalization appears to wane after four or five months after a third shot, and would be expected to fall further.
“I would project that sooner or later, we will need a fourth,” though perhaps only for the elderly and those with underlying medical conditions, at least at first, Fauci said.
Both the cash crunch and Fauci’s warnings come as Biden’s White House Covid team prepares for a change in leadership. Response coordinator Jeff Zients and his deputy, Natalie Quillian, will leave their roles next month and be replaced by Ashish Jha, dean of the Brown School of Public Health. Fauci praised all of them, while cautioning the fall in cases is a good sign, but is not sure to last.
“It’s really in a transition stage. We are obviously going in the right direction,” Fauci said. “We have to be really careful and not declare total victory prematurely. I do believe we will be able to settle into a degree of normality.”
Jha, in tweets Thursday, also predicted that cases could rise again and new variants could emerge. “We are very likely to see more surges of infections,” he said.
The U.S. will need to be flexible, including potentially returning to recommending the use of masks in certain settings, Fauci said.
“We’d better be careful, because history has taught us that what’s gone on in the U.K. generally happens to us three or four weeks later,” he said.” (F)
“The FDA also faces requests to authorize a second booster vaccine dose for adults. But even if they are authorized, Biden administration officials said they lack the funds to purchase those shots. They said they’ve bought enough doses for Americans age 65 and older, as well as the potential initial regimen for children under 5, but can’t buy more doses for people in other age groups unless Congress passes a delayed $15 billion funding package. It’s not yet clear whether additional doses for adults will be necessary, but officials said placing orders for doses ahead of time has been an important lesson of the pandemic. White House officials have expressed worry that vaccine manufacturers will prioritize orders placed by other countries.” (G)
““There are so many things we could be doing, yet the United States has time and time again chosen to be reactive, rather than proactive, and that has cost us dearly,” said Anne Rimoin, an epidemiologist at U.C.L.A. “We’ve been wearing rose-colored glasses instead of correcting our vision.”
A key question remains how much protection people who got sick with the previous version of Omicron can count on — and for how long. A lab study published this week found that vaccinated people who were infected with Omicron had high levels of antibodies that would probably protect against BA.2. If that protection lasts, it could reduce the impact of any wave, given the country’s high levels of infection this winter.
“I think it’s reassuring,” said Dr. Dan Barouch, a virologist at Beth Israel Deaconess Medical Center in Boston and a co-author of the study.
But some scientists said they worried that the immune defenses people built up during the first Omicron surge would wane, leaving them more susceptible to BA.2.
“The timing of BA.2’s emergence, and the potential waning in immunity from the BA.1 wave with masks coming off, isn’t great,” said Nathan Grubaugh, an epidemiologist at the Yale School of Public Health.
Even health experts who said they had become accustomed to the boom-bust cycle of pandemic funding said they were shocked that the money was drying up so soon after the country had outlined plans for adjusting to a new normal.
That money, they said, was essential for avoiding full-scale shutdowns, and instead detecting surges early enough that health officials could recommend masks or increased testing in particular areas and help hospitals prepare.
“People naturally, sensibly want to get back to their lives,” said Jeffrey Shaman, an epidemiologist at Columbia University. “The question, then, is how quickly would we be able to stand up a response?”” (H)
“On 7 January, virologist Leondios Kostrikis announced on local television that his research group at the University of Cyprus in Nicosia had identified several SARS-CoV-2 genomes that featured elements of both the Delta and Omicron variants.
Named by them as ‘Deltacron,’ Kostrikis and his team uploaded 25 of the sequences to the popular public repository GISAID that evening, and another 27 a few days later. On 8 January, financial news outlet Bloomberg picked up the story, and Deltacron became international news.
The response from the scientific community was swift. Many specialists declared both on social media and to the press that the 52 sequences did not point to a new variant, and were not the result of recombination — the genetic sharing of information — between viruses, but instead probably resulted from contamination in the laboratory.
“There is no such thing as #Deltacron,” tweeted Krutika Kuppalli, a member of the World Health Organization’s COVID-19 technical team based at the Medical University of South Carolina in Charleston, on 9 January. “#Omicron and #Delta did NOT form a super variant.”
The story behind how a small crop of SARS-CoV-2 sequences became the focus of a brief and intense scientific controversy is complicated. And although some researchers applaud the system for quickly catching a possible sequencing error, others warn that the events of last week might offer a cautionary tale on the spread of misinformation during the pandemic.” (I)
“The highly contagious Omicron subvariant, BA.2, is now the dominant Omicron variant around the world, the World Health Organization said this week.
Driving the news: BA.2 made up about 86% of cases reported to the WHO between Feb. 16 and March 17, the agency said in a report.
The previously dominant subvariants, BA.1.1 and BA.1, together represent less than 15% of cases globally.
Less than three weeks ago, BA.2 made up 34% of new cases and the BA.1.1 subvariant of Omicron was dominant, according to a WHO report published on March 8.” (J)
- A.The Omicron subvariant BA.2 now accounts for ‘around 30 percent’ of New York City’s cases, officials say., By Michael Gold, https://www.nytimes.com/2022/03/18/nyregion/nyc-omicron-ba2.html
- B.As BA.2 grows in the US, experts look to other countries to predict its impact here, By Brenda Goodman, https://www.cnn.com/2022/03/22/health/ba-2-wave-us-other-countries/index.html
- C.A third of U.S. COVID now caused by Omicron BA.2 as overall cases fall, By Michael Erman and Bhanvi Satija, https://www.reuters.com/world/us/omicron-sub-variant-ba2-makes-up-349-covid-variants-us-cdc-2022-03-22/
- D.Covid cases are rising as omicron’s ‘stealth’ subvariant spreads around the world, by Holly Ellyatt, https://www.cnbc.com/2022/03/15/is-omicron-subvariant-bapoint2-to-blame-for-rising-covid-cases.html
- E.Monoclonal Antibodies Could Run Out by June Without More Funds, Psaki Warns, BY ALEXANDRA HUTZLER, https://www.newsweek.com/monoclonal-antibodies-could-run-out-june-without-more-funds-psaki-warns-1688318
- F.Fauci Warns of Potential Rise in U.S. Covid Cases as Funding Runs Dry, ByJosh Wingrove, https://www.bloomberg.com/news/articles/2022-03-17/fauci-says-u-s-covid-cases-could-soon-rise-as-funding-runs-dry?srnd=premium
- G.Washington Post.
- H.Another Covid Surge May Be Coming. Are We Ready for It?, By Benjamin Mueller, https://www.nytimes.com/2022/03/19/health/covid-ba2-surge-variant.html?referringSource=articleShare
- I.Deltacron: the story of the variant that wasn’t, by Freda Kreier, Deltacron: the story of the variant that wasn’t, by Freda Kreier, https://www.nature.com/articles/d41586-022-00149-9
- J.WHO: Omicron subvariant is now the dominant strain worldwide, by Erin Doherty, https://www.axios.com/who-omicron-variant-pandemic-b461e4d9-13ec-466f-9043-40e84f28bbce.html
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