The COVID variants dominating this fall mean ‘we’re still in the Omicron era’

As Dr. Jake Lemieux, a Harvard Medical System assistant professor of medicine and infectious disease specialist at Massachusetts General Hospital, said Thursday, “The bottom line is we’re still in the Omicron era, or Omicron-plus era.”

BQ.1, a spin-off of fellow Omicron BA.5, leads the nation in infections, comprising a projected 26% of national cases, according to the agency’s Nowcast report, valid through Saturday. On its heels is its child, BQ.1.1, estimated to fuel just under a quarter of infections. 

Former global leader BA.5, which drove a majority of cases this summer, came in third, comprising 24% of infections. Last week it was first, responsible for an estimated 34% of infections.

“The major thing that is notable is that BA.5 has largely been out-competed by BQ.1 and BQ.1.1,” Lemieux said at a Thursday press conference regarding COVID.

For most people, that’s a relatively good thing, given previous fears that newer, more immune-evasive Omicron variants like the ones we’re seeing now could cause a large wave of infections, with the potential to challenge hospital capacity late this year.

In fact, nationally, the number of COVID cases appear to be holding steady—not rising as some, including White House officials, had feared this spring. But with testing at an all-time low and most testing that is occurring happening in homes, data obtained and provided by public health officials is “increasingly less useful,” Lemieux said. 

Still, U.S. hospitalizations and deaths—once considered poor indicators of the virus’ progress due to their lag time behind a rise in cases—are also holding steady, and that’s relatively good news. They’re now some of the pandemic’s most reliable indicators, he said.

The bad news in this week’s forecast is for those who are immunocompromised and rely on monoclonal antibodies, hospital administered IV treatments given to those who are most at risk of severe disease from the virus.

New variants like BQ.1 and BQ.1.1 have rendered useless “our last functional monoclonal antibodies,” Lemieux said. That means that existing treatments used for people who have been infected with previous variants aren’t effective.

This week the CDC added another variant to the list of those it’s tracking: BF.11, yet another descendent of BA.5. While the latest Omicron strains have greater immune evasion abilities than previous strains, they all seem fairly similar to their current competitors. And symptom-wise, they seem almost identical to the versions of Omicron that dominated this spring and summer, like BA.4, BA.5, and BA.2.12.1.

An ever-growing list of Omicron variants are in the race for dominance this winter, Dr. Moritz Gerstung, a professor of computational biology at the German Cancer Research Center, tweeted Thursday.

“Whoever wins, though, is very likely to have predictable characteristics,” he said.

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