Covid-19 Scrabble and Bivalent Boosters in the United States, Europe, and UK: New Vaccines, Vaccinations, and Hospitalizations

In the United States, there are Bq.1, BQ.1.2, Bq.1, Bq.2, Bq.3, Bq.8, bq.7, bq.6, bq.9 and bq.10 In other countries, the recombinant variant XBB has been rising quickly and appears to be fueling a new wave of cases in Singapore. Cases are rising in the UK and Europe, where variant have taken hold.

Dr. Peter Hotez, who co-directs the Center for Vaccine Development at Texas Children’s Hospital, says he thinks of them collectively as the Scrabble variants because they use letters that get high scores in the board game like Q, X and B.

Covid-19 cases are dropping as the US moves into the fall. That would be good news for the nation if it could escape the surge of the past two winters. But virus experts fear that the downward trend may soon reverse itself, thanks to this gaggle of new variants.

It is not known whether the new variant will run around together, sharing a piece of the Covid-19 infection pie, or if it will rise up to compete with the others.

The bivalent booster vaccine, authorized in September, protects against the original strain of the coronavirus as well as the BA.4 and BA.5 subvariants.

It’s almost certain that there will be a lot of cases and hospitalizations in the weeks to come because of the poor take of the new boosters, along with the evasive immune nature of the new variant and waning population immunity.

Evolving Family Trees: Convergent Evolution of the Omicron Disease and the Use of Covid-19 Epidemiologists and Vaccines

convergent evolution happens when branches of the same family tree evolve to share some of the same changes.

Experts think this convergence will mean a new phase of evolution of the virus, one that will see different versions of the same bug at the same time.

“What is likely to happen is that we have several co-circulating, semi-dominate lineages going into the winter season,” said Nathan Grubaugh, an associate professor of epidemiology at the Yale School of Public Health.

Because of convergent evolution, several different lineages can independently obtain the same transmissibility levels.

“This is what predominantly happens for most pathogens, such as the flu and RSV,” Grubaugh wrote in an email. The virus has adapted well to humanesis, and most of what is circulating has high fitness.

Maria Van Kerkhove, the Covid-19 response technical lead for the World Health Organization, said Wednesday that the large mix of new variants was becoming more difficult for WHO to assess because countries were dialing back on their surveillance.

She said that the world expects more waves of infections around the world, but that doesn’t mean they will translate into waves of death.

For now, the Omicron subvariant BA.5 still holds the top spot in the US. According to the CDC, it caused over 70% of new infections in the US last week, but it is quickly being outmatched by newer sublineages.

Most people feel that they will be a substantial proportion in the middle of November, and that they will bumped BA.5 off as the dominant variant, said Fauci.

The variations are different from the viruses, but they are descended from them. So they share many parts of their genomes with that virus.

The scale of what happened when Omicron arrived in November is not on their scale. That strain of the virus, which is now long gone, came out of genetic left field, leaving researchers and public health officials scrambling to catch up.

“We have a BA.5 bivalent updated vaccine as a booster that we’re pushing people to do. It will almost certainly have a good level of cross protection against the BQ.1 and others, as well as the other vaccines, and yet the use of these vaccines is disappointing at this time of year.

According to the latest data from the CDC, 14.8 million people have gotten an updated bivalent booster six weeks into the campaign promoting it. That’s less than 10% of the population that’s eligible to get one.

The rapid growth of the Omicron sub lineage XBB.1.5 and the need for new vaccines and anti-antivirus therapies

The project scientist who monitors the variant at the Scripps Research Institute thinks it will be much bigger than the BA.5 wave. But Zeller says he doesn’t expect this winter’s surge to reach heights of January’s Omicron wave.

The genetic changes these variants share appear to help them escape the immunity created by vaccines and past infections – a recipe for reinfections and breakthrough infections, particularly for people who haven’t had an updated booster.

But antibody therapies are particularly important for people with immune function that has been blunted by drugs, disease or age. These are the same people whose bodies don’t respond robustly to vaccines.

“And the truth is that if we want monoclonals to protect high-risk people – which we do – then at this point, given the speed of viral evolution, the US government has to be a major player in that role,” Jha said. The market can’t take care of itself.

The administration has been thinking about ways to commercialize some parts of the Covid-19 response – to get out of the business of buying vaccines and therapies – ultimately passing the costs on to consumers and insurers. But Jha says the process has to be guided by “the needs on the ground and the realities of the virus.”

He thinks the Biden administration will once again ask Congress for more money to help in the production of new therapies, because of the realities of today.

The public is told not to be alarmed over the rapid growth of the new Omicron sub lineage XBB. 1.5 and to stay informed as they find out more.

Van Kerkhove noted that XBB.1.5, which was first detected in the United States, has spread to at least 29 countries and “is the most transmissible form of Omicron to date.”

A Vanderbilt Vaccine Center Study of Covid-19: Response to a New Respiratory Vulnerabilities Rejectory

An effective tool to prevent Covid-19 infections include rapid tests, high-quality masks, air filters, oral antiviral pills and updated vaccines, according to Jha.

“We will soon have more data on how well vaccines neutralize XBB.1.5,” Jha said, suggesting that research to determine vaccine effectiveness against the new sublineage is underway.

She said WHO is working on a risk assessment for this sublineage and hopes to publish it within the next few days. Real world data on hospitalizations and lab studies are used to assess severity by the group’s technical advisers.

The first known patients in North America were tracked down by researchers in March 2020 and asked to give blood samples, as a new respiratory virus swept the globe.

The blood was shipped to Nashville and the Vanderbilt team analyzed it to see how the immune system responds to a foreign substance. The team at Vanderbilt looked for anti-SRES-coV-2 neutralizing antibodies that could bind to the disease and prevent it from entering the body.

“We had been seeing the data,” says Robert Carnahan, associate director of the Vanderbilt Vaccine Center. We mourned the death of Evusheld and knew it was going to happen. The last drug designed to combat Covid-19 was this one.

The problem with these existing monoclonal antibodies is that they bind to a very small piece of the virus known as the receptor binding domain, part of the spike protein. This part has been constantly evolving, changing into new variations that can no longer be recognized and mitigated.

In November 2022, the FDA revoked the authorization of bebtelovimab, the last of the Covid treatment antibodies, saying the drug was not expected to neutralize Omicron subvariants BQ.1 and BQ.1.1, which made up more than 57 percent of cases at the time. Those subvariants have been quickly supplanted by another, XBB.1.5, which made up around two-thirds of cases as of the beginning of February, according to the Centers for Disease Control and Prevention.