The XBB strain is the first rapidly spreading recombinant variant, meaning it is a fusion of two omicron lines. Its original version caused a wave of infections in Singapore. Then he added two critical mutations to become XBB.1.5, which was first detected in New York.
These two mutations maintain XBB’s high level of immune evasion, while adding a more infectious advantage, giving the virus a better ability to attach to receptors it enters our cells. The identified variant has quickly become dominant throughout the Northeast and is destined to do so nationwide in the coming weeks.
Moreover, it is gaining momentum in many European and Asian countries. This tells us that XBB.1.5 is no slouch. It outperforms a soup of new omicron variants that have appeared in recent months.
Although there is no indication that XBB.1.5 is more pathogenic or virulent, its ability to spread seems striking, given how quickly it became dominant in New York and the contiguous states. XBB.1.5 now includes well over 75 percent infections in New York, Connecticut, New Jersey and Massachusetts. Hospitalizations have increased among the elderly to levels that only the first omicron wave surpassed.
Of course, it’s hard to attribute this solely to XBB.1.5, given waning population immunity, less frequent use of masks and other mitigating measures, and indoor gatherings during the holiday season. But the spike in hospitalizations in those states is significantly larger than in other parts of the country. And it is people aged 65 and over who, along with immunocompromised people, are the most vulnerable.
What can be done to defend against XBB.1.5? Boosting is key, as new data from the Centers for Disease Control and Prevention To display. People aged 65 and over who have received the bivalent vaccine are 80% less likely to be hospitalized. Furthermore, there is evidence that the bivalent vaccine – even though it targeted the earlier BA.5 variant – helps induce neutralizing antibodies and broaden immunity against XBB.1.5. Beyond reminders, the use of high-quality masks, rapid testing before gatherings, distancing, ventilation and air filtration will all help protect against infection.
Americans can take comfort in the combined immunity from the massive number of infections, reinfections, vaccinations and recalls in the country. This should mitigate the effect of XBB.1.5. Yet we have already seen levels of covid hospitalizations in the United States peak at nearly 11 monthsand we are not done with this wave yet.
The implications of XBB.1.5 are also far greater than this formidable variant. The virus speaks to us and tells us that it has many other ways to evolve. It is telling that it can not only simulate or evade our immune response, but also better penetrate our cells. What will happen next? Will we see a whole new family of distinct variants of the omicron family appear? It’s entirely possible.
And we are not ready for that. Genomic surveillance around the world fell 90% since the start of 2022, as evidenced by sequenced samples deposited at the Global Avian Influenza Data Sharing Initiative. This is unacceptable. China is in the midst of a covid crisis with unmitigated spread, and it could become fertile ground for functionally significant variants in the coming months.
Worse still, there are no coordinated, high-priority, accelerated, or even funded efforts — either in the United States or around the world — to develop the next-generation vaccines that will block infections, such as vaccines Variant-proof universals with extended protection time. We also have no drugs to replace the monoclonal antibodies that no longer work or for Paxlovid, in case resistance emerges to this treatment.
We went from complacency to outright capitulation at just the wrong time. If XBB.1.5 tells us one thing, it’s that we can’t be oblivious. We are all tired, but we face a force that is not. We have the smarts, the resourcefulness and the ingenuity to finally get ahead of the virus, but politics and the reluctance to invest are holding us back. We cannot afford this stalemate.
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