Why our third COVID winter could be a “variant soup” – but also less severe

The third winter of COVID-19 is approaching. This year, with the cold weather, increased transmission and a host of other respiratory infections are on the way.

For the most part, we know the drill: Mask up in crowded indoor spaces. Test regularly. Ventilate spaces. Isolate if sick. To get vaccinated.

But with recall rates lagging behind and Washington’s COVID state of emergency set to expire on Monday, Secretary of State for Health Dr. Umair A. Shah said “now is the time to to act”.

“More than two years later, we are still talking about COVID,” Shah said Thursday. “…And now is the time to get your flu shot, get your COVID shot, or get a booster. We must do everything we can to prepare for the next respiratory season. »

It’s still too early to tell how severe this winter’s surge will be, but projections indicate one is definitely on the way, said Dr. Larry Corey, former president and director of the Fred Hutchinson Cancer Center who led groundbreaking research into herpes, HIV and covid treatment.

Corey also recently received the Alexander Fleming Lifetime Achievement Award from the Infectious Diseases Society of America. At last week’s ceremony in Washington, D.C., Corey’s longtime friend and colleague Dr. Anthony Fauci, President Joe Biden’s chief medical adviser, presented the award and recognized his decades of work in the development of antivirals, the organization of clinical trials and research into vaccines.

Among his greatest accomplishments, he tested the drug acyclovir, the first antiviral drug used to treat herpes; the formation of the Global AIDS Clinical Trials Group; and coordinate massive trials of multiple COVID vaccine candidates in 2020.

This week, Corey and state Health Department leaders sat down to help answer some of the most pressing questions about what to expect from COVID in the months ahead.

What’s going on with COVID in Washington right now?

With the exception of a slight increase in cases in early September, the state’s COVID cases have been steadily declining since mid-summer.

In mid-October, the state reported a seven-day rate of about 57.5 infections per 100,000 people and 3.4 hospitalizations per 100,000. The number of deaths, which lags the cases and hospitalizations, is about 0.5 deaths per 100,000, or about six deaths per day.

By comparison, the state recorded more than 1,800 infections per 100,000 over seven days at the height of the omicron surge in January.

Is another COVID spike on the way?

Although Corey said another winter surge is very likely, chances are it will be shorter than previous ones. While last year’s delta variant summer peak lasted four to five months and omicron’s winter surge lasted about three months, Corey predicted the numbers would rise for about two months this year.

“But we’re still going to see the virus infect more people, especially high-risk people, and you’re going to see vaccine breakthroughs,” he said. “For people who aren’t boosted – there hasn’t been a lot of enthusiasm for boosting – you’re going to see a lot of disease.”

What are the factors that can determine the duration of a wave?

Population immunity and the outcome of competing variants and subvariants are two main factors that help experts predict how long the next surge will last, said Dr. Tao Sheng Kwan-Gett, chief scientific officer of the state, at a press conference this week.

Although the evolution of variants is largely unpredictable, we have control over increasing population immunity through vaccination, he said.

Because so many people were infected with the omicron variant or one of its subvariants last winter and spring, they likely developed some immunity to serious infections, Corey added.

How could this year be different or similar to past pandemic winters?

One of the most notable differences this year is that Washington no longer requires face masks in most indoor settings, with the exception of health care and correctional facilities. In the Seattle area, grocery stores, schools, sports games, restaurants and bars are increasingly full of unmasked people – which contributed to higher than normal respiratory infections this fall, said Corey.

“We knew it worked for the flu and other respiratory illnesses,” Corey said. “And it always works. There is stigma and confusion, but there should be no confusion about whether masking works.

The sub-variants on the horizon also present a new challenge. This year, instead of just one variant to watch, multiple variants have emerged in what some experts call a “soup of variants” – each with a fairly strong ability to evade immunity.

What variants are beginning to surge in other countries? And here?

In Washington, the BA.5 subvariant of omicron has been the dominant variant for months, accounting for approximately 78% of all variants in circulation. A few others, including BF.7, BA.4.6, and BA.2.75, are also in the state, but Kwan-Gett said none are yet showing signs of emerging as the next dominant subvariant.

About a month ago, BA.2.75 took off in South Asia while BA.4.6 and BA.7 gained momentum, according to the Washington Post. Another omicron sub-variant, BQ.1.1, began development a few weeks ago and could be a contender to take over in Europe and North America. Scientists are also looking for another line called XBB, the Post reported.

In general, how do we do it?

Things are going well, but not great, Corey said. As people have learned to test for COVID, self-isolate, social distance, wear masks and seek medical attention if needed, action at the federal and international levels has slowed, he said. .

“We could create better vaccines,” Corey said. “But it requires funds and pressure, and we don’t see that. So you’re starting to see the infrastructure that we’ve built for COVID start to disappear.

Clinical trials are smaller. Work on the development of new monoclonal antibodies is lagging behind. Federal funding is exhausted.

“Get boosted,” he said. “…I see it does no harm. It can only help. I think the cards here are that the virus is still evolving and still creating a significant amount of disease, so all the tools we have are needed.

Leave a Comment