The number of coronavirus cases and hospitalizations have steadily increased in the United States over the past few months. This is at least partly due to the half dozen subvariants that seem to have better immune evasion and at transfer Compared to previous virus versions.

Now, a subvariant, XBB.1.5, is spreading even more rapidly. A hybrid of two BA.2 variants and the so-called “nightmare variant,” a relative of XBB that caused a surge in Singapore in the fall, XBB.1.5 is raising concerns about a possible wave in the United States as people return to Are from the holiday trip.

According to the Centers for Disease Control and Prevention, the circulation of XBB.1.5 nearly doubled every week in December. Just before Christmas, it accounted for 21.7 percent of new COVID cases in the United States. in one Update On December 30, the CDC stated that XBB.1.5 comprised 40.5 percent of cases and excluded other subvariants (such as BA.5, BF.7, BQ.1 and BQ.1.1, among others) that are currently In the Northeast, XBB.1.5’s hold is even stronger: it’s causing about 75 percent of new cases, accounting for the rest of the cases in the US.

Here’s what experts know so far about the new subvariant and what its mutations may mean for frequent infections, symptoms, case numbers and treatment options.

The development of coronavirus variants is not a new thing. “Viruses and pathogens are constantly trying to adapt to and avoid the immune pressure that we put upon them,” said Dr. Albert Ko, a physician and epidemiologist at the Yale School of Public Health.

XBB.1.5 is slightly different from its relatives, as it not only avoids protective antibodies, but it is also better able to bind to cells. This means that healthy adults are more likely to become infected with it, even after vaccination or after any other type of infection.

But other parts of the immune system can still come to our rescue, says Dr. Otto Yang said.

Even if mutations in certain parts of the virus prevent antibodies from blocking the infection, T cells must be able to recognize the core part of the virus spike protein, Dr. Yang said. And because T cells remember how to respond to the coronavirus based on what they’ve learned from previous encounters or vaccines, they can attack quickly if you become infected. “They’re the ones that prevent serious disease,” Dr. Yang said. “People who are up to date on their vaccines and who get treated early with Paxlovid or remdesivir are going to do fine, for the most part.” (Paxovid is an oral antiviral drug, and remdesivir is an injectable.)

Immune evasion and infection is a major concern for people who are immunocompromised or who do not mount a strong immune response to vaccines. This includes people who have had stem cell or solid organ transplants, people receiving cancer treatment, people with autoimmune diseases, and people who require immunosuppressive medication. various medical conditionssaid Dr. Alpana Waghmare, Infectious Disease Specialist at Fred Hutchinson Cancer Center.

immunotherapy that many immunocompromised people rely on, such as preventive shots Evushled and intravenous covid treatment bebtelovimab, are not effective against XBB.1.5 and other newer subtypes. As a result, immunocompromised people may have more severe disease, but other antiviral treatments will prevent deaths from rising in this group.

Dr Waghmare said there is so far no evidence to suggest that people who are infected with any of the new subvariants experience new or unusual symptoms or that their disease is more severe than with previous Omicron variants.

The most common symptoms still include mild runny nose, headache and sore throat. These may precede a positive COVID test, and symptoms may be mild or moderate for the duration of the illness.

The best thing most people can do to protect themselves is to get and promote vaccination. In particular, those at high risk, as well as those who haven’t had a booster shot or a Covid infection in the past four to six months, should plan to get the shot, Dr. Yang said. Some experts recommend a booster even earlier.

The bivalent booster can train your immune system to recognize the original virus as well as the BA.5 Omicron variant from 2020. While it remains to be seen how well the antibodies from the bivalent shot may work against XBB.1.5, the T cell protection generated from the booster should still be able to protect you from severe disease if infected, Dr. Yang he said. In terms of vaccine effectiveness, “if we see that the death toll goes down and if the rate of serious illness and hospitalization goes down, even if people get infected, that’s still a great success.” ,” said Michael Osterholm, epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

People who are at high risk of severe COVID-19 or have vulnerable family members should also consider wearing a mask, avoiding crowded indoor spaces, and asking others about symptoms or exposure to COVID , especially after gatherings. Dr. Osterholm said that they should also get frequent Covid tests done and if any test comes back positive then immediately take an antiviral drug like Paxlovid.

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