Fall and winter have not been kind to us in recent years.
In 2020, COVID-19 cases began to increase in October. And at this time last year, we were in the calm before the storm, so to speak, with delta-driven case counts slowly dipping before the omicron variant began its path to global domination at the end of November (Serial number: 12/1/21). What will happen in our third pandemic winter, as omicron continues to evolve and many people shed their masks?
Only time will tell. But there are already some warning signs that we could face another wave of infections, hospitalizations and deaths. On the one hand, cases and hospitalizations are increasing in some European countriesincluding the UK.
What happens across the pond often foreshadows what will happen in the United States. Nationwide and in most states, cases continue to decline. But experts worry that may not be true for long, as temperatures drop and more people gather indoors where the coronavirus is most likely to spread. Some states in the Northeast, for example, have seen a sharp rise in coronavirus levels in sewage, suggesting there has been an increase in transmission even if it is not yet reflected in official case counts (Serial number: 04/22/22).
There is also a wild card this year, which complicates things. New versions of omicron abound. How could they change the near future of the pandemic?
It is a difficult question to answer. On the one hand, we are in a very different place than we were two years ago, or even last year, with more treatments available and a omicron specific reinforcement (Serial Number: 05/11/22; Serial number: 9/2/22). But the coronavirus has been known to throw us some curveballs. Experts expect winter to usher in another wave, but it’s unclear what it will look like and how high it will crest.
“While we may feel good that we are going in the right direction, we cannot let our guard down,” National Institute of Allergy and Infectious Diseases Director Anthony Fauci said in a statement. October 4 Webinar conducted by the Annenberg Center for Health Journalism at the University of Southern California in Los Angeles.
There’s some good news: Most people have been exposed to the virus, either through vaccination or, the less desirable route, infection, or both. That means our immune system has the mugshot of the virus at hand. Our antibodies and T cells are trained to go into overdrive if the coronavirus sets off any red flags by entering our noses, throats, or lungs.
These immune barriers can decrease the ability of the virus to spread between people, as well as protect many from becoming seriously ill. As a result, fewer people may end up in the hospital or die than in previous years.
But then there’s the bad news: Over the past year, the omicron variant has taken on some disguises in the form of mutations that help the virus hide from our immune systems. During the summer, a version called BA.5 became dominant, displacing its relatives BA.2 and BA.2.12.1. Now, researchers are aware of a new alphanumeric smorgasbord of omicron versions.
It’s possible that a worrying new variant will suddenly appear and overtake all its relatives, as the delta and omicron variants did in 2021. The next name on the list would be “pi”.
But another possibility, perhaps more likely, is that in the coming months, our attention will not be focused on a single bloodline sweeping the world, but on a swarm of new variants. That’s thanks in part to the arms race between our immune systems and the virus.
Now that so many people have some kind of protection, compared to 2020 or early 2021, the coronavirus must constantly change in ways that poke holes in those defenses in order to spread. Some variants now circulating independently have acquired the same mutations, imparting similar antibody-dodging abilities in laboratory tests, the researchers report in a preliminary study published Oct. 4 on bioRxiv.org. With multiple variants using the same tactics to circumvent people’s immune systems, it can be difficult for a single variant to win.
Two of the newer versions of omicron, BQ.1.1 and BA.2.75.2, are particularly adept at dodging some individual antibodies taken from people who had recovered from a BA.2 or BA.5 infection, the researchers found. That means some people may be more susceptible to another infection if the new versions, which are so far present at low levels in the United Statesspread widely this fall.
Officials have already taken some steps to address this ever-changing virus. This fall, Pfizer/BioNTech and Moderna released modified versions of their mRNA vaccines that target both the original version of the coronavirus and omicron to refresh immune systems. But few of these updated shots are making it to the guns. Half of American adults say they have heard little to nothing on COVID-19 backups, according to a Kaiser Family Foundation survey released Sept. 30. And so far, just around 4 percent of people 12 years or older have received the new punctures. (On October 12, the US Food and Drug Administration and the Centers for Disease Control and Prevention signed on bivalent boosters for children 5 to 11 years old).
Additionally, the continued evolution of omicron means that vulnerable people are rapidly losing out on COVID-19 treatment options. The Oct. 4 study, which has not yet been peer-reviewed, also found that the last bastion of antibody drugs used to treat or protect high-risk patients — therapies called bebtelovimab and Evusheld — failed to recognize some of the new variants. when tested in laboratory plates. And on October 3, the FDA warned that Evusheld, which is used as a pre-exposure treatment to protect immunocompromised people, does not work for all variants. The drug still offers protection against many of the variants currently circulating, the FDA said, as does the antiviral Paxlovid.
Another unknown we face this winter is how much other respiratory infections could add to an already heavy COVID burden. Flu season in Australia, usually a fixture for those of us north of the equator, is back after a two-year hiatus and starting earlier than usual. The experts are back warning about a possible “twindemia” in the northern hemisphere, with influenza and coronavirus making people sick (Serial number: 09/18/20). Not to mention that there are a myriad of other infections that most people have not been exposed to in recent years thanks to mask wearing and social distancing.
That’s not to say that everyone should prepare for another lonely winter. But it is a sobering reminder that it would be wise to take extra precautions, like getting tested before social gatherings and masking up, especially around vulnerable people, even as we go about our lives. And that reminds me: I need to order more masks.