The latest subvariant of the new coronavirus that has become dominant in Europe, the United States and elsewhere is also, in many ways, the worst so far.
The BA.5 subvariant of the basic Omicron variant appears to be more contagious than any previous form of the virus. Apparently, it’s also better to dodge our antibodies, which means it may be more likely to cause innovative, recurrent infections.
Vaccines and reinforcements remain the best defense. There are even specific Omicron booster shots in development that, in the coming months, could make the best vaccines more effective against BA.5 and its genetic cousins.
Still, the ongoing BA.5 uprising in the middle of the planet is a strong reminder that the COVID pandemic is not over. “We’re not done yet,” wrote Eric Topol, founder and director of the Scripps Research Translational Institute in California, in his Substack.
High levels of at least partial immunity from previous vaccines and infections continue to prevent the worst outcomes: mass hospitalization and death. But globally, the number of gross cases is rising, with serious implications for millions of people potentially facing an increasing risk of long-term illness.
Equally troubling, the latest wave of infections is giving the coronavirus the time and space it needs to mutate into even more dangerous variants and subvariants. “The development of variants is now a freight train,” Irwin Redlener, the founding director of Columbia University’s National Disaster Preparedness Center, told The Daily Beast.
In other words, unstoppable.
BA.5 first appeared in viral samples in South Africa in February. In May it was dominant in Europe and Israel, displacing earlier forms of the basic Omicron variant while causing an increase in daily COVID cases from about 477,000 a day in early June to 820,000 a day this week.
In late June, BA.5 became dominant in the United States. Cases have not yet risen: the daily average has been around 100,000 since May. But that could change in the coming weeks, as BA.5 continues to compete with the less transmissible subvariants.
Topol offered a concise explanation of the rise of BA.5. Where the mutations that produced many of the above variants mainly affected the ear protein, the part of the virus that helps it catch and infect our cells, BA.5 has mutations throughout its structure. “BA.5 is quite different and very appropriate, representing a marked difference with all the previous variants,” Topol wrote.
Widespread mutations in BA.5 made the subvariant less recognizable for all antibodies we have created from previous vaccines, booster, and infections. BA.5 has been able to overcome our immune systems, in the ninja style, contributing to the increase in the rate of innovative cases and reinfections.
This is no surprise to epidemiologists who have warned for many months that persistently high case rates, which they largely attribute to a stubborn antivax minority in many countries, would facilitate increasingly infectious and evasive variants and subvariants. The more infections, the more chance of significant mutations.
A young child receives a Modern COVID-19 vaccine at Beth Shalom Temple in Needham, Massachusetts, on June 21, 2022.
Joseph Prezioso / AFP / Getty
In this sense, BA5 could be a preview of the coming months and years. A year ago, we had the opportunity to block the major vectors of SARS-CoV-2 transmission through vaccines and social distancing.
But we didn’t. Restrictions on businesses, schools and crowds have become politically toxic around the world. Vaccination rates remained stubbornly low, even in many countries with easy access to the blows. In the US, for example, the percentage of fully vaccinated people has stagnated at around 67 percent.
Thus, COVID lasts, 31 months after the first case was diagnosed in Wuhan, China. The longer the virus circulates, the more variants it produces. BA.5 is the almost inevitable result of this tragic dynamic.
The situation is not entirely desperate. Yes, BA.5 seems to reduce the effectiveness of the best messenger RNA vaccines. Vaccination manufacturer Moderna released data indicating that a booster vaccine that is being developed specifically for Omicron and its offspring only works by a third against BA.5 compared to the previous subvariants.
But previous vaccines, booster, and infections still offer significant protection, if reduced, against BA.5. “Even an increase in the original genome, or a recent infection, will [produce] some cross-protective antibodies to reduce the severity of a new subvariant Omicron infection, ”Eric Bortz, a virologist and public health expert at the University of Alaska-Anchorage, told The Daily Beast.
The more extra strokes you get on top of your main course, the more protected you will be. Undoubtedly, the best protection results from the first two strokes of the Pfizer or Moderna mRNA vaccines plus a couple of reinforcements. “Do your damn fourth shot!” said Redlener.
The problem, in the United States, is that only people 50 years of age or older or with certain immune disorders can opt for a second booster. And the U.S. Food and Drug Administration won’t say if, or when, it could authorize second reinforcements for the younger ones. “I have nothing to share right now,” an FDA spokesman told The Daily Beast when asked about reinforcements for under-50s.
A girl is taking a COVID-19 test at a test station on July 7, 2022 in Shanghai, China.
Hugo Hu / Getty
It is an obvious bureaucratic lie. Up to a million booster doses are about to expire in the US, all for lack of grips. “A deep residue, which should be made available to all people under the age of 50 seeking additional protection,” Topol wrote.
To be fair, Pfizer and Moderna are working on new drivers that they have specifically adapted to Omicron’s variants. On June 30, an FDA advisory board approved these variant-specific enhancements. The FDA announced it could approve them for emergency use for some Americans as early as this fall.
But there is a risk that these strokes appear too late, especially if they are highly optimized only for a recent subvariant and are therefore ineffective against future subvariants. “Chasing variants is a flawed approach,” Topol wrote. “When a BA.5 vaccine booster is available, who knows what the predominant strain will be?”
Fortunately, there are alternatives. Masks and voluntary social distancing, of course. Post-infection therapies, including the antiviral drug paxlovid, also help. “This is not a time to abandon non-pharmaceutical intervention,” Redlener stressed.
But the voluntary use of the mask and paxlovid are rinsed from a global wound. The increase in BA.5 infections creates the conditions for the following important subvariant: BA.6, if you will. It can be even worse.
It seems more and more likely that COVID will be with us, well, forever. “COVID is becoming like the flu,” Ali Mokdad, a professor of health metrics at the University of Washington Health Institute, told The Daily Beast.
That is, endemic. An ever-present threat to public health. The big difference, of course, is that COVID is much more dangerous than the current flu. And it continues to mutate in ways that make it even worse.