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The BA.5 subvariant of Omicron has now been declared the dominant strain of Covid, accounting for the majority of cases in the U.S. (The BA.4 subvariant accounts for closer to 20% of all cases.) If it feels like we’ve been here before, you’re not wrong. In spring 2022, the BA.2 subvariant was in the top spot, outpacing Omicron’s BA.1 and Delta before that. Experts now say that we’re in yet another new wave of cases—due in large part to the BA.5 subvariant’s sheer ability to evade antibodies from both vaccines and prior infection.
Given the fact that reporting rates have slowed, both as a result of more home testing and reduced frequency of state reporting, it’s hard to gauge the true picture of where we are now. But the information flow about BA.5 from other countries experiencing a surge can be a useful bellwether for what we could possibly expect stateside. Here’s what we know.
The BA.5 variant is not considered more severe
As a subvariant of Omicron (which was much less severe than Delta, Alpha, or the original strain of SARS-CoV-2), BA.5 is not currently considered to be especially severe, but it is highly transmissible. The CDC notes that there is no evidence so far that BA.5 is more severe than other Omicron subvariants. That said, it is still causing hospitalizations to increase around the world, which could be an issue of when more people become infected, there tends to be a rise in hospitalizations.
“The good news is that the vast majority of breakthrough infections now are outpatient illnesses. They are not resulting in the kind of severe illness that we saw earlier in the pandemic when no one had immunity, which led to increased hospitalizations and deaths,” says Dean Blumberg, MD, chief of pediatric infectious diseases at UC Davis Children’s Hospital, in a post.
Symptoms of BA.5 seem to be similar to other strains, too: fever, runny nose, coughing, sore throat, headaches, muscle pain and fatigue are still the most common complaints. Omicron is much more likely to be concentrated in the upper respiratory tract than the lower respiratory tract.
The virus is now better at evading vaccine antibodies—but vaccines are still protective
“The main reason this variant has become the predominant one that is now circulating is that it is able to evade previous immunity,” says Dr. Blumberg. “Even people who have partial immunity from a previous infection or vaccination can still have a breakthrough infection.” That’s because the subvariant has mutated so drastically—and so quickly—that our immune system has trouble recognizing and responding to it. But experts still say a fourth shot would help offer baseline protection against severe illness.
Though hospitalizations may be on the rise in Europe currently, “What we’re not seeing is an increase in intensive care unit admissions, so the vaccines are still very much working,” an official with the World Health Organization said this week in The Times.
To catch up to the dominant strains and reduce the gap in immunity, vaccine manufacturers have rushed to develop Omicron-targeted boosters, which would lend increased protection against the Omicron strains. However, the boosters currently being developed are based on earlier Omicron subvariants, which means it’s not yet known just how well they’d protect against BA.4 and BA.5.
Prior infection does confer some immunity—but not much
Most adults and kids are now walking around with some level of immunity to the coronavirus, whether that's from vaccines or infection. But how well that immunity protects you seems to be quickly waning. That means that yes, you or your child can get Covid more than once, even if you’ve been recently infected—and even if you’ve had a previous version of Omicron (likely if you've been infected since January 2022). Unfortunately, we're seeing many instances of repeat infections around the world, which suggests that the former thinking that prior infection gave you a natural immunity for up to three months no longer holds when it comes to BA.5.
But it's not all for naught. Prior infection with Omicron does confer some degree of immunity, says Eric Topol, professor of molecular medicine at Scripps Research, to The New York Times. “But it’s not anything like what we would hope.”
What’s especially worrying is that recent research shows that, at least for adults, with every repeat infection—including asymptomatic infections—the risks of long-term health complications increase, including heart attack, stroke, diabetes, lung problems, digestive and kidney disorders and dementia. Your risk of long Covid increases with each subsequent infection, too. Which is why it’s important to take precautions to prevent further infections. But it's important to remember that we have antiviral medications now available for both kids and adults that can help fight off the virus, too.
What to do now
Get boosted. Any antibody protection against the new variant (and there are surely more to come in the future) is better than none. And vaccines are the best way to protect yourself and your family from long Covid, too. “There is abundant evidence that being vaccinated and getting all of the boosters that you are eligible for helps protect you against severe disease,” says Dr. Blumberg.
Help your family members stay up to date. Vaccines are now available for everyone age 6 months and older, and boosters are available for kids age 5 and up. The more people who are fully vaccinated, the less the vaccine is able to spread and eventually mutate, experts say.
Wear a mask. When you’re indoors or even outdoors at a large public gathering, wear a fitted face covering (an N95 or KN95 or KF94 are recommended). Especially if you’re at higher risk for severe illness. If you’re currently pregnant or have recently been pregnant, you’re considered high risk.
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