BA.5 is driving a new wave of cases in the U.S.
The evasive BA.5 omicron variant is driving up Covid cases and hospitalizations as it spreads rapidly across the United States—but despite deaths remaining lower compared to earlier waves, experts tell Forbes there are still plenty of reasons to remain cautious and warn Americans against letting their guard down too soon.
While Covid-19 cases and hospitalizations have been on the rise in most states in recent weeks and jumped 20% nationwide over the past fortnight, deaths have risen only modestly and have hovered around 300-400 a day since April.
Driving the new wave is BA.5, an omicron offshoot that has a “superpower to cause reinfection” and can evade immunity from vaccination and previous infection, even from other omicron variants, Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco, told Forbes.
The disconnect reflects the fact that vaccines and past infections still provide strong protection against serious illness and death for BA.5 as well as there being more options available to treat early disease like Pfizer’s Paxlovid.
Chin-Hong said there are still plenty of reasons to avoid infection, not least because Covid can still cause severe symptoms “even if you don’t end up in the hospital” and symptoms can “last for weeks.”
Infection also carries the risk of “long Covid”—lingering and sometimes debilitating symptoms that can persist for months or years—and early evidence suggests this is more likely the more times you get infected.
Avoiding infection also helps safeguard people around you who may have less protection against serious disease like children, the elderly and those with weakened immune systems, Dr. Stuart Turville, a virologist at the University of New South Wales in Australia, told Forbes.
Increasingly transmissible variants of omicron have surged across the U.S. this year. BA.5, the most infectious form of the virus yet, rapidly spread and became the dominant variant in early July. It now accounts for an estimated 78% of cases, according to the Centers for Disease Control and Prevention and community transmission has spiked. Concerns over BA.5, as well as the related BA.4, prompted officials to direct vaccine makers to target the variants in updated shots and the Biden Administration announced new plans to tackle its spread. Officials and experts say it is especially important to ensure strong protection against serious disease by keeping up-to-date on vaccinations, including booster shots. Despite the appeals of public health officials and being available for many months, booster uptake in the U.S. is poor. Fewer than half of fully vaccinated people have received their first booster dose and fewer than 30% of those who have and are eligible for a second have taken up the offer, according to CDC data.
What To Watch For
More variants. It is inevitable that SARS-CoV-2, the virus that causes Covid-19, will evolve and spawn new variants over time. Another omicron offshoot, BA.2.75—inexplicably and successfully dubbed “Centaurus” by the internet—has already caught the eye of virologists. The variant is spreading rapidly in India, has been detected across Europe and North America and shows signs of evading immunity. Little data is available and it’s not clear whether BA.2.75 causes more severe disease. It’s also not clear whether it would be able to take over from BA.5 “as the ruler of the roost,” Chin-Hong explained, as they haven’t had a chance to directly compete with each other as yet.”
What We Don’t Know
A great deal. Data collection and surveillance is poor compared to earlier on in the pandemic. Individual testing is down, genomic surveillance is reduced and evidence suggests cases could be vastly higher than official figures state. Conversely, hospital figures are inflated and reflect routine testing upon admission, which catches many “incidental” infections from people seeking care for other problems. There is a lot to be understood about the newer omicron variants as well, experts say. BA.5, as well as other more recent omicron offshoots like BA.4 and BA.2.75, are relatively new pathogens that are infecting or reinfecting large numbers of people in the community, Turville explained, which makes it hard to provide absolute and definitive answers. “As with most things with SARS CoV-2, it is a large bag of unknowns,” he added.
Turville told Forbes the decoupling of deaths from cases shows the longer term effects of vaccination and exposure to the virus. It’s a “maturing immunity to SARS-CoV-2 in general” which has taken off the “edge of disease severity,” he added.
While cases are growing—and likely undercounted—it’s worth noting that they are a long way from the earlier omicron peak in January. In July, there were around 100,000-120,000 cases reported on average compared to more than 800,000 in mid January.