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    As if you weren’t sick of hearing about COVID-19, a new subvariant of omicron has now been identified in more than 40 countries, including the United States. Called “BA.2,” some public health officials suggest it may be more contagious. Whether it can compete with the dominant omicron variant currently in the U.S. remains to be seen.

    Variants are a concern because they may circumvent strategies currently used to quell the pandemic like vaccines, antibodies, and oral therapies. For example, in Massachusetts last week, there were 46,092 new “breakthrough” COVID cases. These are infections in people who have been vaccinated. The previous week saw 86,450 new COVID infections in vaccinated people. Therefore, the need to know more makes it important to always keep an eye out for “variants of interest.”

    There is good news: It’s been suggested that the current omicron, being very contagious but not as deadly as the delta variant, may signal the light at the end of the tunnel for the pandemic. Viruses mutate randomly, but to be successful, it has to become easier to catch but rarely kill its human host. A virus that kills everyone it infects is doomed to extinction. This points, in the end, to COVID-19 becoming an endemic disease (always around) but no more deadly than, say, influenza virus.

    (Note: This is not to say that influenza virus can’t be deadly; it can be a major issue for the very young, the elderly, and those with weakened immune systems.)

    Knowing how fast and frequently RNA viruses mutate, it’s not surprising that new variants come around, much like the influenza virus arrives in a slightly different incarnation on a regular basis. The sheer number of COVID subvariants, however, is impressive. BA.2 already has at least 20 just in the spike protein.

    Doctors don’t yet know if someone who’s already had COVID-19 caused by omicron can be sickened again by BA.2. They’re cautiously optimistic that cross-protection via a prior omicron infection may decrease the effect of BA.2 on a patient.  

    While some officials refer to BA.2 as “stealth omicron,” conventional COVID-19 tests can still detect it. Some, including myself, question the benefit of using “stealth” and other adjectives which could stir up fear and panic. Stealth or not, BA.2 doesn’t appear to cause more severe disease than the original omicron. If further evaluation determines it’s a concern, BA.2 will get its own Greek letter; It may be named the “Pi” variant if this is the case.

    When a new strain emerges, it’s important to tell whether the strain can evade vaccines or oral treatments better than its predecessor or causes more severe disease. At present, all the available data suggests the new strain is similar to omicron in both respects.

    Luckily, most variants never become a major issue. The “Mu” variant, for example, was on the rise late last year in the UK, but there have been few, if any, new cases since the beginning of 2022. Many come and go so quickly, the public hardly knows they existed at all. Hopefully, this will be the case with BA.2.

    I’ll continue to report on new variants and other infectious diseases as they emerge, like I did with COVID in early January of 2020, but not to instill panic. Forewarned is forearmed, they say. Armed with knowledge, you can make informed decisions as you plot your route out of this pandemic.

    Joe Alton MD

    Joe Alton MD

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