Omicron BQ variants predominate, XBB circulates low

A person is tested for coronavirus disease (COVID-19) as the Omicron variant of the coronavirus continues to spread in Manhattan, New York, USA December 22, 2021.

Andrew Kelly | Reuters

Sub-variants of the omicron BQ coronavirus have come to dominate the US as people gather and travel for the Thanksgiving holiday, putting those with weakened immune systems at increased risk.

BQ.1 and BQ.1.1 cause 57% of new infections in the US, according to data released by the Centers for Disease Control and Prevention on Friday. The omicron BA.5 sub-variant, once dominant, now accounts for only a fifth of new Covid cases.

According to the National Institutes of Health, BQ subvariants are more immune evasive and likely resistant to key antibody-based drugs like Evucheld and bebtelovimab, which are used by people with weakened immune systems. This includes organ transplant patients and patients undergoing cancer chemotherapy.

Currently, there is no replacement for these drugs. President Joe Biden told people with weakened immune systems in his October speech that they should consult their doctors this winter and take extra precautions.

“New options may render some existing protections ineffective for immunocompromised people. Unfortunately, this means you may be at particular risk this winter,” Biden said.

The XBB subvariant now also circulates at low levels, causing about 3% of new infections. White House chief medical adviser Dr. Anthony Fauci said at a briefing on Tuesday that XBB is even more immune-protected than sub-options of BQ.

Fauci, director of the National Institute of Allergy and Infectious Diseases, said the new boosters that have been developed against omicron BA.5 are likely not as effective against infections and mild illnesses caused by XBB. But vaccinations should protect against serious diseases, he said. He added that there was a spike in cases from XBB in Singapore, but there was no significant spike in hospitalizations.

Moderna and Pfizer said last week that their boosters elicit an immune response against BQ.1.1, which is a descendant of the BA.5 subvariant.

Fauci, at a press briefing, said public health officials believe there is sufficient immunity from vaccination, booster vaccination and infection to prevent a repeat of the unprecedented Covid spike that occurred last winter when omicron first emerged.

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