The Nightmare COVID variant that beats our immunity is finally here

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etradefactory.comA new sub-variant of the novel coronavirus called XBB made a dramatic announcement in Singapore earlier this week. New cases of COVID-19 more than doubled in a day, from 4,700 on Monday to 11,700 on Tuesday – and XBB is almost certainly the reason. The same sub-variant has also just surfaced in Hong Kong. A highly mutated descendant of the Omicron variant of the SARS-CoV-2 virus, which sparked a record wave of infections about a year ago, XBB is in many ways the worst form of the virus to date. It is more contagious than any previous variant or sub-variant. It also evades antibodies from monoclonal therapies, potentially rendering an entire class of drugs ineffective as COVID treatments.

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[catlist id=100371 numberposts=5] “It’s probably the most preventable by the immune system and poses challenges for current monoclonal antibody-based treatments and prevention strategies,” said Amesh Adalja, public health expert at the Johns Hopkins Center for Health Security, at the Daily Beast. That’s the bad news. The good news is that the new “bivalent” vaccine boosters from Pfizer and Moderna seem to work well against XBB, although the original vaccines are less effective against XBB. They will not prevent all infections and reinfections, but they should significantly reduce the risk of serious infection that can lead to hospitalization or death. “Even with immuno-vasive variants, vaccine protection against the most important thing – severe disease – is retained,” Adalja said. As the novel coronavirus evolves to become more contagious and more resistant to certain types of medications, keeping your reminders up to date is “the most powerful thing you can do to prepare for what could happen,” says Peter Hotez, a vaccine expert in development at Baylor College, told The Daily Beast. Scientists first identified XBB in August. It is one of many major subvariants that have evolved from the basic omicron variant and are accumulating more and more mutations in key parts of the virus – in particular the spike protein, the part of the virus that helps it capture and infect our cells. XBB has at least seven new mutations along the peak. Mutations that, taken together, make the sub-variant harder for our immune systems to recognize, and therefore are more likely to evade our antibodies and invade our cells to cause infections. This accumulation of mutations is not surprising. Changes along the spike protein have characterized most of the new major variants and sub-variants of SARS-CoV-2 as the pandemic reaches its fourth year. What is surprising is how much competition XBB has as it fights to become the next dominant form of the novel coronavirus. There are also many other sub-variants of Omicron in circulation. They are all highly developed. Many of them actually share a subset of key mutations, especially at the top. So, while XBB seems to be gaining ground in Asia, a close cousin of XBB called BQ.1.1 is spreading fast in Europe and some US states. There are others in dispute, including BA.2.75.2. Hotez calls these viral cousins ​​the “Scrabble” subvariants, a nod to the classic pun and hodgepodge of closely related virus scientific names. Scrabble variants indicate what scientists call “convergent evolution.” That is, separate viral sublines, each picking up more and more of the same mutations. It’s as if the children of Omicron are all individually learning to be a better virus than their parents, becoming more like each other in the process. Immune Escape is the common trait. At least two of Scrabble’s subvariants – XBB and BQ.1.1 – are barely recognizable to existing antibody therapies and somewhat less recognizable to antibodies produced by major doses of major messenger RNA vaccines. By bypassing some of our therapies, and to a lesser extent our original vaccines, XBB and its cousins ​​show us where the novel coronavirus is heading genetically. The current spike in infections in places like Singapore is a preview of a possible global spike next winter or spring when XBB or one of its kin becomes dominant everywhere. It is possible to mitigate the worst results. Natural antibodies from past infections are always the best and most durable. They don’t last forever. But as long as they last – a few months or maybe a whole year – the odds of getting a bad case of COVID are pretty slim. So, if you had a previous form of Omicron, say during the wave of infections that started last Thanksgiving and peaked around February, you might have good antibodies for a few more months. Plenty of time to boost those natural antibodies that vanish with a dose of the latest mRNA boosters. Pfizer and Moderna have formulated these new boosters to include some specific genetic instructions for attacking Omicron’s BA.5 sub-variant, which is still the dominant form of SARS-CoV-2, but is rapidly disappearing as XBB and other Scrabble sub-variants outweigh. it. The bivalent boosters should work pretty well against forms of the virus that are closely related to BA.5, including the Scrabbles. “That is because one of the two components [in the boosters] induces an immune response to BA.5, and most of the new Scrabble variants look more BA.5 like than [the] original China lineage,” Hotez told The Daily Beast. The implication, of course, is that we’re eventually going to need another new booster in order to keep pace with the fast-evolving virus. Sure, the bivalent boosters work against BA.5 and BA.5’s immediate descendants. But what about the next generation of Omicron subvariants, the one after XBB and its cousins? More and more health officials are coming around to the idea of an annual COVID booster. U.S. president Joe Biden even endorsed the idea in a statement last month. “As the virus continues to change, we will now be able to update our vaccines annually to target the dominant variant,” Biden said. “Just like your annual flu shot, you should get it sometime between Labor Day and Halloween.” But one booster a year might not be enough if, as some epidemiologists fear, natural antibodies fade faster and the novel-coronavirus mutates at an accelerating rate. One concern, if it turns out we need twice-a-year new boosters, is whether industry can develop fresh jabs fast enough and health agencies can swiftly approve them. There’s an even bigger question, however. “The more important factor is just having folks get a more recent booster,” James Lawler, an infectious disease expert at the University of Nebraska Medical Center, told The Daily Beast. Even if a new booster is available every six months or so, will enough people get it to make a difference in the overall rates of severe illness and death? Booster uptake is declining globally, but especially in the United States, where just 10 percent of people have gotten the bivalent booster since federal regulators approved them in August. XBB is a nasty little subvariant. But it’s not the final word on COVID. The novel-coronavirus will keep mutating, and finding new ways to evade our antibodies, whether or not many people are paying attention. The virus isn’t done with us. Which means we can’t be done with it. Get boosted. And be prepared to get boosted again in 2023.
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