Another New COVID Variant: BQ.1 and BQ.1.1 Have Arrived – CNET

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Most cases of COVID-19 are now caused by the BQ.1 and BQ.1.1 variants, versions of omicron.
More than half — about 63% — COVID-19 cases in the US are now caused by variants BQ.1 or BQ.1.1, according to the latest estimate by the US Centers for Disease Control and Prevention. Both are subvariants of omicron, which has had a tight grip on the world since last holiday season. 
BA.5, the highly contagious omicron subvariant that caused a lot of reinfections or first infections in people who hadn’t had COVID-19 this summer and fall, is fading and now only responsible for about 14% of cases. 
Viruses like COVID-19 mutate; we’ve learned to accept this by now. But not all mutations are created equal, which is why scientists are watching to see how the plethora of omicron forms will affect people this winter, when there are also a high number of influenza and RSV cases circulating. 
Cases of COVID-19 have simmered at much lower levels than this time last year. Deaths reported from COVID-19 are also down considerably, though somewhere between 250 and 270 people per day are still dying from COVID-19. The stability we had this fall, however, may be coming to an end. According to The New York Times’ COVID-19 data tracker, hospitalizations are rising again in nearly all states.
Like all new versions of COVID-19, we’ll need more time to see how BQ.1 and BQ.1.1 play out in the US — especially after the holidays, with the travels and gatherings that we may expect to fuel the fire of contagious illness like COVID-19 and influenza. Both have also reduced the effectiveness of our monoclonal antibody treatments, which have been reserved for immunocompromised patients.
Here’s what we know about the latest versions of omicron.
BQ.1 and BQ.1.1 are newer versions of the omicron variant — a “variant of concern” that first emerged last winter and caused a massive wave of COVID-19 infections. According to the World Health Organization, BQ.1 is specifically descended from BA.5 and carries a few extra mutations. BQ.1.1 carries an additional key mutation, making it one to keep an extra close eye on.
Omicron, delta, alpha and earlier strains of COVID-19 were given their own Greek alphabet label and separate distinction as variants of concern because they proved troublesome enough to scientists in the way they evaded vaccine immunity, caused more severe illness or created more serious problems. By contrast, although BA.5 was extremely contagious and caused more reinfections in people who already had COVID-19, it didn’t necessitate a big enough change in our public health response to get its own name from the WHO, according to the classification logic.
Monoclonal antibody treatments, including Evusheld for immunocompromised patients, will likely no longer work against BQ.1 or BQ.1.1, according to information from the National Institutes of Health. Bebtelovimab (the monoclonal antibody made by Eli Lilly) also doesn’t work against the now-dominant subvariants of COVID-19, and the FDA revoked its authorization in the US on Nov. 30. Other monoclonal antibody treatments were removed from the US market earlier in the pandemic as the virus rendered them ineffective. 
There’s no indication that Paxlovid, an antiviral for higher risk patients in the first few days of their illness, won’t work against the newer forms of omicron.
How much protection will be given against BQ.1 and BQ.1.1 from the new, updated boosters, which are tweaked formulas meant to target the BA.5 subvariant in addition to the “original” form of the virus? Moderna said earlier this month that a small analysis showed a “robust” antibody response against BQ.1.1, though there was about a five-fold drop in antibody titers compared to BA.4/BA.5, Moderna said. Some early research does suggest that BQ.1.1 is neutralized more effectively by the bivalent boosters compared to the original vaccines. 
While there’s still some gray area over how much better the new boosters are at protecting people compared to the original formulas, and some scientists have called for a new approach to vaccines in general (which could possibly include a faster track for a nasal COVID-19 vaccine), boosters and vaccines in general have protected against severe disease and death throughout the pandemic and across mutations of the virus. In August, unvaccinated adults were over five times more likely to die from COVID-19 compared to adults aged 18 and up who were up to date on their shots.

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