An informed guide to the pandemic, with the latest developments and expert advice about prevention and treatment. |
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 | | The New York Times |
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The subvariants of summer |
The troublesome hits just keep coming from the Omicron strains — and each sequel is more contagious than the last. |
The two strains are often lumped together because they have similar mutations in their spike proteins, which attach to human cells. BA.5 is pulling ahead of its sibling, according to C.D.C. data. |
Many readers of this newsletter — and the people who write and edit it — know of many recent cases among friends, family and co-workers. Some scientists estimate that the current wave of cases is the second largest of the entire pandemic. |
We're going to get into the weeds about why these variants are more infectious, what type of symptoms they cause, and how public health officials are evaluating the recent turn of events. |
The key advantage of the BA strains, especially the latest strains, seems to be their ability to infect people who have already been vaccinated, or have already had Covid, or both. That's a big edge given that much of the world already has some kind of immunity. BA.4/5 are significantly more infectious than BA.2, which itself was more infectious than Omicron. |
"The Omicron lineage of SARS-CoV-2 continues to evolve, successively yielding subvariants that are not only more transmissible but also more evasive to antibodies," a new study in Nature concluded this week. |
"They're the Houdini of Covid," Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco, told my colleague Dani Blum. "They're the escape artists." |
Some patients are getting reinfected within just two to three months of past infections, said Dr. Stuart Campbell Ray, a professor of medicine at Johns Hopkins Medicine. |
Experts say the subvariants have similar symptoms to Omicron, including a cough, runny nose, sore throat, fatigue, headaches and muscle pains. Patients are less likely to lose their senses of taste and smell, or to experience shortness of breath, Dr. Chin-Hong said. |
People tend to experience upper respiratory symptoms, "from the vocal cords to the tip of the nose," said Dr. Joseph Khabbaza, a pulmonary and critical care physician at Cleveland Clinic. He's seen many patients with bad sinus congestion, and sore throats so severe they thought they had strep throat. |
As is often the case with coronavirus variants, it's unclear whether BA.4 and BA.5 are more severe than their predecessors, or just more contagious. The answer lies in the demographics of a given population, and the mix of vaccination and immunity. |
New deaths have stayed below 400 per day on average, data from state and local health agencies show. That is a fraction of the thousands seen daily during the winter Omicron peak. |
"Thankfully, other immune system mechanisms continue to work to reduce severe disease," said Katelyn Jetelina, who writes the newsletter Your Neighborhood Epidemiologist. |
"The deaths that we're seeing are generally among people who are either elderly, frail, many comorbidities who've had a lot of vaccine shots, or people who are unvaccinated," said Rochelle Walensky, the director of the Centers for Disease Control and Prevention, in late June. |
If you were only looking at public data, it might be hard to notice any difference. The average number of new confirmed cases per day has hardly budged for weeks, hovering between 95,000 and 115,000 a day each day in June. |
But a closer look shows that we are most likely experiencing a wave of cases in the dark: Many public testing sites are closing down, and many states have also stopped giving daily data updates, creating a foggier look at the state of virus across the country. |
"One of my favorite lines from somebody at the C.D.C. was, 'You don't need to count the raindrops to know how hard it's raining,'" Walensky said. |
What else we're following |
A little over a year ago I was one of the first to respond to your requests for how we are handling the pandemic. Since then I have been so touched by all the submissions and have saved every one in a file on my computer. It helps me to not feel so alone. Back then I wrote to you about how my Uncle Stu had died from Covid in December of 2020, and that even though everyone was ready to go back to normal — for my family and many others, life will never be normal again. I was vigilant about my Covid prevention protocol, maybe overly so, but my uncle's death was so sudden and traumatizing, plus I am immune compromised.Two weeks ago, my boyfriend got Covid. My heart sunk because I knew there was no way I would avoid it. I got pretty sick, as sick as I've ever been. I am better now, albeit weary, and I feel a bit hopeless. Is this ever going to be over? —Sunnie Haeger, Denver |
Let us know how you're dealing with the pandemic. Send us a response here, and we may feature it in an upcoming newsletter. |
| Thanks for reading. Jonathan Wolfe will be back soon. — Adam. |
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