COVID-19 cases are rising again in the UK, potentially signaling a future rise in infections in the US and other countries.
A pair of new sub-variants of the dominant Omicron variant – BA.4 and BA.5 – appear to be driving the rise in UK cases. other forms of the SARS-CoV-2 virus.
There are also some suggestions that the newer subvariants evolved to target the lungs, unlike Omicron, which generally resulted in a less dangerous upper respiratory infection.
But there is good news among the bad. While cases are increasing in the UK, hospitalizations and deaths are increasing more slowly or even decreasing so far. “This could mean that higher transmissible variants, BA.4 or 5, are in play, [and] these variants are much less severe,” Edwin Michael, an epidemiologist at the Center for Global Health Infectious Disease Research at the University of South Florida, told The Daily Beast.
Trends could change, of course, but the decline in deaths is an encouraging sign that, 31 months into the pandemic, all that immunity we’ve built up – at the cost of half a billion infections and dozens billions of dollars worth of vaccines—is still most holding.
When it comes to COVID things were really looking up in the UK until recently. COVID cases have steadily declined from their recent peak of 89,000 new daily infections in mid-March. Deaths from the March wave peaked a month later at around 330 a day.
In early June, cases and deaths were near pandemic lows. Then come BA.4 and BA.5. The grandchildren of the base variant of Omicron that first appeared in fall 2021, BA.4 and BA.5 both show a trio of major mutations in their spike protein, the part of the virus that l helps to cling to and infect our cells.
Eric Bortz, a virologist and public health expert at the University of Alaska-Anchorage, described BA.4 and BA.5 as “immunologically distinct sublineages.” In other words, they interact with our antibodies in surprising new ways.
The European Center for Disease Prevention and Control – the European Union’s response to the US Centers for Disease Control and Prevention – labeled BA.4 and BA.5 “variant concerns” in mid-May. Two weeks later, the two new sub-variants began the gradual process of overtaking older Omicron forms in the UK. That’s when the cases started to rise again.
It doesn’t help that the UK, like most countries – China is a big exception – has lifted almost all restrictions on schools, businesses, crowds and travel. These restrictions helped reduce cases, but were largely unpopular and came at a high economic cost.
“There’s a disconnect between the reality of how infections happen…and how people decide not to take very many precautions,” said John Swartzberg, professor emeritus of infectious diseases and vaccinology at the University. University of California-Berkeley School of Public Health. The daily beast. He described it as “COVID fatigue…100% of the world’s population must have it by now.”
The combination of a fully reopened economy and new COVID subvariants had an immediate effect. The UK Health Security Agency recorded 62,228 new infections in the week ending June 10, a 70% increase on the previous week. Hospitalizations for COVID grew more slowly over the same period, rising 30% to 4,421.
However, COVID deaths actually fell, slipping 10% to 283. Deaths tend to lag infections by weeks, of course, so it shouldn’t be surprising if the death rate flattens or rises. later this month or early next month.
But it is possible not. Yes, BA.4 and BA.5 are more transmissible, thanks to this mutated spike protein. But that doesn’t mean they’re going to kill a lot of people. Despite their unusual qualities, BA.4 and BA.5 might not be more dangerous than the previous sub-variants.
Bortz sketched a possibility, that BA.4 and BA.5 are “evasive enough to infect, but generally not evasive enough to counter vaccine-acquired immunity and/or prior infection.”
Of course, immunity varies from community to community, country to country. The UK’s 67 million people have, for their part, developed quite serious immunity over the past two and a half years.
Tens of millions of UK residents have natural antibodies from past infection. 87% of the population is fully vaccinated. 68 percent is boosted. All of these antibodies might not prevent breakthrough infections, but they tend to prevent serious breakthrough infections.
The severity of the current surge in cases depends to a large extent on the durability of these antibodies. Immunity, whether from previous infection or vaccines, tends to decline over time. But how quickly it declines, and to what effect, is unpredictable.
It is possible that widespread immunity will continue and the swelling of BA.4 and BA.5 waves in the UK ridges within weeks without making many more people sick or killed. This is the best-case scenario given the lack of political will and public support for a new round of restrictions. “If higher cases didn’t lead to significant illness or death, then maybe we could live with this virus,” Michael said.
The worst-case scenario is that BA.4 and BA.5 turn out to be more capable of evading our antibodies than experts currently predict. Keep an eye on hospitalization statistics. If COVID hospitalizations begin to increase in proportion to the growth in cases, it’s a sign that the new sublines are dodging our hard-won immunity.
In this case, a large death spike is sure to follow.
This could be a big red flag for the Americas. Variants of COVID tend to travel from east to west, around the world. New variants and sub-variants tend to appear in the US within weeks of becoming dominant in the UK. Currently, BA.4 and BA.5 represent only one-fifth of new cases in the United States. Expect this proportion to increase.
The problem for the Americans is that they are much less protected than the British. Yes, Americans have lots of antibodies from past infections, but they’re also much less likely to be vaccinated — and even less likely to be boosted. Only 67% of Americans are completely vaxxed. Just over a third of the US population has received a booster.
So if BA.4 and BA.5 end up causing an increase in the number of deaths in the UK, they are likely to inflict even bigger death toll across the Atlantic Ocean. “We’re kind of in this zone now, in between and in between,” Swartzberg said. “We don’t know which direction things will go.”
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