New ‘Scary’ Variants for Halloween and Boosting Your Immunity: COVID Fast Episode 41

New ‘Scary’ Variants for Halloween and Boosting Your Immunity: COVID Fast Episode 41

Lewis asked: Hello and welcome COVID, fast, a Scientific American podcast series!

Josh Fischman: This is your quick update on the COVID pandemic. We introduce you to the science behind the most pressing questions about the virus and disease. We demystify research and help you understand what it really means.

Lewis: I’m Tanya Lewis.

Fischmann: I’m Josh Fischman.

Lewis: And we are the senior health editors of Scientific American. Today we’re going to talk about the new alphabet soup of variants and sub-variants that are likely to be this winter…

Fischmann: And we’ll talk about how boosters add protection even if you’ve already had COVID.

Fischmann: We are heading into another pandemic winter. Although a completely new variant of the COVID virus has not yet emerged, there are several new Omicron sub-variants. You call them scary for Halloween, Tanya. What do we know so far?

Lewis: The Omicron variant first appeared last fall, and over the past year, the COVID cases have mostly been driven by different versions of Omicron. First was B.1.1.529. Then there were BA.1, BA.2 and BA.3, then BA.4 and BA.5.

Now there are some new kids on the block: there’s BA.4.6, which evolved from BA.4 and accounts for about 12 percent of U.S. COVID cases, and then there’s BQ.1 and BQ.1.1, which together make up more than 11 percent cases, according to the CDC’s variant tracker. And those proportions are constantly growing.

Meanwhile, in Singapore, a sub-variant called XBB is causing a surge in cases and may be the most immune-evading variant we’ve seen to date.

Fischmann: So at least 4 newcomers. How worried should we be?

Lewis: Anthony Fauci, Biden’s chief medical adviser, called them “problematic.” Like other varieties before them, they grow quickly. And at least in the case of BQ.1.1, it seems to be better at evading our immunity than a previous infection or vaccination – even though vaccines should still provide protection.

Another concern involves monoclonal antibody treatments, as we discussed on the last show. The one given prophylactically to immunocompromised people, known as Evushed, is not effective against the BA.4.6 variant. And another antibody drug called Bebtelovimab, for which the US has already ordered 60,000 doses, is not effective against BQ.1, the FDA said.

Fischmann: That’s bad news for people whose immune systems can’t mount a strong response to vaccines.

Lewis: That’s right. Biden administration officials are discussing developing alternatives, but it is unclear whether they will arrive in time for the winter increase.

Fischmann: Do the experts think we are headed for another surge? And what role will the new variants play?

Lewis: The number of COVID cases is already on the rise in Europe, which is usually a few weeks ahead of the US, so I’d say the odds are pretty good that we’ll see another spike. But this was happening even before the new variants arrived on the scene. Some people think that variants will just speed things up.

Fischmann: So how can people protect themselves?

Lewis: The best thing to do is to get a booster shot. The new bivalent booster protects you against both the original strain of SARS-CoV-2 and Omicron’s BA.4 and BA.5 subvariants, and is likely to provide some protection against newer variants as well. Still, as of a few weeks ago, only about 5 percent of eligible people in the U.S. had received the vaccine.

Fischmann: This leaves many people unprotected.

Lewis: There is. And many young children are not even vaccinated at all. But there’s still time to stock up before the holidays—or the turkey might not be the only thing on the table.

Lewis: We were just talking about how few people are getting new injections. There are many possible reasons. Many people are simply not that worried about COVID anymore, and more and more have already had it and recovered. Some may think that they now have natural immunity against new infections. Do they?

Fischmann: Somehow. I mean, yes, natural immunity is a real thing. But research shows it’s not as strong as what scientists now call “hybrid immunity,” which is an older infection plus a new booster.

Lewis: Does this mean that people who have been infected in the past AND received the vaccine have better protection?

Fischmann: Yes. Some of the best data on this comes from a large study done in Qatar and published this summer in the New England Journal of Medicine. He followed about 150,000 people. Qatar has a very strong system of national health records. That way, the researchers could tell who was infected or reinfected with Omicron and when. And they had records of who was vaccinated with Pfizer or Modern shots, or who didn’t get vaccinated at all.

Lewis: Did they find any significant differences?

Fischmann: They are. First, unvaccinated people had the highest risk of infection, and this is no real surprise. People with a previous infection reduced their risk of new infection by about 50 percent.

And people who only had the original two-shot regimen had a similar risk. Scientists think this is because people received these injections about 8 months earlier, so their immunity has weakened.

A big advantage, however, went to people who had a previous plus infection three shots. It’s the original two kick plus booster. This reduced the chances of re-infection by about 80 percent. And that was true for Pfizer and Moderna vaccines.

Lewis: That’s a really striking benefit. Has it held up to serious illness, keeping people out of hospital and reducing death rates?

Fischmann: It is. This hybrid immunity prevented serious diseases, again by about 80 percent.

Lewis: Even in people without previous infections, a booster shot helps.

Fischmann: Yes, it reduces many of your symptoms. And as someone who was recently laid up with COVID for two weeks, I can tell you that fewer symptoms is a big deal.

Reinforcement data comes from another study, a Five-month examination of about 1100 health workers, which just came out in the journal JAMA. Those who received a booster shot in addition to the original two shots were less likely to have a fever or chills if they were infected with Omicron. They were less likely to need medical attention and could take care of themselves at home. They also missed fewer work hours. All this compared to people who did not get vaccinated at all.

Lewis: Do boosters do anything about the risk of transmission? Chances of spreading the infection to other people?

Fischmann: They seem to help. They lowered the viral load – how much virus you have in your body – by about a third, compared to unvaccinated people. Now, a lower viral load does not automatically mean lower transmission, the scientists noted. But other studies have made that connection.

And about 20 percent of the people with Omicron infection in this study had no symptoms, so they didn’t know they had the virus and were probably socializing with other people.

Lewis: So that in itself increases the chances of transmission.

Fischmann: There is. So boosters help in several ways. And, as you said, now is the time to go out and get one.

Lewis: You are now in the loop. Thanks for joining us. Our show is produced by Jeff Delviscio and Tulika Bose.

Fischmann: Come back in two weeks for the next episode of COVID, quick! And check for updated and detailed news about COVID.

[The above text is a transcript of this podcast.]

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