Opinion: Why the new covid variant is not cause for concern — yet

Opinion | The Checkup With Dr. Wen: Why the new covid variant is not cause for concern — yet It’s not yet time to bring back covid restrictions. Leana S. Wen The Washington Post

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Whether a new set of mutations has public health consequences hinges on three key questions: Does it cause more severe disease? Will immunity through prior infection and vaccination protect against it? And is it more transmissible than currently dominant variants?

On the first question, there are too few cases of BA.2.86 to know whether people infected with it will become sicker than those who contract other omicron descendants. The good news is that the Centers for Disease Control and Prevention expects existing treatments — specifically antiviral pills Paxlovid and molnupiravir and remdesivir injection — to be effective against the new variant. These are crucial tools that dramatically reduce the chance of being hospitalized or dying because of covid-19.

The second question is what’s most worrying to scientists. The genetic sequence of BA.2.86 has more than 30 amino acid differences compared with the BA.2 subvariant it evolved from. It also has significant deviation from the XBB.1.5 subvariant, which has been the dominant variant throughout much of 2023 and is the target of the new booster that’s on track to be released in late September.

Will the new booster be as effective against BA.2.86 as it is against XBB.1.5 and other currently circulating variants? No one knows the answer to this yet, but the number of mutations and where they are located are prompting urgent laboratory studies.

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the third crucial question, for which we also don’t yet know the answer: Is BA.2.86 so highly contagious that it will outcompete other variants?

Based on what we’ve seen thus far, this does not appear to be the case. There have been very few BA.2.86 cases detected to date, including a small number reported in the United States. Even if it is more immune-evasive, this new variant won’t have a meaningful impact unless it becomes more prevalent and displaces other variants.

None of this is meant to downplay the potential significance of this highly mutated offshoot. If BA.2.86 ends up increasing as a proportion of total cases and the worst-case scenarios about its immune evasiveness end up being true, a change in strategy will be needed. That includes a discussion of whether the new booster shot should be reconfigured to take this variant into account.

Those vulnerable to severe disease from covid-19 should continue to take precautions — not necessarily to avoid the small possibility of contracting this variant but to reduce their chance of becoming ill from the dominant variants. Vulnerable people should discuss with their health-care providers the optimal timing of the booster and be sure to have a plan for antiviral treatment if they become ill.

For now, though, most Americans do not need to change their daily lives. This is not the moment to bring back government-mandated mask requirements and other broad public health restrictions. Those measures should be reserved for a true emergency, which we currently do not have.

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