The World Well being Group (WHO) is monitoring a brand new COVID-19 subvariant referred to as XBB.1.16, which has been circulating all through India for just a few months and is inflicting a brand new surge of circumstances there. The Times of India reported on Apr. 3 that greater than 3,600 new COVID circumstances had been recorded within the nation since the day gone by, marking India’s largest single-day bounce in case numbers in additional than six months. “In India, XBB.1.16 has changed the opposite variants which can be in circulation,” stated Maria Van Kerkhove, WHO’s COVID-19 technical lead, throughout a Mar. 29 press conference. “So that is one to observe.”
XBB.1.16 is considered one of greater than 600 Omicron subvariants which can be presently circulating, in response to WHO. It’s much like the XBB.1.5 variant that has dominated the U.S. all through 2023 however is distinguished by a mutation within the spike protein that “might give it some further progress benefits,” says Dr. Peter Hotez, co-director of the Texas Kids’s Hospital Middle for Vaccine Growth. In lab research, this extra mutation “reveals elevated infectivity, in addition to potential elevated pathogenicity,” Van Kerkhove stated. “It has potential modifications that we have to hold a very good eye out on.”
To date, XBB.1.16 has been discovered primarily in India and Nepal, the place at least 10 cases were confirmed on Apr. 3. However, as we’ve seen with previous variants, issues can change rapidly, Hotez says. Take XBB.1.5, which accounted for lower than 1 / 4 of COVID-19 circumstances within the U.S. going into late December final 12 months. “Over the following week, XBB.1.5 turned the dominant variant,” says Hotez. If the brand new variant reaches the U.S., “the query is whether or not XBB.1.16 goes to do the identical, or whether or not the 2 are [closely related] sufficient.”
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Nonetheless, a brand new variant—even one ratcheting up case numbers—is just not by itself trigger for alarm. “We haven’t seen a change in severity in people or in populations,” Van Kerkhove stated. Regardless of the rise in circumstances, reported hospitalizations and deaths in India have remained low, says Dr. Monica Gandhi, affiliate division chief at UC San Francisco’s Division of HIV, Infectious Ailments, and International Drugs, and Indian well being officers have responded to the brand new dominant variant by recommending further boosters for folks over 65 or who’re immunocompromised and in any other case susceptible. Proper now, many international locations have excessive inhabitants stage immunity, so boosting those that are susceptible on the outset of a wave of circumstances is a dependable and repeatable technique, she says.
“Any new subvariant of Omicron, it’s not fazing us,” Gandhi says. “It doesn’t change [the WHO’s] baseline suggestion, which is to spice up older and susceptible folks. There’s a risk that we get actually unfortunate and we get a worse variant, after which we might increase everybody, however the motive that we all know this isn’t what XBB.1.16 is is that it’s inflicting the anticipated rise in circumstances with no excessive rise in hospitalizations.”
It’s been a 12 months since WHO launched their plan for the way the world will get out of the emergency section of the pandemic, which included three attainable paths. Even with the emergence and unfold of variants like XBB.1.16, Gandhi says that the world remains to be on the best-case state of affairs path, during which new variants proceed to look however don’t trigger outbreaks with excessive occurrences of extreme illness and hospitalizations.
Although XBB.1.16 is just not presently among the many Omicron variants accounting for U.S. infections, Hotez believes it’s time for public well being officers to think about authorizing one other booster for susceptible populations who had been among the many first to obtain the bivalent boosters again in September 2022. “I’m a bit of puzzled about why we’ve not heard from the FDA or CDC about that,” he says.
Because the virus continues to evolve, Hotez is most involved concerning the “dismantlement” of unbiased monitoring efforts that the U.S. has relied on to identify and monitor new variants earlier than they change into dominant. “I feel we’re letting our guard down,” he says.
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