Why BA.4 and BA.5 pose big coronavirus risk to California

Will people in your lifetime get infected with the coronavirus even after being caught in a previous wave?

You’re not alone. For the third straight year, the arrival of summer has brought new uncertainties to California’s COVID-19 outlook.

The latest development, which is turning the pandemic landscape on its head, is the growing dominance of two subvariants – BA.5 and to a lesser extent BA.4 – which are not only ultra-contagious but have also shown the ability to infect those who are infected with previous Omicron strains to reinfect.

This combination of initial and recurrent infectivity has tremendous implications. Here’s what we know:

How common are BA.4 and BA.5?

According to the latest figures from the US Centers for Disease Control and Prevention, BA.5 accounted for an estimated 53.6% of new cases nationwide in the week-long period that ended Saturday. This completes a staggering climb towards dominance of the subvariant, which just a month ago was thought to account for just under 10% of new cases.

In the week to Saturday, BA.4 accounted for an estimated 16.5% of new cases – making it the third most common omicron strain in circulation after BA.5 and BA.2.12.1.

Estimated virus proportions are similar in the US Southwest, which includes California, Arizona, Nevada, Hawaii and the US Pacific Territories.

What are the concerns about BA.4 and BA.5?

Both subvariants are highly contagious. The concern is that this trait, combined with its apparent re-infectivity, could prolong or worsen California’s already months-old coronavirus wave.

Of particular concern is BA.5. dr Eric Topol, director of the Scripps Research Translational Institute in La Jolla, recently called it “the worst version of the virus we’ve seen.”

“It takes immune escape, which is already extensive, to the next level and as a function of this, enhanced transmissibility that far exceeds Omicron (BA.1) and other variants of the Omicron family that we have seen,” he wrote in a blog post.

Omicron has spawned a number of subvariants since it emerged late last fall, and these have largely been characterized by increased infectivity. But “BA.5 is another beast with a new superpower: enough change in spike protein that immunity against either previous Vax or previous Omicron infection (including recent infection) doesn’t offer much protection.” corresponding dr Robert Wachter, Chair of the Medical School at UC San Francisco.

“As BA.5 becomes the dominant US variant, its behavior will determine our fate for the next several months until it either burns itself out by infecting so many people, or is replaced by a variant even better at it, humans.” to infect,” says Wachter wrote on Twitter on Sunday. “Both are not a happy scenario.”

Among the major impacts of BA.5 are he addedis that “previous infection – including an Omicron infection that occurred just in the last month – no longer provides robust protection against reinfection”.

“The old adage about hybrid immunity (vax plus infection) providing an ‘immunity superpower’ and therefore needing no care is no longer true.” he wrote. “We’re seeing people like that get reinfected within 1 to 2 months.”

Can BA.4 and BA.5 make you sicker?

In an epidemiological update released last month, the World Health Organization noted that the evidence currently available does not indicate a change in the associated severity of the disease. But the agency also said its growing prevalence in several regions “coincided with increases in cases,” with those increases leading to increases in hospital admissions in some countries.

BA.5, Topol said, “resulted in a significant increase in hospital admissions in Portugal, where it quickly became dominant,” and has a similar effect in many European countries and Israel.

There were reports that a wave powered by BA.4 and BA.5 in South Africa was associated with slightly lower mortality rates than their first omicron waves.

What about vaccines?

A key question is whether the potential introduction of an Omicron-specific booster later this year will help combat the rise of BA.4 and BA.5. Given how much the variant has changed over the past seven months, there are concerns that such an offering could be relatively outdated by the time it becomes available.

Meanwhile, officials and experts alike say getting vaccinated and boosted, where permitted, continues to offer strong protection against the worst health effects of COVID-19.

According to the latest available data from the California Department of Health and Human Services, unvaccinated individuals were more than five times more likely to contract COVID-19 than their vaccinated and boosted counterparts. They were 7.5 times more likely to be hospitalized and 14.5 times more likely to die from the disease.

“Vax/Boost remains tremendously valuable in preventing a serious case that could lead to hospitalization/death,” Wachter wrote. “But its value in preventing a COVID case or preventing transmission is far less now than it used to be.”

Where is California?

According to the latest data, California saw a 12% increase in coronavirus cases compared to mid-June, averaging more than 16,900 a day in the week ended Thursday, according to data from The Times. Per capita, that is 303 cases per week per 100,000 inhabitants.

Two-thirds of the state’s counties are now at the high COVID-19 community level, where the CDC recommends universal masking in indoor public spaces.

“With the continued increase in cases, and now that you’re seeing the corresponding increase in hospitalizations, we’re really concerned,” LA County Public Health Director Barbara Ferrer said last week.

“Our case numbers remain fairly high,” Ferrer said. And she expressed concern about the rising number of even more contagious Omicron subvariants, BA.4 and BA.5, at a time when more and more people have lowered their vigilance and shed their masks.

So far, Los Angeles County health officials have not issued any new masking rules. However, they have warned that this could potentially be required later in July if new coronavirus-positive hospitalizations continue to rise.

“It seems clear that BA.5 will result in a sustained plateau, if not a modest surge that will continue through the summer and fall,” Wachter said wrote. “In addition, a lot depends on whether a new variant emerges that displaces them. Given the pattern of the past year, it would be foolish to bet against it.”

How do you protect yourself?

VACCINATIONS: Residents looking to stave off the worst health effects of COVID-19 should also get vaccinated if they haven’t already, officials said — and get a first and/or second booster if needed. Residents aged 50 and over, as well as those aged 12 and over who are immunocompromised, are eligible for a second booster four months after their first in March.

MASKS: Although masks aren’t required in indoor public spaces, many experts say they can be a good idea. California officials have consistently urged residents to use face coverings in indoor public spaces — including stores, restaurants, theaters and family entertainment centers. Los Angeles County has gone a step further and still requires face coverings on public transit, including ridesharing, and in closed transit hubs.

SELECT: Outdoor gatherings are preferable to indoor ones. If you must gather indoors, make the area as ventilated as possible by opening doors and windows whenever possible. Wearing masks also provides an extra layer of protection, officials say.

TESTING: Officials recommend using rapid tests to check infection status as soon as possible before the start of a gathering — especially when the elderly or those with underlying health conditions are present, or when attendees have frequent contact with those at risk.

https://www.latimes.com/california/story/2022-07-05/why-ba-4-and-ba-5-pose-big-coronavirus-risk-to-california Why BA.4 and BA.5 pose big coronavirus risk to California

Alley Einstein

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