Coronavirus: 2022 ends with the looming threat of a new variant, public health experts warn



CNN

As the world enters a new year, many public health and infectious disease experts expect monitoring of novel coronavirus variants to be an increasingly important part of Covid-19 mitigation efforts — and some are turning their attention to the surge in cases in China.

Sub-variants of the Omicron coronavirus variant continue to circulate globally, and “we see Omicron doing what viruses do, picking up mutations along the way that help it evade a little bit of the immunity caused by previous infection or vaccination,” said Andrew Pekosz, a microbiologist. and Immunology in Johns Hopkins Bloomberg School of Public Health in Baltimore.

“We haven’t seen any big leaps in terms of Omicron’s development in some time,” he said. But “we’ve reached that point where we have to continue to monitor him.”

In the US, Omicron sub-variants XBB.1.5, BQ.1.1, BQ.1, BA.5 and XBB cause almost all Covid-19 infections, according to Data from the US Centers for Disease Control and Prevention.

For this week, the CDC estimates that XBB.1.5 now causes 40.5% of cases in the United States, followed by BQ.1.1 at 26.9%; BQ.1 by 18.3%; BA 5 at 3.7%; and XBB, up 3.6%.

“SARS-CoV-2, the virus that causes COVID-19, is constantly changing and accumulating mutations in its genetic code over time. New variants of SARS-CoV-2 are expected to continue to emerge,” CDC researchers Type in their tracking data. “Some variants will appear and disappear, while others will appear and continue to spread and may replace earlier variants.”

Omicron subsidiaries appear to be dominating globally as well, but as the coronavirus continues to spread – particularly in China after Beijing’s rapid easing of restrictions – there are now concerns about where Covid-19 trends could head in 2023 and the risk of new variants emerging.

It’s a concern,” said Dr. William Schaffner, a professor in the Department of Infectious Diseases at Cairo University. Vanderbilt University Medical Center in Nashville and medical director of the National Foundation for Infectious Diseases. “And that, of course, led to the Centers for Disease Control and Prevention recently announcing that it would require people who come into this country from China to have a test and test negative before they can come into the country.”

US health officials announced Wednesday that starting January 5, travelers from China will be required to show a negative Covid-19 test result before traveling to the country. Passengers traveling to the United States from China will need to be tested no more than two days before flying and provide proof of a negative test to their airline before boarding.

Officials also announced that the CDC is expanding its passenger-based genome surveillance program to airports in Seattle and Los Angeles, bringing the total number of participating airports to seven with about 500 weekly flights from at least 30 countries covered, including about 290 weekly flights from China and surrounding areas.

The Chinese government hasn’t shared much information about the genetic makeup of the viruses you see there, Schaffner said.

“Because the Chinese government hasn’t done that, that was the main reason the CDC put these new travel requirements into place. It certainly doesn’t prevent simple transmission of Covid from China here. We have a lot of Covid. That would be a Telling people not to pour a bucket of water into the pool.” “This travel test requirement is a way to buy us some time and help create a barrier to some degree between us and China, should a new variant suddenly emerge in this country.”

He added that the United States would need “as much time as possible” to update vaccines and antiviral drugs to respond to a possible emerging variant of concern.

Dr. Carlos del Rio, executive associate dean at Emory, said US testing requirements for travelers “will buy some time,” but won’t prevent new Covid-19 cases from coming to the US or new variants emerging. Grady College of Medicine and Health System in Atlanta.

“I don’t think we’ll see much benefit, frankly,” he said of the travel requirements. “The most important thing we need right now is, we need the Chinese to have more transparency and tell us exactly what’s going on, and that’s very much a diplomatic decision. This is about diplomacy.”

In terms of publicly accessible genetic data on coronaviruses in China, “it’s really a bit of a black hole,” Picos said. barely 250 million people in China may have contracted Covid-19 in the first 20 days of December, according to an internal estimate from the nation’s top health officials, Bloomberg News and the Financial Times reported last week.

“For me, what I’m really concerned about is the ongoing infection and whether it’s producing more variants in China that might be of particular concern to us, and testing people before they board a plane is not going to answer that question,” Pecos said. .

“What we really need to do is do a much better job of sequencing viruses from individuals who travel from China so that we can help in terms of understanding what kinds of variants are circulating there,” he said, adding that throughout the pandemic, Chinese officials have not been very transparent about their data about variants.

The continued spread of the virus is what can lead to the emergence of variants. The more the virus spreads, the more it mutates.

“For a variant to emerge — and this applies not just to Covid, but to influenza and many other viruses — the most important thing is that the more cases you have, the more likely it is that the virus will start accumulating mutations that may have the potential to evade immunity in a way more effectively or transferred more effectively,” Picos said.

“So when you have a situation like what’s starting to turn out in China, where you’re going to have millions and millions of infections, every single one of those infections is just one more chance for the virus to pick up a random mutation that has made it better at infecting people,” he said. “Combine that with the fact that the Chinese population is using less-than-optimal vaccines and it seems that they have not been as good at putting boosters into their population as other countries, and that means there is likely to be less immunity in the population.”

China’s health authorities have “significantly” increased the number of coronavirus genome sequences and other relevant data they provide to GISAID global databasean initiative that maintains databases for scientists around the world to share data on influenza viruses and coronaviruses.

But many experts argue that this is not enough.

GISAID said in an email to CNN on Wednesday that the Chinese Center for Disease Control and Prevention, and several regional centers in the country, have “significantly increased the number of submissions of genome sequences and associated metadata from samples taken in recent days.”

The GISAID Data Science Initiative announced that it has released genome sequence data from 167 SARS-CoV-2 samples collected during the current outbreak in China. SARS-CoV-2 is the name for the virus that causes Covid-19. GISAID also confirmed that the sequences from China “are all highly similar to the globally circulating variants seen in various parts of the world between July and December 2022,” compared to the 14.4 million genomes in the GISAID database.

According to the GISAID Data Science Initiative, “This latest data provides a snapshot of the evolution of Omicron variants and shows that these recently shared sequences from China are closely related to variants that have been circulating for some time.”

Covid-19 is in a relatively “stable” state right now in the United States, but the nation still sees about 350 deaths related to the disease each day, said Dr. Jessica Justman, assistant professor of medicine in epidemiology. Columbia University Mailman School of Public Health and Senior Technical Director of the ICAP Global Health Programme.

While levels of Covid-19 remain well below those of previous increases, trends are picking up in parts of the US, new hospital admissions have jumped nearly 50% over the past month, and there is growing concern that case numbers may Rising after the winter holidays.

Justman said that to reduce the risk of further spread of Covid-19, it will be important for people in the new year to continue to stay up to date with their Covid-19 vaccinations.

Only 14.6% of the US population ages 5 years and older have received an updated booster dose, According to CDC data.

“After that time, this question will be closed? This takes me to China,” Justman said.

“I am concerned that China is now a giant incubator for SARS-CoV-2. There is a possibility that there will be a lot of infections and with that, there are new variants,” she said.

“I think we’ll be looking at new variants of concern” in 2023, Justman said. “The question is: Are we going back to a point where we have a variant of the variant causing such severe disease that we don’t benefit from our protection from previous infections and from previous vaccinations? .. I would be optimistic and say I don’t think we will go back to that point.”

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