{"id":261901,"date":"2023-01-10T19:21:50","date_gmt":"2023-01-11T03:21:50","guid":{"rendered":"https:\/\/siliconeer.com\/current\/?p=261901"},"modified":"2023-01-10T19:27:00","modified_gmt":"2023-01-11T03:27:00","slug":"the-future-covid-pandemic-continues-xbb-1-5","status":"publish","type":"post","link":"https:\/\/siliconeer.com\/current\/the-future-covid-pandemic-continues-xbb-1-5\/","title":{"rendered":"The Future of COVID: The Pandemic Continues with XBB.1.5"},"content":{"rendered":"

(Shutterstock)<\/em><\/p>\n

 <\/p>\n

A new subvariant of omicron, named XBB.1.5, now accounts for 40 percent of Covid-19 infections in the U.S. XBB.1.5 is even more prevalent on the East Coast, accounting for 75 percent of infections.<\/h3>\n

At an Ethnic Media Services<\/a> briefing, Jan. 6, speakers \u2013 Dr. Ben Neuman, Chief Virologist of the Global Health Research Complex,Texas A&M; Jill Rosenthal, Director of Public Health Policy at the Center for American Progress; Sophia Tan, Research Data Scientist, UC San Francisco; and Dr. Oliver Brooks, Chief Medical Officer, Watts Healthcare \u2013 spoke on the origins of the new subvariant; whether our current vaccines, including the updated boosters, can provide sufficient protection against XBB.1.5; new therapeutics in the pipeline; and a possible drop-off in people seeking treatment once Paxlovid is no longer free\/subsidized as the public health emergency ends. Researchers also discussed a novel study that looks at the prison population to note the rates of infections in fully vaccinated people and reinfections in people that have already experienced COVID.<\/p>\n

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(Above, l-r): Dr. Ben Neuman, Chief Virologist of the Global Health Research Complex,Texas A&M; Jill Rosenthal, Director of Public Health Policy at the Center for American Progress; Sophia Tan, Research Data Scientist, UC San Francisco; and Dr. Oliver Brooks, Chief Medical Officer, Watts Healthcare. (EMS)<\/figcaption><\/figure>\n

\u201cWhen speaking about COVID, I think it is important to remember that COVID was the third leading cause of death in 2020; the third leading cause of death in 2021; and also the third leading cause of death in 2022. So anyone who’s telling you that COVID is over is misinformed, at the very least,\u201d said Dr Ben Neuman.<\/p>\n

\u201cFor those tracking other diseases, Influenza peaked about five weeks ago and has been coming down. That’s good news. Respiratory Syncytial Virus (RSV) peaked eight weeks ago and has been coming down steadily. That is also good news.<\/p>\n

\u201cHowever, COVID cases are rising driven by XBB.1.5 and some other variants, but mostly that one. XBB.1.5 appears to grow well and have a little bit better affinity for the receptors in our lungs. It is better at holding on to people essentially than some of the previous strains it evolved from. It has many changes in the receptor binding domain. This is the part that makes contact between the virus and the human, and it has 12 changes in this region compared to the original virus, and five mutations in this region compared to BA.5, which is currently used as the other half of the bivalent vaccine, along with the original version.<\/p>\n

\u201cWhen Omicron first appeared and started cutting through immunity, it had seven or eight mutations in that region compared to the strains that were circulating at the time. XBB represents nearly, but not quite as large, an evolutionary step as Omicron and based on the rapid rise, it would appear it is living up to its genetic destiny. It appears that it is very infectious and is overcoming at least some components of immunity,\u201d said Dr Neuman.<\/p>\n

\u201cThere are multiple problems in dealing with XBB.1.5. One of those is the low vaccination rate which is entirely voluntary, and currently sits for the U.S. at about 15 percent of the total population.<\/p>\n

\u201cThe Moderna bivalent vaccine has been approved even for people under five-years-old. The Pfizer version is approved for people five-years-old and older. Uptake has not been very high lately,\u201d said Dr Neuman.<\/p>\n

\u201cThe other problem is that the current bivalent vaccine provides some protection but not very good protection particularly against XBB. Those studies were done with XBB.1. XBB.1.5 is a little bit different, but not at the key receptor binding domain, so that should be representative.<\/p>\n

\u201cBut as the authors of that paper concluded, and the authors of several other papers concluded, it is time to update the vaccine strain.<\/p>\n

\u201cUnfortunately, the FDA vaccines advisory committee has not met in three months. It has not met to discuss COVID-19 specifically in seven months.<\/p>\n

\u201cThe World Health Organization committee that chooses vaccine strains and makes recommendations, has not announced anything in the past seven months, and the World Health Organization has not made an announcement on XBB in the past two months, when it was a very different situation.<\/p>\n

\u201cCollectively, at the individual level and also at some administrative levels, we’ve essentially taken our eye off the ball as refers to COVID-19.<\/p>\n

\u201cThis variant was first picked up in India, but it’s probably a mistake to try to tie it to a country. This is a virus that came from an infected human almost certainly, and we’re all very much alike on the inside. The virus was picked up in six other countries within a week of that first detection and genome sequence, so it had likely spread a little bit earlier than that,\u201d said Dr Neuman.<\/p>\n

\u201cThe hospitals are currently doing okay. They’re about 80 percent occupied in the U.S., and only between seven and eight percent of that is COVID.<\/p>\n

\u201cBut COVID cases are rising, and there is some concern that at least in some spots, it will exceed capacity if nothing is done to stop it at this point.<\/p>\n

\u201cWhen the FDA and vaccine manufacturers met about a year ago to discuss updating COVID vaccines, they concluded that one year was certainly too long to wait between vaccine updates, and that with mRNA technology, we should be able to move more quickly and fluidly.<\/p>\n

\u201cIt’s been a year. The vaccine needs an update, and neither main vaccine mRNA vaccine-producing companies has released a statement on whether they will be updating it. \u201cUnfortunately, for other vaccines such as the Chinese vaccines, the prospects are dim because the current variants like Omicron and XBB are difficult to grow in cell culture. Think of these as something like animals that do not breed well in captivity. They grow very well in people’s lungs but are a little harder to make large quantities. Vaccines that require large quantities of virus like the inactivated virus vaccines will be very difficult to update, as will some of the vaccines that are based on expressed proteins, which are also rather tiresome to farm.<\/p>\n

\u201cWhile it appears we may have achieved herd immunity against the early strains from 2019-20 and \u201921, We’re still unfortunately vaccinating against one of those strains and against another strain that appears to be on the decline.<\/p>\n

\u201cI think this is a problem that can be solved by humans, but I think it won’t be solved by standing still, and I think each of us has a part to play, and at least for the individual, that part would be getting the updated booster, which is a lot better than anything else that’s out there now,\u201d said Dr Neuman.<\/p>\n

\u201cThe FDA virus and related biological products advisory committee is meeting Jan. 26, and they will be discussing what Dr Neuman had pointed out,\u201d Dr Oliver Brooks.<\/p>\n

\u201cOur plan will be, anyone coming in, people coming into my house, and saying, \u2018I have back pain,\u2019 \u2018I have cough and runny nose,\u2019 we’re going to test everyone with URI symptoms. If you test positive for COVID with the rapid test, then we’ll take care of you. If you don’t have it then when you’re going inside and get your back pain treated, so testing is still crucially important,\u201d said Dr Brooks.<\/p>\n

\u201cXBB comes off BA.2. It’s a little tricky. We got BA.4.5 vaccine in the bivalent. It does give some response to BA.2, but not much, not a very good response against XBB.<\/p>\n

\u201cConcepts of how well it responds, and the new variant, are all well and good, however, the vaccine is safe and effective, and there’s no reason not to get vaccinated,\u201d said Dr Brooks.<\/p>\n

Jill Rosenthal from the Center for American Progress talked about the cost of Paxlovid once the public health emergency ends, and the end of free COVID testing and treatment.<\/p>\n

\u201cSince the passage of the American Rescue Plan act in March of 2021, Congress has not met the administration’s requests for additional COVID funding, and that short-sighted failure to invest in the response leaves us without the tests, treatments, and vaccines, we need going forward. It leaves us unable to continue to track the disease, and it leaves us unprepared for future surges,\u201d said Rosenthal.<\/p>\n

\u201cAs the bivalent vaccine was developed to provide enough doses for the population, the White House had to take funding from other areas to be able to pay for that.<\/p>\n

\u201cBecause of inadequate funding we saw a decrease in at-home test availability.<\/p>\n

\u201cWe’ve heard that there’s less personal protective equipment being put into the national stockpile and a lack of support for continued vaccine development and treatment,\u201d said Rosenthal.<\/p>\n

\u201cFunding to cover testing and treatment through the uninsured program ran out in March (2022). Funding to cover provider fees for vaccinations through the uninsured program ran out in April (2022) and what this means is that some community members have been turned away from testing sites in places where the clinics can’t sustain the cost to administer the tests.<\/p>\n

\u201cWe’ve seen that in the future as commercialization of the COVID response occurs, consumers will have to pick up the costs of treatments and tests. This threatens access for low income and uninsured people because of the Affordable Care Act preventive services coverage standards.<\/p>\n

\u201cThe COVID vaccine will remain free to individuals who have public insurance and most individuals with private insurance even after the public health emergency has expired but for people who are uninsured, they can be charged part or the full amount of the vaccine, which will be $100, $110, $130 per dose. Obviously, that’s an access barrier.<\/p>\n

\u201cWe’re preparing to end continuous coverage protection for people on Medicaid, and at the same time we have the depletion of Federal Supply and resources, and we have the end of the public health emergency coming, and we have the end of continuous eligibility for Medicaid, so this can make access challenges even greater.<\/p>\n

\u201cIt is critically important that people get vaccinated. It’s the number one thing that we can do to protect ourselves,\u201d said Rosenthal.<\/p>\n

Sophia Tan discussed her novel research into the prison population and the vaccine efficiency, and the rates of infection, and re-infection, in the prison population.<\/p>\n

\u201cThis study was done in collaboration with many folks at UCSF and UC Berkeley and was also conducted in collaboration with the California Prison System.<\/p>\n

\u201cWith the rise of these more contagious variants like Omicron, there have been more frequent cases in a few different groups of people. We see a lot more breakthrough infections, which are infections that we see in people that have been vaccinated for COVID-19. There are more cases among people that have had previous infection, so these are re-infections. There are also cases in people that have had both prior COVID-19 vaccination and prior infection, and so we’ve seen all these different cases, but the question that we were really wondering is, what are the benefits from vaccination in preventing the future transmission of COVID,\u201d said Tan.<\/p>\n

\u201cSome of the key takeaways from this study were that COVID-19 vaccination, and prior SARS Cov2 infection reduce the infectiousness of Omicron infections. There’s added benefit in having vaccination even though you’ve had prior infection, it will further reduce your infectiousness if you happen to then contract an Omicron infection.<\/p>\n

\u201cWe also saw that there’s additional benefits from having additional doses of vaccine and also having more recent vaccination,\u201d said Tan.<\/p>\n

\n","protected":false},"excerpt":{"rendered":"

(Shutterstock)   A new subvariant of omicron, named XBB.1.5, now accounts for 40 percent of Covid-19 infections in the U.S. XBB.1.5 is even more prevalent on the East Coast, accounting for 75 percent of infections. At an Ethnic Media Services briefing, Jan. 6, speakers \u2013 Dr. Ben Neuman, Chief Virologist of the Global Health Research…<\/p>\n

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