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Should We “Beware the Kraken,” New COVID-19 Variant?

General

New COVID-19 Variant is More Contagious

The World Health Organization (WHO) initially detected the COVID-19 Omicron subvariant XBB.1.5 in Oct. 2022. Nicknamed “Kraken,” by Jan. 2023, CDC believed it to be the dominant COVID-19 variant in the United States. Though symptoms are similar to other COVID-19 variants, this is believed to be more contagious. To learn more about this COVID-19 variant and understand its risks, we spoke with MRIGlobal’s Dr. Gene Olinger, Ph.D., Chief Science Advisor 

Where have cases of this variant been seen thus far?
WHO notes that this new COVID-19 variant has been observed in 25 countries so far, including the United Kingdom and United States. CDC reports that 40 percent of new COVID-19 cases in the U.S. the week ending Saturday, Dec. 31 are due to this variant, with 75 percent of cases in the Northeastern states being this variant. The Midwestern U.S. has been spared to-date, with about 8 percent of cases being this variant, but it is likely to increase in the coming weeks. 

Is this variant more contagious than past variants?
Virus survival depends on a variety of characteristics, however, there is a tendency for the virus to modulate virulence (disease outcome) and/or contagiousness. It is like a teeter totter; with the factors we play into making an impact on how the interplay between virus and the world plays out.  Vaccination, human-to-human contact, and even reverse spillover – for instance, the virus goes into an animal like white tail deer and then back into humans with changes – will lead the variant with potential for more or less virulence or infectivity. Overall, there seems to be a trend that the virus is evolving to be more infectious, spreading more easily between people, but is likely less severe than the Alpha and Delta variants. This is ideal, but the more times the virus infects people, the greater the potential for something that we dread, which would be a virus that is a high consequence variant, which we have not yet observed.  

What is the risk with this variant?
Because this sub-variant of Omicron seems to be less dangerous, but more contagious, it will lead to a new “wave” of virus infections and in higher numbers of people. However, the less dangerous aspect is misleading because higher infectiousness and the lack of constraints people are using to protect themselves means that highly susceptible people are being or will become infected, possibly for the first time during this pandemic. These individuals often have co-morbidities or conditions that result in hospitalization and death. Further, as they age and experience life, new comorbidities arise that they may not have had in the prior years, so it is a constant pressure between us and the virus.  

What preventative measures should people take to stay safe?
It is important to take care of yourself and your loved ones through preventative health care, good nutrition, exercise, and of course handwashing and good hygiene. We also learned during the first years of the pandemic the value of managing our social networks and social distancing, which could be beneficial again now. Further, if you are in a crowded room, assume someone may be infected and understand how that would impact your health or those who live with you. You should also wear a mask and limit your time in that space. When I visit a restaurant or store, if it is busy and crowded, I simply go to another location or come back at a less busy time.  

Should I get a vaccine booster?
There are benefits to getting a vaccine booster shot. There is some evidence that vaccination boosters may have limited impact on the antibody response for this particular variant in providing complete protection. However, that doesn’t mean that cellular response is completely blunted, so there may be some value in doing so, as it will likely decrease the severity and length of illness if infected. If you have a co-morbidity or multiple issues, vaccine boosters are encouraged, so talk to your healthcare provider. Also, if you have not had an infection or booster vaccination since July 2022, you may want to consider the newer vaccines that are available now.   

Will existing diagnostics and treatments still work on this variant?
Studies are underway to determine vaccine or natural immunity on the new variant and any impacts on existing diagnostic assays. The very effective antibody treatments available for Alpha, Delta, and early Omicron variants are not available for salvage therapy anymore since they have lost the ability to bind to this variant and stop the infection. If a patient is hospitalized, medical professionals are focusing on oral/IV drug treatments and supportive care, while new antibody treatments are being developed.  

Anything else we should know about this variant?
My experience is that individuals who have avoided the virus since the beginning are now becoming infected, some of whom are vulnerable people. Diagnostic assays seem to become positive days after someone first feels ill, which can be up to five days in some cases. Individuals infected remain positive for more than a week, even after feeling better. Those who take the orally available drugs are observing rebound after a week or so of treatment. Too, the more vulnerable people who have thus far avoided infection and have recently become infected are experiencing long-haul COVID symptoms, mainly exhaustion and not feeling normal well after the course of disease. 

 

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