You may not know it by looking around at all those unmasked faces, but there are still a lot of new coronaviruses. And it looks like the virus is mutating faster than ever, producing increasingly contagious variants and subvariants.
The evolutionary trend with SARS-CoV-2 may not mean that there will no doubt be large increases in infections, hospitalizations, and deaths. At least not everywhere or for a long time.
But he points out an uncomfortable truth: that despite the lifting of COVID restrictions in most non-Chinese countries, despite the eagerness of many people to overcome the pain and uncertainty of the past two years, the pandemic has not finished. The virus has not finished mutating.
The latest subvariants are the most transmissible to date. BA.4 and BA.5, both descendants of the Omicron variant, first appeared in South Africa last month. BA.2.12 and BA.2.12.1, closely related, first appeared in New York at the same time.
BA.4 and BA.5 are 10 percent more contagious than its immediate predecessor, the BA.2 form of Omicron. BA.2.12 and BA.2.12.1 are 25 percent more contagious. Equally alarmingly, BA.4, BA.5, BA.2.12 and B.2.12.1 are rapidly becoming dominant in their respective regions of origin only a couple of months after BA.2 became dominant. BA.2, on the other hand, outperformed the competition and replaced its own parent company, BA.1, a few months after BA.1 became dominant.
China’s new COVID crisis could generate the worst variant yet
In other words, it seems that the new main subvariants are coming to us faster and faster. In this sense, the virus may appear to be gaining genetic gambling. In the face of a semipermeable barrier of antibodies from previous vaccines and infections, the pathogen is increasingly transmissible.
Immune pressure “will increase the rate of selection of the most appropriate variants already circulating in the population,” Edwin Michael, an epidemiologist at the University of South Florida’s Global Health Infectious Diseases Research Center, told The Daily Beast . “This will result in cascades of new variants appearing and extending to the host population more frequently.”
But this cascade of variants is a price we pay for our expanding immunity to the entire population. You can’t have the latter without getting some of the former. So while it looks like COVID is winning, in fact, its genetic victories could be short-lived.
Niema Moshiri, a geneticist at the University of California, San Diego, last year urged The Daily Beast to think of every COVID infection as a player playing a slot machine. Each individual infection tends to produce two mutations every two weeks, Moshiri explained. In other words, the virus gets two levers twice a month, hoping to get a genetic jackpot that will give it a new edge over other viruses and a new way to infect its host.
“What if we had 50 million people pulling the levers of the slot machines simultaneously at the same time?” Moshiri asked. “We expect at least one person to reach the jackpot fairly quickly. Now, replace the slot machine with a ‘clinically significant’ SARS-CoV-2 mutation, ‘and that’s the situation we’re in.”
To complete the metaphor, add a growing sense of urgency from the virus as immunity rises around you. Sensing threats around him, the new coronavirus is playing catch-up with increasingly serious determination.
A man sets up a COVID test shop in Times Square on April 27th.
Spencer Platt / Getty
Over the last 30 months, there have never been less than several million active cases of COVID. During the worst increases in early 2021 and early 2022, there were tens of millions of simultaneous infections. Given the high rate at which SARS-CoV-2 mutates, it is not surprising that the virus has produced a steady stream of significant new variants: “lineage” is the scientific term.
There was Delta, the most virulent lineage that drove the worst waves of infections in 2021 as much of the world was just beginning to have access to effective therapies and vaccines. In late 2021, scientists in Botswana and South Africa detected the first cases of a new lineage, Omicron.
Mutations in the ear protein, the part of the virus that helps it catch and infect our cells, make Omicron more contagious than Delta. On the worst day of the Omicron wave on January 19, officials counted no less than 4 million new infections in just 24 hours. These are four times more cases than in the worst days of the consecutive waves of the Delta in January and April 2021.
Strong global adoption of the vaccine, in addition to persistent antibodies in tens of millions of people due to a past infection, reduced Omicron’s worst results. When Omicron first appeared, about half of the world’s nearly 8 billion people had received at least one dose of vaccine. Today more than two-thirds are at least partially punctured.
Add natural antibodies from hundreds of millions of past infections, and the human immunity wall looks pretty impressive. Innovative infections are common, but all of these antibodies are really good at preventing the virus from causing serious illness that can end in death.
So the cases increased as Omicron became dominant, but the deaths did not. The deadliest day of the rise of Omicron on February 9, 13,000 people died worldwide, 5,000 less than the worst day of Delta on January 20, 2021.
More cases but fewer deaths, a phenomenon that epidemiologists call “decoupling”, has come to define the evolution of COVID-19 as we pass the third year of the pandemic. There are indications that decoupling could become more extreme. After all, immunity leads to decoupling too stimulates a virus to mutate more rapidly in increasingly transmissible lineages.
Two variants of COVID have just been combined into a “Frankenstein” virus.
Immunity boosts mutants, which can boost immunity by sowing antibodies to a mild infection. It is an accelerated positive feedback loop whose products are antibodies and viral lineages.
A growing gap between infections and deaths could actually be the best scenario, unless the new coronavirus miraculously “extinguishes” itself by running into a genetic corner. Many experts strongly believe that an evolutionary dead end is an illusion when it comes to respiratory viruses. “I think self-extinction is very unlikely,” Jesse Bloom, a researcher at the Fred Hutchinson Cancer Research Center in Washington State, told The Daily Beast.
The bad news is that we will probably have to learn to deal with the increasingly contagious variants and subvariants of SARS-CoV-2 that are appearing more and more rapidly. The good news is that we know how to deal with it. BA.4, BA.5, BA.2.12, and BA.2.12.1 have some ability to prevent our natural, vaccine-induced antibodies: “immune escape,” experts say.
A Los Angeles International Airport passenger wears a face mask on April 18 after a Florida federal judge overturned the national mask warrant covering airplanes and other public transportation.
MediaNews Group / Long Beach Press-Telegram via Getty
A little immune evasion does not mean a total immune leak. Natural antibodies and vaccines still work. They are the reason why the cases and deaths of the basic Omicron lineage were decoupled. They are also the reason why it is likely to go wrong with Omicron’s nasty offspring. “The mutants don’t look as pathogenic as Delta, for example,” Stephanie James, head of a COVID testing lab at Regis University in Colorado, told The Daily Beast.
That is, expect to hear a lot about new lineages and sub-lineages in the coming months as they emerge and become dominant at an accelerated pace. Don’t be surprised if you catch one, even if you are vaccinated and strengthened and may even have antibodies from a past infection.
But don’t be scared. Keep up to date with your vaccines and you’ll probably be fine.
Unless, of course, the evolution of SARS-CoV-2 takes a dangerous turn. The immune breakdown has been quite minor with all the major lineages and sub-lineages we’ve seen over the last couple of years. This is not to say that the virus cannot evolve to achieve a significant immune leak. If mutations are like the pathogens playing in the slot machines and a jackpot is a new variant, then a variant that can cross our antibodies is a mega-jackpot.
If the virus never wins that bet, everything changes.
Read more in The Daily Beast.
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