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XBB.1.5 omicron variant of COVID is spreading rapidly in the US as the flu wanes: vaccines

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US infectious disease experts worry that a wave of winter respiratory illnesses — like the one that overwhelmed emergency rooms with COVID-19 patients in January 2021 — could yet materialize this winter, with multiple circulating viruses wreaking havoc. So far, though, it looks like the first peaks of RSV and flu are subsiding.

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Mario Tama/Getty Images


US infectious disease experts worry that a wave of winter respiratory illnesses — like the one that overwhelmed emergency rooms with COVID-19 patients in January 2021 — could yet materialize this winter, with multiple circulating viruses wreaking havoc. So far, though, it looks like the first peaks of RSV and flu are subsiding.

Mario Tama/Getty Images

As the new year begins and winter approaches, US infectious disease experts tracking the “tripledemic” virus stew plaguing the country say there’s good news — and bad.

The good news is that the worst seems to be over with the RSV outbreak that has made life miserable for many children and their parents. RSV cases have been dropping steadily since late November, according to the Centers for Disease Control and Prevention.

At the same time, the flu — which also returned with a vengeance this fall, after nearly disappearing for the previous two years — appears to be finally subsiding in most places, according to the latest data released Friday by the CDC.

“In some areas, we are seeing an increase or plateau in activity,” said Dr. Shikha Garg, a CDC medical epidemiologist, told NPR in an interview on Friday. “But in most areas, it’s slowing down.”

The virus that poses the biggest threat right now is – you guessed it – the one that causes COVID-19.

COVID “concerns us most” in coming days and weeks

“We are seeing sustained increases in COVID infections across the country,” said Dr. Ashish Jha, White House coronavirus response coordinator, told NPR in an interview. “So COVID is what we’re most concerned about as we look ahead to the days and weeks ahead.”

The rate at which the coronavirus is being detected in wastewater, which has become an indicator of the pandemic, has tripled or quadrupled in many parts of the US in recent weeks, says Jha. Hospitalizations for COVID-19 are up 70%, he says. And 300 to 400 people are dying every day from COVID-19.

To make matters worse, this is all happening because another new and even more transmissible variant has taken over the United States. Called XBB.1.5, this new omicron subvariant was barely on the radar in late November. But according to new estimates released Friday by the CDC, XBB.1.5 now accounts for nearly a third of new infections and is the dominant variant in the Northeast.

“The current surge in cases that we’re seeing really started around the Thanksgiving holiday, when people would get together. And as we entered the biggest holiday season – the Hanukkah/Christmas holiday – that accelerated infections even more,” he says. Jha.

Since “all major holidays have led to an increase in cases throughout the pandemic, it stands to reason that we will see a clear increase in infections, cases and hospitalizations, unfortunately, in the coming weeks,” he says.

Why the XBB.1.5 omicron subvariant is spreading so fast

The prevalence of the XBB.1.5 omicron subvariant of the coronavirus “has gone off like a rocket,” says Sam Scarpino, who has been tracking new variants at Northeastern University. “This variant has displaced other variants in a way that we’ve never seen before. That’s kind of alarming.”

The good news is that so far there is no evidence that the new variant makes people sicker than previous versions of the coronavirus. And the immunity that people have to being infected and vaccinated should protect the majority from actually getting sick. So no one thinks this winter will be anything like the first two horrible pandemic winters.

But XBB.1.5 can partially bypass the immunity as easily as anything before it. And he developed something that none of his predecessors had: a mutation that allows him to infect cells more easily than others. This makes this version of COVID-19 even easier to detect.

“XBB.1.5 got a specific mutation that allows it to retain the antibody’s escape properties while offering an advantage in spreading through the population,” says Jesse Bloom, a virologist at the Fred Hutchinson Cancer Center in Seattle who studies variants.

This means that many people are likely to get COVID-19 this winter.

“The question is not whether it will cause an outbreak. It almost certainly will. The question is, how big will the outbreak be?” says Scarpino.

Therefore, public health officials are once again urging people to protect themselves.

How to protect yourself from the XBB.1.5 coronavirus subvariant

“What’s clearer now than even a year ago is that we can actually mitigate the worst by doing the things we know work,” says Jha.

This includes getting vaccinated and boosted, especially if you are older. Most COVID-19 deaths are occurring in people aged 65 and older.

Other precautions include avoiding parties, restaurants, bars and other crowded and poorly ventilated places; testing before collection; and, yes, put that mask back on in risky situations. And if you do get sick, check with your doctor about getting treatment quickly.

“It’s time not to let your guard down,” warns Dr. Tina Tan, an infectious disease specialist at Northwestern University.

Fortunately, most precautions that reduce your risk of getting COVID-19 also help protect you against any RSV or flu flare-ups. Winter is still young and the flu is still circulating at very high levels in many places, experts note, which means that many people still suffer from fever, body aches, chills and other symptoms. And the holidays may have started more infections that will continue to surge and spread in the coming days. as people return home from travel and family gatherings, schools reopen and people return to work.

The US could see another flu wave later this winter. This is what happened in some parts of the Southern Hemisphere winter, and it also happens frequently in the Northern Hemisphere.

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