February 28, 2024

The pandemic is much from over, as evidenced by the fast rise to international dominance of the JN.1 variant of SARS-CoV-2. This variant is a by-product of BA.2.86, the one different pressure that has carried greater than 30 new mutations within the spike protein since omicron first got here on the scene greater than two years in the past. This could have warranted designation by the World Well being Group as a variant of concern with a Greek letter, comparable to pi.

By wastewater ranges, JN.1 is now related to the second-biggest wave of infections in america within the pandemic, after omicron. We’ve misplaced the flexibility to trace the precise variety of infections since most individuals both take a look at at house or don’t even take a look at in any respect, however the very excessive wastewater ranges of the virus point out about 2 million Individuals are getting contaminated every day.

In a number of international locations in Europe, wastewater ranges reached unprecedented ranges, exceeding omicron. Clearly this virus variant, with its plethora of recent mutations, has continued its evolution with mutations tailored for infecting or reinfecting us.

‘Up to date’ booster nonetheless efficient

There’s, nevertheless, some excellent news about this massive wave of infections. It has not resulted within the surge of hospital admissions seen with omicron. The “up to date” booster (based mostly on the XBB.1.5 variant that rose to dominance within the U.S. in February), obtainable right here since September, has some cross-reactivity with JN.1 in lab research for inducing neutralizing antibodies to the virus, and a latest Kaiser Permanente report confirmed the booster supplied safety from hospitalization within the vary of about 60% towards JN.1 and different just lately circulating variants.

With the marked variations within the spike protein between XBB.1.5 and JN.1, we’re very fortunate to see this degree of vaccine-induced immune response. Nonetheless, solely 19% of eligible Individuals have gotten the up to date booster. The Kaiser examine additionally confirmed low ranges of safety towards hospitalization and emergency room visits for individuals who had acquired solely prior variations of the vaccine, with out the up to date booster. That aligns with much more placing variations within the virus sequence of early strains in contrast with JN.1, and the issue we have now with waning immunity 4 to 6 months after vaccination.

All of that is occurring on prime of the flu and RSV waves, each of that are at very excessive ranges, not clearly having peaked but, with some individuals experiencing two of those infections without delay.

The place are the masks?

With all three respiratory viruses circulating at full power, you’ll suppose we’d be seeing individuals sporting masks all over the place in public. That couldn’t be farther from the reality. The state of denialism and basic refusal to take easy steps to cut back the danger of an infection might be seen all over the place.

It has taken well being care techniques many weeks after JN.1 confirmed up in October to acknowledge the risk. Solely very just lately have some reinstated masks mandates for well being care staff and sufferers. Little has been accomplished throughout the nation to enhance indoor air high quality, upgrading filtration and air flow.

Now in its fifth yr, SARS-CoV-2 has as soon as once more proved to be extremely resilient, able to reinventing itself to contaminate us. But we proceed to make-believe that the pandemic is over, that infections have been remodeled to frequent chilly standing by prior publicity(s), and that life has returned to regular. Sadly, none of that is true.

The huge variety of infections within the present wave will undoubtedly result in extra individuals affected by lengthy COVID. For a excessive proportion of individuals, particularly these of superior age, immunocompromised or with coexisting circumstances, getting COVID is nothing near an easy respiratory an infection.

On the lookout for the exit

What’s the exit technique that might get us to “return to regular”? It actually can’t occur with the present complacency and false perception that the virus will burn out and go away. Inevitably, there will probably be one other pressure sooner or later that we aren’t in any respect ready for and can result in yet one more very massive wave throughout the planet.