New COVID variant is ‘something completely different’. Here’s what you should know.

For nearly two years, we have been in something of an Omicron holding pattern.

A new Omicron subvariant of the COVID virus popped up every few months with a small number of mutations that resulted in subtle changes to the way it spread and infected.

“We’re just going from iPhone 1 to iPhone 5 to iPhone 8, iPhone 14 — It’s a variation on a theme,” one epidemiologist told the N&O. “It’s not jumping to an Android.”

But a new COVID variant, BA.2.86, has threatened to disrupt that progression.

Several health agencies, including the Centers for Disease Control and Prevention and the World Health Organization, have been monitoring this highly mutated variant because of its potential to evade the immunity most Americans have built up over the last few years.

In other words, this is not the next iPhone generation.

“This is an Android,” said Dr. David Montefiori, a Duke epidemiologist.

Here’s what you need to know:

Where is the new variant spreading?

As of last week, the variant has been confirmed in several countries and two U.S. states, Virginia and Maryland.

The virus has also been detected in Ohio wastewater, which suggests there are more cases than have been detected with testing in the United States.

There is significantly less COVID testing now than there was during the height of the pandemic, which makes tracking the variant difficult, Montefiori said.

Is it better at evading immunity?

It’s too soon to know how this virus will act in a real-world environment.

Because BA.2.86 is so different from variants we’ve been exposed to, some experts fear it will be better at evading our immune responses, including those made stronger with vaccines.

The number of genetic differences between this variant and Omicron is roughly the same as the difference between the original Omicron variant and Delta. More variants mean a pathogen may be at lower risk of being detected by our defense systems.

“Usually, when a new variant emerges, there are just a small number of mutations,” Montefiori said. “This is a pretty big jump.”

Experts are also concerned about where some of the mutations fall on the virus: a part that Montefiori said is a “hotspot for evading our immunity”.

The good news? Immunity from past infections or vaccination is likely to provide “some protection” against severe disease from this variant, according to the CDC.

Will BA.2.86 make us sicker?

Montefiori said we don’t yet know — there are just too few cases right now.

In a recent report, CDC officials wrote that they have not detected an unusual increase in hospitalizations or emergency department visits in places where the variant has been detected, but cautioned it was too soon to make any definitive statements.

More good news: The mutations are not likely to affect the efficacy of commonly prescribed antiviral treatments, like Paxlovid, Montefiori said.

Will new boosters target the variant?

This October, health care providers will begin offering reformulated COVID boosters, which are designed to target the original COVID strain and XBB — an Omicron subvariant that circulated this summer.

Even though these vaccines aren’t tailored for BA.2.86, they are still likely to be helpful protecting people from it, Montefiori said.

That’s because vaccines bolster your immune system in several ways.

Even if the vaccine-generated neutralizing antibodies — important for avoiding a COVID infection — aren’t a perfect weapon the shot will help develop T-cell immunity, which helps prevent severe illness, Montefiori said.

Montefiori’s lab at Duke is testing how effective BA.2.86 is at circumventing immunity from the updated booster. The results of those experiments are likely to be released in coming weeks, he said.

Get boosted now or wait until October?

This decision is largely based on each individual’s personal risk level, Montefiori said.

Someone traveling internationally might want to get the current booster ahead of their trip, for example. Someone who is rarely in crowded public areas might be better off waiting for the fall vaccine, he said.

A good number of North Carolinians have not had the latest vaccine. Just 14% have had at least one dose of the still available bivalent booster released last fall, said a NC Department of Health and Human Services spokesperson.

While the variant is a nice reminder to stay up to date on vaccines, Montefiori said it shouldn’t be cause for alarm yet.

“We don’t know whether this variant is going to really take,” he said. “Sometimes they pop up and then just disappear.”

Teddy Rosenbluth covers science and health care for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.

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