Omicron subvariant BA.5 still dominant in Hawaii, but newer mutations gaining ground
Oct. 15—New omicron subvariants, such as BA.4.6 and BF.7, represented 10 % of variants circulating in the state.
The latest variant report from the state Department of Health shows emerging new subvariants are gaining ground in the state, similar to national trends.
Omicron subvariant BA.5, which the new bivalent boosters target, remains dominant, making up 88 % of new COVID-19 cases in Hawaii for the two-week period ending Sept. 24, compared with 91 % in the previous reporting period. New omicron subvariants, such as BA.4.6 and BF.7, meanwhile, are growing in proportion, and represented 7 % and 3 %, respectively, of variants circulating in the state.
Subvariant BF.7, a descendant of BA.5, has been flagged as a variant of concern by the United Kingdom Health Security Agency, due to rising cases in Europe.
"Fortunately, both BA.4.6 and BF.7 are offshoots of omicron and the new bivalent boosters provide increased protection against them, " DOH spokesperson Brooks Baehr said in a statement.
Others detected and listed in the report that epidemiologists are watching with concern include more immune-evasive subvariants such as BA.2.75.2, a descendant of BA.2.75, along with BQ.1, a sub lineage of BA.5.
One study called BA.2.75.2 "the most neutralisation resistant variant evaluated to date." Another report found BA.2.75.2 to have "profound immune escape " and resistance to treatments such as Evusheld and Sotrovimab monoclonal antibodies, as well as significant growth advantage in the United States.
DOH confirmed Friday that omicron subvariants BA.2.75.2 and BQ.1 have been detected for the first time in Hawaii.
"While BA.2.75.2 and BQ.1 are also subvariants in the omicron lineage, they have mutations that suggest an increased ability to escape immunity from vaccination and previous infection, " said Baehr. "DOH is closely monitoring these subvariants."
The U.S. Food and Drug Administration earlier this month its fact sheet for Evusheld to warn users of the increased risk of developing COVID-19 when exposed to variants not neutralized by the treatment used to help protect immunocompromised people.
Subvariant BQ.1 and BQ.1.1, both offshoots of BA.5, meanwhile, are spreading quickly in Europe and growing in proportion in the U.S.
The Centers for Disease Control and Prevention recently listed BQ.1 and BQ.1.1 separately in its Nowcast model. The two subvariants together now make up 11.4 % of new COVID-19 cases in the U.S.
The new subvariants of concern continue to edge out BA.5, which now makes up only about 68 % of variants circulating across the nation.
In addition to BQ.1 and BQ.1.1, subvariant BA.4.6 makes up about 12 %, while BF.7 makes up about 5 % and subvariant BA.2.75.2 about 1.4 %.
The Johns Hopkins Bloomberg School of Public Health said changes in the viral spike protein of BQ.1.1 make it harder for antibodies from vaccination or previous infection to neutralize it. This, in turn, makes it more difficult to treat active COVID-19 infections with monoclonal antibodies.
"That said, there isn't evidence yet that BQ.1.1 will be anywhere as devastating as omicron was when it first emerged last year, " the Bloomberg School of Public Health stated in its weekly newsletter. "Many more people have at least some immunity to COVID from either infection or vaccination, and most places are seeing a decline or flattening in hospitalizations and deaths—trends experts are hopeful will continue." The good news, the school added, is that the bivalent boosters offer some degree of protection.
