COVID cases may peak again in fall and winter with the rise of ‘Eris’ and now ‘Fornax’.

COVID cases may peak again in fall and winter with the rise of ‘Eris’ and now ‘Fornax’.

The Ever-Evolving World of COVID Variants

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As we approach the fourth anniversary of the COVID-19 pandemic, it seems that we are still far from out of the woods. Just when we thought we had seen it all, new variants continue to emerge, each with its unique characteristics and challenges. Enter “Fornax” FL.1.5.1, a relative of the well-known “Eris” variant, named after a constellation in the Southern Hemisphere. The naming of these variants has taken on a playful tone, with street names like “Kraken” assigned by biology professor Ryan Gregory at the University of Guelph in Ontario.

FL.1.5.1 is currently the top variant reported in New York, a state considered a bellwether by variant trackers. Wastewater levels and hospitalizations are on the rise, indicating that the variant is spreading. Nationwide, wastewater levels, which have become our best indicator of viral activity, are showing a relatively modest increase compared to the previous surges caused by the Delta, Omicron, and “Kraken” XBB.1.5 variants. However, the current rise is still significant, surpassing the levels observed during the low points of the pandemic.

It’s clear that COVID is still very much present and continues to pose a threat. But the way the virus behaves has changed since last summer. Instead of distinct waves driven by individual variants like Alpha, Delta, and Omicron, we now have a continuous high level of cases sustained by multiple overlapping mini-waves of new variants. It’s like a high sea level rather than a tsunami, as Gregory puts it.

Looking ahead, we can expect to see more variants and mutations in the coming months. Variant trackers have their eyes on a few mutations that have the potential to further evade immunity and enhance the virus’s infectivity. It’s becoming increasingly clear that we are entering a phase where the conversation will shift from variant names to the names of problematic mutations that make the virus more transmissible or severe. Successful variants will likely acquire these concerning mutations, making them even more challenging to control.

The good news is that updated vaccines targeting the dominant strain of the past winter will be available by the end of September. These vaccines are expected to be effective in preventing severe outcomes like hospitalization and death. They could also play a crucial role in containing the predicted late-November peak in cases. However, there is concern that many Americans may choose not to get vaccinated. A survey conducted by the CDC indicates that only a small percentage of adults and adolescents have received an Omicron booster. As the pandemic emergency state has been officially lifted by the WHO and CDC, vaccine uptake may decrease further.

There is also the issue of timing. Dr. Eric Topol, a professor of molecular medicine at Scripps Research, is worried that the vaccines may not be available soon enough for the immunocompromised and elderly. With schools reopening and wastewater levels already rising, waiting until September or October could be too late to prevent a significant surge.

The possibility of another “tripledemic” involving COVID, flu, and RSV (respiratory syncytial virus) looms in the background. Last year, the dropping of pandemic mitigation measures led to surges in these three respiratory illnesses. However, there are reasons to be cautiously optimistic. The Southern Hemisphere, which experiences winter during our summer, didn’t see significant COVID surges or a severe flu season. This suggests that the winter in the Northern Hemisphere might fare similarly.

Interestingly, there is historical precedence for this phenomenon. During the H1N1 bird flu pandemic in 2009, the flu virus waxed and waned, peaking again in the fall. As it did, other respiratory viruses like RSV, H3N2 flu, and Influenza B suddenly disappeared—one theory suggests that competitive viruses can “cancel out” other viruses for periods of time. The mystery of why these viruses behave in such a manner remains unsolved.

With the ever-changing nature of the pandemic, it’s no wonder that experts like Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, still feel uncertain about the pathogen. As he puts it, “I still sleep with one eye open all of the time because of COVID.”

In conclusion, as we navigate through the fourth year of the pandemic, we must prepare ourselves for the ongoing challenges posed by new COVID variants. The continuous emergence of these variants alongside mutations that enhance the virus’s transmissibility and severity calls for vigilance and a proactive approach. Vaccines remain our best defense, and it is crucial that enough people choose to get vaccinated to achieve widespread protection. The future of the pandemic may be uncertain, but by staying informed and adhering to public health guidelines, we can better navigate the ever-evolving world of COVID variants.