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The latest covid subvariants BQ.1.1 and XBB are on the run, spreading fast, and it means there’s a new threat on the block. XBB and BQ.1.1 have very different mutations. Neither causes more severe illness than omicron. But what scientist are calling a ‘soup’ of new coronavirus subvariants looks set to drive a wave of infections across continental Europe, the UK and the US this month. Some countries are already experiencing it, others are just about seeing the end of it.
So far covid has leapt from one lineage to the next, for example delta to omicron. New variants overtook the originals pretty fast. Now there’s a new mix of subvariants out there, displaying an entire portfolio of mutations right across the virus’s genome.
It looks like high levels of immunity are creating evolutionary pressure to favour immune-evading variants. Because early on in the pandemic we saw so many fast lineage jumps as covid got better at infecting us, that side of things is now optimised. The many new, smaller mutations we’re seeing mean the virus us doing its best to avoid the immunity the human race has acquired.
One of the most worrying is BQ.1.1, a subvariant we’ve been talking about recently. It’s descended from the omicron BA.5 subvariant BQ.1 and has so far turned up in 65 countries. It accounts for half the cases in France at the moment and cases are doubling weekly. No wonder it’s already so widespread. BQ.1.1 might also be what’s driving most covid cases in Africa but limited testing on the continent makes it hard to tell – and that in itself is pretty worrying.
The BQ.1.1.subvariant has six mutations affecting the surface of its spike protein, the protein vaccines use to generate an immune response. So far it looks like the mutations are letting it evade the neutralising antibody responses we get from previous infections and vaccines. In fact BQ.1.1 has one of the highest immune-evading mutations out there.
The omicron subvariant XBB is hitting India hard at the moment, the country it first turned up in. Like BA.1.1 it’s a potentially powerful foe. It came from a ‘recombination event’ where two different BA.2 descendants infected one cell, exchanging genetic material to create a hybrid subvariant with seven key mutations for evading immunity, more mutations than any other circulating subvariant so far. XBB is also rife in Singapore, along with its descendent XBB.1, and it’s busy making its way around Asia, found in 35 countries so far.
The USA’s huge RSV surge
The USA is mired in a serious RSV surge right now. Respiratory syncytial virus mostly affects young children, and the surge is already overwhelming North American hospitals.
Most of us have had RSV by the time we’re two years old, and it’s very common. Mild cold-like symptoms are normal but it can be life-threatening for children aged less than five as well as older people and the immunocompromised. About 160,000 people die of RSV per year and so far there’s no treatment and no vaccine. Luckily there are vaccines underway for kids and old people, and they could be with us as early as 2023. It’s important news since the hospitalisation rate in the USA for RSV was nearly double what it was a year before, and we’re also seeing dramatic rises in the UK. In fact the number of kids in hospital in the UK with RSV was reported as ‘soaring’ by the media last week. The flu is also spreading at record rates this year.
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