Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week.
Hoping these posts help to educate and empower you
to be healthy and create healthy communities.
Today’s Three Things Thursday is inspired by a conversation I had with one of the reporters at Erie News Now where I am an exclusive contributor (shout out to Ethan!). While on Zoom earlier this week, it felt like déjà-vu. We were together again for the second time in five days talking about the XBB.1.5 subvariant. Aside from the fact that we were wearing different clothing, we were having the same conversation.
It was a Groundhog’s Day moment1 — we were reliving the same conversation over and over again. And it was the same conversation we had with BA.1, BA.4, BA. 5, and other subvariants. The news cycle related to new subvariants goes something like this… the virus evolved, it now spreads easier from person to person, there’s an uptick in cases and hospitalizations, and then the next subvariant is on the scene.
Repeat.
Repeat again.
And again. Repeat.
Each new subvariant is unique in terms of its genetic structure and how it moves from person to person and within our bodies. These are scientific discoveries. This is scientific news (not always public health concern). And in the days before prepublications were shared online and on Twitter, this scientific news would be shared through peer-reviewed journals or CDC’s Morbidity & Mortality Weekly Report (aka the MMWR). It would rarely make it to your TV sets or newspapers.
But now, each discovery is discussed on Twitter, picked up by the news, and discussed ad nauseam. It is becoming harder and harder to determine if the news being shared is the discovery of just a new subvariant or a warning that something is up and COVID is of more concern.
Is it just scientific discovery news? or is this news that impacts our health?
We — the public — need a guide to help us understand the information that is being presented to us about new variants and subvariants and variants of concern and how that information can be used to make healthy decisions.
Today’s Three Things Thursday is that guide —
The first thing to know — new forms of the SARS-CoV-2 virus (new variants, subvariants, or strains) are going to continue to arise. The virus is going to continue to evolve as it jumps from person to person, and we all develop immunity (from vaccines and infections). And public health researchers are going to continue to conduct genomic surveillance of the virus — the lab techniques used to identify the variant/subvariant.
When you hear of a new subvariant, this is not an immediate cause for concern. This does not mean another lockdown is coming or masks need to be worn 24/7. We are actively following the virus’s evolution and we know that it will change.
News of a new subvariant is the report of a discovery. Not an alarm bell.
Second, the XBB.1.5 is the most transmissible form of the SARS-CoV-2 virus we’ve seen. It is quickly spreading across the U.S. Nearly 1 in 5 cases of COVID diagnosed during the past week were caused by XBB.1.5 (up from less than 4% in December 2022). And this may result in the next wave of cases ( though right now case counts in the U.S. are actually down by 2%).
Viruses evolve (or change/mutate).
And it is advantageous for a virus (in order to stay alive) to easily pass from one host (a person) to the next with ease.
Reading that the new subvariant is more transmissible is expected.
When a headline reads it is the most transmissible form of the virus yet, your response should be —
“This is what we expected.”
Again, news about increased transmissibility is a discovery. NOT an alarm bell.
I cannot answer why each new subvariant becomes the source of so many news broadcasts, articles, tweets, or discussions — other than news of these discoveries is shared publicly through websites and social media.
How do we digest all of the information about new subvariants?
Is there a way to discern a discovery from an alarm bell?
How do we stay healthy? protect our families? and still, live our lives?
How do we not get bogged down by the alphabet soup of COVID subvariants that monopolize the headlines?
There is no simple answer, but here is what I propose we all do —
First, we acknowledge that new subvariants with increased transmissibility are to be expected. When the newest one is discussed in the news, we acknowledge it as a discovery. It is NOT an alarm bell.
Second, we must recognize the difference between a report of a discovery from a public health concern. When there is evidence that a new subvariant is able to completely evade our immune system, is more virulent (aka causes more severe disease), or cannot be diagnosed by our current PCR or rapid/antigen tests, then — and only then — should we begin to think about the new subvariant as a public health concern.
Finally, finding a middle ground between complete ignorance and absolute fear is necessary.
This means we must understand what is expected from the virus and that discoveries will be reported. The virus will evolve. And most new forms of the virus (variants/subvariants) will be more transmissible. If those discoveries are reported or are a headline, there is no reason to fear. But we should be listening for evidence that the virus is evading our immune system, causing severe disease, or is undetectable by current testing methods.
If there is evidence of any one of those three things, then we can treat the news as a public health concern.
And we should look toward trusted sources of public health information for guidance.
In terms of XBB.1.5, yesterday the WHO “reserved judgment” ~ saying there is not enough evidence to know whether XBB.1.5 will erode vaccine protection or trigger more severe disease. And there is a lot of evidence out there (including studies published just this week) that vaccines are working to prevent severe disease and to keep people out of the hospital.
Given all of that — (at this point in time) XBB.1.5 is a discovery.
With the information we know now, I do not feel there is a reason to fear; our concern about COVID does not need to change (people are still getting sick, vaccines work, and being vaccinated + previous infection is the best way to avoid infection and severe disease).
At this point in time (despite all the news about XBB.1.5), the SARS-CoV-2 virus is doing what we expect it to do.
And this could all change tomorrow. Or not.
There is no virus crystal ball (much to my disappointment).
Finding a reliable source of public health information is key. Be sure you are subscribed here so that if things do change and the news moves from discovery to public health concern you will get that information and advice for responding to it.
If you have questions, please let me know.
And be sure to share this with your friends & family.
If you haven’t seen the movie (from 1993), watch it now. It stars Bill Murray, who plays Phil Connors, a cynical television weatherman covering the annual Groundhog Day event in Punxsutawney, Pennsylvania. He becomes trapped in a time loop, forcing him to relive February 2nd repeatedly.