COVID-19 Update: Omicron BA.2 Raises Questions, FDA Limits GSK Antibody
The new normal may not be particularly new or particularly normal. Although cases of COVID-19 appear to be dropping — unless the BA.2 subvariant surges — deaths in the unvaccinated are still high. For that and more COVID-19 stories, continue reading.
As Omicron Fades, Rise of Omicron BA.2 Subvariant Raises Questions About Safeguards
For what seemed like only a matter of days, public health officials announced that the Omicron surge appeared to be fading and numerous states and cities were retracting masking guidelines and other pandemic restrictions. But now a subvariant of Omicron, BA.2, which appears to be even more transmissible than Omicron, is accounting for more than a third of global COVID-19 cases. In the U.S., BA.2 made up only 3.9% of COVID-19 infections sequenced as of February 12. But other countries have struggled with rising BA.2 infections, accounting for 92% of cases in Denmark.
Although BA.2 appears to be about 35% more transmissible than Omicron BA.1, they both seem to cause about the same level of severity, which is lower than that caused by the Delta variant. Still, fully vaccinated and boosted individuals appear to be mostly protected against severe disease and death, although they can still become infected.
“We’re looking not only at how quickly those peaks go up, but how they come down,” said Maria Van Kerkhove, an epidemiologist with the World Health Organization. “And as the decline in cases occurs … we also need to look at: Is there a slowing of that decline? Or will we start to see an increase again?”
The data, at least in the U.S., shows that even though COVID-19 cases are dropping in the country, more people are dying of the disease than during most periods of the pandemic. For the last month, there have been more than 2,000 COVID-19 deaths per day, and that recently dropped to 1,900 on Monday, February 21, although since it was a federal holiday, that might have delayed reporting. But prior to Omicron sweeping past Delta, there were only approximately 100 other days with more than 2,000 COVID-19 deaths, per Johns Hopkins University. The highest previous period was during the first winter surge. The Omicron surge has been deadlier for longer than the Delta was as well.
Dr. Stephen Threlkeld, medical director of the infectious diseases program at Baptist Memorial Health Care in Memphis, said, “I’ve long since lost track of the number of people I’ve seen die of the disease, but the reality is that almost everybody who is critically ill, in the ICU or dying now remains unvaccinated. That has been true since the beginning. But in the beginning, people didn’t have the opportunity to be vaccinated. None of us taking care of Covid patients need CDC statistics or anyone else to tell us that, because we simply see that reality play out every day and have for quite some time.”
FDA Limits GSK and Vir’s Antibody Treatment
The U.S. Food and Drug Administration placed limits on the use of GlaxoSmithKline and Vir Biotechnology’s COVID-19 antibody therapeutic, sotrovimab. Although Vir has said it maintains neutralizing activity against the Omicron subvariant BA.2, the FDA has warned against using the therapy where the common variants not susceptible to the treatment are most common. The agency and other research have suggested that BA.2 is resistant to almost all of the monoclonal antibodies that have been tested, although sotrovimab seems to work against Omicron BA.1.
CDC Suggests Longer Period Between 2 Doses of Pfizer-BioNTech & Moderna Shots for Some People
The U.S. Centers for Disease Control and Prevention has amended its guidelines on the spacing of the first two shots for the Pfizer-BioNTech and Moderna COVID-19 vaccines. They recommend that instead of the three or four weeks that has been the default in the U.S. since they first became available, some people should consider waiting up to eight weeks between the two shots. The agency indicates they are basing this change on data recommending a longer interval can create more enduring protection, especially in males ages 12 to 39 and 12- to 64-year-olds. The longer period also seems to decrease the already rare risk of myocarditis in some young men. The agency also points out that 73% of people in the U.S. 12 years and older have already received two doses of the vaccines.
MIS-C Rare in Vaccinated Teenagers
A study published in The Lancet Child & Adolescent Health found that multisystem inflammatory syndrome in children (MIS-C) is very rare in children 12-to-20 years of age who have been vaccinated against COVID-19. This was built on nine months of follow-up data in the U.S. in people aged 12 to 20 who had at least one dose of the Pfizer-BioNTech vaccine from Dec. 14, 2020, to Aug. 31, 2021. Out of more than 21 million people vaccinated in this age group, there were only 21 cases of MIS-C, and 15 were diagnosed with COVID-19 despite vaccination. Six developed MIS-C for unknown reasons.
Of the 21, all were hospitalized, with 12 requiring ICU care. There were no deaths.
“Our results suggest that MIS-C cases following COVID-19 vaccination are rare and that the likelihood of developing MIS-C is much greater in children who are unvaccinated and get COVID-19,” said Dr. Anna R. Yousaf, lead author and researcher at the CDC. “COVID-19 vaccination is recommended for everyone aged 5 years and older in the United States for the prevention of COVID-19.”