COVID’s comeback tour?

NICK EICHER, HOST: Up next: the COVID-19 subvariant helping to drive an uptick in new cases.

MARY REICHARD, HOST: It doesn’t have the catchiest name: BA.2.12.1. That’s what scientists are calling the latest omicron subvariant now set to become the dominant strain in the United States.

COVID cases have been on a steady rise since about the first of April. Hospitalizations are also up a bit. The good news is that deaths continue to decline.

EICHER: Will that remain the case? And could this subvariant—or another—again disrupt American lives that have mostly returned to normal?

Here to help us answer those questions and others is Zach Jenkins. He’s a pharmacist who specializes in infectious diseases.

REICHARD: Good morning, Zach!

ZACH JENKINS, GUEST: Good morning.

REICHARD: Well, this subvariant—we’ll just call it BA212— is not the first spinoff from omicron is it? This is a subvariant of a subvariant. Do I have that right?

JENKINS: You do have that right and this is where it gets pretty complicated. A lot of the virologists out there tend to drive people in my world of infectious disease a little crazy sometimes with all these different naming schemes that are out there. The big thing that we're seeing here, though, these are slight modifications to existing variants. That's the way to think about these. Once you deviate really far, that's when they actually will kind of title it with a new variant name.

REICHARD: And how does this latest subvariant differ, if at all, from earlier strains in terms of symptoms? What symptoms should you look for with this variant?

JENKINS: It’s really similar to Omicron in general, as far as how it presents with people. What you'll see is more upper respiratory infections. So that's the contrast, that kind of presentation with the earlier strains of COVID, which tended to manifest more in the lower bases of the lungs and cause more pneumonias. So what you see in these cases, especially early on, are runny nose, sore throat, and sneezing, which, unfortunately, if you think about the time of the year that we're in, we see a lot of that with pollen. We see a lot of that, even with the flu right now, actually. Flu is happening around the country a little bit out of season. So it's kind of throwing off our efforts to try to diagnose and triage people.

REICHARD: BA212 looks to be about 30 percent more infectious than the last subvariant did, according to reports. But again, deaths are not up. In fact, they’ve continued to decline. So can we deduce that the subvariant is less virulent? Less dangerous?

JENKINS: So I think it's important to probably differentiate between severity of illness and virulence. So, virulence we typically think of as almost viral fitness. So when something's more virulent, it means it's going to spread faster, and be more effective at surviving in the elements in the world. In contrast, what you kind of see with severity is when you have a more severe virus, it tends to fizzle out. So in those particular instances, you actually have things that become very deadly, not really transmit very far. We saw that pretty early on with early strains of COVID. But now we're dealing with things that are spreading more rapidly, so they're better as far as viruses go. The downside is, as things change, there's always this possibility that we could have situations where some of our immunity or some of our therapeutics that we have may not work as effectively.

REICHARD: Professor, some experts say we’re seeing a familiar pattern here, that as viruses continue to mutate, they often become more contagious but less virulent. Is that typical? And is that what we’re seeing here?

JENKINS: I think absolutely, that's the pattern that we're following. This is becoming more contagious. The biggest hiccup I would say in all of this is unlike what you might see normally with the flu, where the previous generation sort of informs the next generation to come. With COVID We actually have a couple of major lineages that we've dealt with. Delta is actually a very different offshoot than what we're seeing with Omicron. So our hope would be we see this progression where it spreads more rapidly and causes less and less severe illness. And while that trajectory is heading that direction, there's always this possibility, though, that you could have something else kind of spiral out and present something a little bit more severe.

REICHARD: How much protection do the Covid shots and boosters provide against this subvariant?

JENKINS: So that's a great question. What we do know based on the data that we have thus far is natural exposure, natural infection tends to actually last somewhere about a year and most people before we see antibodies decline. And then when you see that in comparison with the vaccinations, at least a two shot regimen tends to last about six months before declined. So natural immunity might be a little bit more favorable in some instances. However, the best immunity seems to be when you combine the two. That actually supersedes both in length. That being said, there's going to be some breakthrough infection you're going to see at some point. There have been reports of this happening in both cases—with natural infection and with vaccinations. I think the big difference here is that severity of illness protection still remains. So you may have symptomatic cases, but they won't necessarily be as severe.

REICHARD: What do we know about this subvariant in other countries?

JENKINS: So, South Africa is probably one of the best places to look at. They've actually dealt with a lot of the various Omicron variants. The two that they're currently dealing with are actually not the one that we're projecting maybe the dominant one in the U.S. They're dealing with ba4 and ba5, and they're actually seeing cases skyrocket in relation to those. We do have those present in the U.S. right now. They really don't have much of a foothold, though, at least based on our current data. Looking at South Africa, broadly though, we do know that while hospitalizations are maybe rising and cases certainly are rising, deaths are still decoupled from that. And what that means is deaths have remained relatively low compared to other waves of the coronavirus that we've dealt with.

REICHARD: We can’t ask you to predict the future, but do you think the days of our lives being turned upside down by COVID are at least probably behind us for the foreseeable future?

JENKINS: At least with the current iteration of the virus that we're dealing with the U.S., I would say yes. It was always a balance between short term public health and long term public health consequences. And we're at a point now where the balance sheet doesn't look very favorable for long term consequences with short term gain. So we're not more than likely going to see any major closures or lockdowns like we saw before. But if you look at other parts of the world that did those things, and almost had a zero COVID approach—China is a great example—they're having huge spikes right now. And it's so problematic, in fact, they don't really have all the measures in place to deal with it. So we probably won't see it in the U.S., but other parts of the world are seeing that right now.

REICHARD: Zach Jenkins is a pharmacist and pharmacology professor at Cedarville University, a Christian college in Cedarville, Ohio. Zach, thanks so much for joining us today!

JENKINS: Thanks for having me.

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