New Coronavirus News from 25 Nov 2022

One year since the emergence of COVID-19 virus variant Omicron [World Health Organization, 25 Nov 2022]

What has changed, and why there hasn’t been a new variant of concern

It was 26 November 2021 that WHO declared that the world was facing a new variant of concern: Omicron. It would go on to change the trajectory of the COVID-19 pandemic.

Emerging evidence was quickly shared by scientists from Botswana, Hong Kong and South Africa and discussed in a special meeting of WHO’s Technical Advisory Group for Virus Evolution (TAG-VE).

Experts at the meeting worried about the large number of mutations present in this variant, which differed greatly from the other variants that had been detected so far. Early data showed Omicron’s rapid spread in some provinces in South Africa and an increased risk of reinfection compared to the previously circulating variants.

Just hours later, WHO declared this new variant a variant of concern: we were dealing with something new, something different, and something that the world had to quickly prepare for.

The Omicron effect
Omicron was quickly identified as being significantly more transmissible than Delta, the preceding variant of concern. Within 4 weeks, as the Omicron wave travelled around the world, it replaced Delta as the dominant variant.

Countries which had so far been successful in keeping COVID-19 at bay through public health and social measures now found themselves struggling. For individuals, the greatest price was paid by those who were at risk of severe disease but not vaccinated, and we saw hospitalizations and deaths rise in a number of places around the world.

By March 2022, WHO and partners estimate that almost 90% of the global population had antibodies against the COVID-19 virus, whether through vaccination or infection.

Overall, though, this new variant caused less severe disease than Delta on average. Scientists worked to understand why this was so. A number of factors likely played a role. For example, the virus replicated more efficiently in the upper airway, and population immunity had been steadily increasing worldwide due to vaccination and infections.

While vaccines reduced the impact of Omicron, they themselves were impacted: studies have shown that vaccine effectiveness against infection, disease, hospitalization and death waned (though at different rates) over time. However, protection against hospitalization and death have remained high, preventing millions of people from dying.

The next variant of concern?
Since the emergence of Omicron, the virus has continued to evolve. Today, there are over 500 sublineages of this variant circulating, but not one has been designated as a new variant of concern.

So far, these sublineages of Omicron have much in common: they are all highly transmissible, replicate in the upper respiratory tract and tend to cause less severe disease compared to previous variants of concern, and they all have mutations that make them escape built-up immunity more easily. This means that they are similar in their impact on public health, and the response that is needed to deal with them.

If the virus were to change significantly – like if a new variant caused more severe disease, or if vaccines no longer prevented severe disease and death – the world would need to reconsider its response. In that case, we would have a new variant of concern, and with it, new recommendations and strategy from WHO.

WHO, together with scientists and public health professionals around the world, continues to monitor the circulating variants for signs of the next variant of concern. However, there is apprehension because testing and sequencing are declining globally and the sequences that are available aren’t globally representative (most sequences are shared from high-income countries).

WHO and partners also remain concerned that surveillance at the human-animal interface is limited, where the next variant of concern could come from.

While it might be difficult to stop a new variant from emerging, quick detection and information sharing means its impact on our lives can be minimized.

WHO remains grateful to public health professionals around the world for their continued surveillance of the COVID-19 virus and the sharing of sequences and analyses.

China COVID cases at record high as iPhone city on lockdown [Axios, 25 Nov 2022]

By Rebecca Falconer

China has recorded the highest number of COVID-19 cases since the pandemic began, as Beijing authorities lock down more areas this week — including parts of the central city Zhengzhou, where Apple's main iPhone factory is located.

The latest: China hit a new daily record for a second straight day on Friday as authorities moved to enforce restrictions in an attempt to control outbreaks across the country, per Reuters.

State of play: Beijing eased some pandemic measures earlier this month, including reducing quarantine periods, in an attempt to cause less disruption to the world's second-largest economy.

• However, authorities are now moving to cordon off major cities "block by block" and introducing other curbs while conducting mass testing in an attempt to curb surging COVID cases, Bloomberg reports.
• It's triggered panic-buying in parts of Beijing, and grocery stores the capital's largest district, Chaoyang, have stopped accepting orders due to delivery apps being inundated with requests, according to Bloomberg.

Meanwhile, some 6.6 million Zhengzhou residents were affected by five-day stay-at-home orders that began Thursday — including the area where Apple manufacturer Foxconn's factory is located and where police in hazmat suits clashed with workers following a pay dispute Tuesday and Wednesday, AP reports.

Of note: Chinese President Xi Jinping's zero-COVID policy has already increased wait times for Apple's newest iPhone 14 Pro models as fresh restrictions in China hamper production during the tech giant's most crucial time of the year, the holiday quarter, Axios' Hope King writes.

• Foxconn issued a statement earlier this month that it was "operating at significantly reduced capacity."

By the numbers: China's National Health Commission said Thursday 31,454 local COVID cases were recorded within the past 24 hours.

• That broke the previous record set in April when financial hub Shanghai was on lockdown when 29,390 COVID cases were recorded, AFP notes.
• On Friday, Reuters reports that the NHC recorded 32,695 domestic infections.

The big picture: Nearly three years into the pandemic, China is the last major economy to have retained the strategy of trying to keep out the virus by imposing strict measures such as lockdowns and quarantines.

• Outbreaks of defiance from citizens against the sustained strict measures first emerged earlier this year, with spasmodic protests erupting in the face of food shortages, family separations and lost wages from lockdowns.
• It's also impacted the country's economy, along with global business, though China's gross domestic product grew 3.9% from a year earlier in the third quarter of the year.

Yes, but: Activity is slumping and growth is set to fall far short of the ruling Chinese Communist Party's 5.5% target, AP notes.

China Covid Latest: Beijing Scenes Show Residents Fear of Going Out [Bloomberg, 25 Nov 2022]

Fear of Quarantine Camps, Not Covid, Is Shutting Beijing Down
• Stores are fully stocked but residents fear in-person shopping
• People voluntarily stay home to reduce their risk of exposure

There are serious ramifications to being exposed to Covid-19 in China -- and not just infection.

As the country confronts its biggest outbreak ever, residents in major cities are hunkering down because of the prospect of being sent to a quarantine camp or locked down at home.

Going out in the capital of Beijing means having to scan a QR code to enter venues like shops and restaurants, or to even take public transportation. Under the country’s ubiquitous contract-tracing surveillance system, visiting the same places as someone who later turns up infected can land you in a government isolation facility, where conditions can be so poor that some people say they are buying chamber pots and portable tents in preparation.

Omicron BQ Covid variants, which threaten people with compromised immune systems, are now dominant in U.S. [CNBC, 25 Nov 2022]

By Spencer Kimball

• The omicron BQ coronavirus subvariants have risen to dominance in the U.S. as people gather and travel for the Thanksgiving holiday, putting people with compromised immune systems at increased risk.
• BQ.1 and BQ.1.1 are causing 57% of new infections in the U.S., according to CDC data.
• The BQ subvariants are likely resistant to key antibody medications used by people with compromised immune systems, putting them at increased risk.
• The more immune-evasive XBB subvariant is also circulating at a low level.

The omicron BQ coronavirus subvariants have risen to dominance in the U.S. as people gather and travel for the Thanksgiving holiday, putting people with compromised immune systems at increased risk.

BQ.1 and BQ.1.1 are causing 57% of new infections in the U.S., according to data published by the Centers for Disease Control and Prevention on Friday. The omicron BA.5 subvariant, once dominant, now makes up only a fifth of new Covid cases.

The BQ subvariants are more immune evasive and likely resistant to key antibody medications, such as Evusheld and bebtelovimab, used by people with compromised immune systems, according to the National Institutes of Health. This includes organ transplant and cancer chemotherapy patients.

There are currently no replacements for these drugs. President Joe Biden, in an October speech, told people with compromised immune systems that they should consult with their physicians and take extra precautions this winter.

“New variants may make some existing protections ineffective for the immunocompromised. Sadly, this means you may be at a special risk this winter,” Biden said.

The XBB subvariant is also circulating at a low level right now, causing about 3% of new infections. Chief White House medical advisor Dr. Anthony Fauci, in a briefing Tuesday, said XBB is even more immune evasive than the BQ subvariants.

Fauci, director of the National Institute of Allergy and Infectious Diseases, said the new boosters, which were designed against omicron BA.5, probably aren’t as effective against infection and mild illness from XBB. But the shots should protect against severe disease, he said. Singapore saw a spike in cases from XBB, but there wasn’t a major surge in hospitalizations, he added.

Moderna and Pfizer said last week that their boosters induce an immune response against BQ.1.1, which is a descendent of the BA.5 subvariant.

Fauci, in the press briefing, said public health officials believe there is enough immunity from vaccination, boosting and infection to prevent a repeat of the unprecedented Covid surge that occurred last winter when omicron first arrived.