What to know about dominant COVID-19 strains BQ.1 and BQ.1.1

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A health information sign on the COVID-19 coronavirus outbreak is seen outside of a Walgreens in Wheeling, Ill., Thursday, April 2, 2020. (AP Photo/Nam Y. Huh) Nam Y. Huh/AP

What to know about dominant COVID-19 strains BQ.1 and BQ.1.1

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The new coronavirus subvariant BQ.1 and its sibling BQ.1.1 account for the majority of COVID-19 infections in the United States, though so far concerns that the new variants could fuel a winter resurgence in case counts have yet to materialize.

The two, which descended from BA.5, an omicron subvariant, now collectively account for over 62% of COVID-19 cases circulating in the U.S., according to data from the Centers for Disease Control and Prevention. Meanwhile, BA.5, which had been the dominant strain for months until November, only makes up roughly 13% of cases.

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Health officials say there is not much known about the two subvariants, though limited data suggest it is highly transmissible and symptoms appear similar to those of earlier omicron strains.

While it may be easier to get infected, the new subvariants do not appear to be increasing the severity of illnesses compared to earlier omicron strains, which in turn were judged to be significantly less severe than the previous strains of the coronavirus.

Officials are warning that people with weak immune systems could be at more risk, as current COVID-19 antibody therapies are not as effective against BQ.1 and BQ.1.1.

Earlier this week, the Food and Drug Administration ended its emergency authorization for Eli Lilly’s bebtelovimab, which was used to treat people with compromised immune systems who caught COVID-19, citing that it’s not as effective against the emerging omicron subvariants.

Other treatments, such as the antiviral Paxlovid, remain available, though some patients might not be able to take advantage of the treatment, such as transplant recipients who cannot take it at the same time as their other medications.

The protection offered by updated COVID-19 booster shots against the newer strains has also slightly diminished, as they were designed to target subvariants BA.4 and BA.5, though officials have said that they continue to offer an added benefit over previous shots, particularly against severe illness.

“These subvariants — obviously, we’re tracking them very closely. The good news is, even if you see a diminishing of our vaccines, they’re still effective against these subvariants — way more effective than the original vaccine,” said Dr. Ashish Jha, the White House coronavirus response coordinator, in a press briefing last week. “There’s always a caveat here of, like, you know, things out of left field, you can’t predict and you can’t — but nothing I have seen in the subvariants makes me believe that we can’t manage our way through it effectively, especially if people step up and get their vaccine.”

Pfizer-BioNTech said last month that its updated booster offers more protection against newer omicron subvariants, including BQ.1.1, than its original COVID-19 vaccine.

As the coronavirus pandemic evolves, case counts in the U.S. have remained relatively low over the past few weeks. As of Nov. 30, there were over 303,000 current COVID-19 cases, roughly half the number of cases reported at the same time last year, according to the CDC.

Weekly deaths from COVID-19 have recently been trending down, with 1,780 deaths reported for the week ending Nov. 30. Last year, over 7,000 deaths were recorded for the same period.

Other respiratory viruses are on the rise, including the flu and the respiratory syncytial virus (also known as RSV), leading to overcrowding in some hospitals across the country.

Health officials are encouraging people to get their updated COVID-19 boosters, cautioning that trends could change like they did last winter, when cases jumped up with the emergence of BA.4 and BA.5, as uptake remains low for the new omicron shots. Only 12.5% of people ages 5 and older have gotten an updated booster shot as of Dec. 1.

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“Please, for your own safety, for that of your family, get your updated COVID-19 shot as soon as you’re eligible to protect yourself, your family, and your community,” said Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, last week in his last appearance at the White House.

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