This latest covid variant could be the best yet at evading

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This latest covid variant could be the best yet at evading immunity
By Fenit Nirappil
August 25, 2023 at 6:00 a.m. EDT
Experts say the rise of BA.2.86 is more of a subject for scientific scrutiny than public panic. (John Minchillo/AP)

A highly mutated form of the coronavirus that threatens to be the most adept yet at slipping past the body’s immune defenses is capturing the attention of virologists and health officials.

While only about a dozen cases of the new BA.2.86 variant have been reported worldwide — including three in the United States — experts say this variant requires intense monitoring and vigilance that many of its predecessors did not. That’s because it has even greater potential to escape the antibodies that protect people from getting sick, even if you’ve recently been infected or vaccinated.

The latest variant does not appear to make people sicker than earlier iterations of the virus; antiviral treatments should still work against it and tests should still detect it, according to a risk assessment published Wednesday by the Centers for Disease Control and Prevention. It’s too soon to know whether the updated booster formula expected to come out next month that targets a different subvariant would be effective against this highly mutated one.

If this feels familiar, it should.

What to know about covid-19 this fall
Today, the latest on covid-19 and other viruses on the horizon, and how to protect those most at risk this fall.

After igniting a global explosion of cases in the winter of 2021-2022, the highly contagious omicron variant spawned a slew of immune-evading descendants. Most fade into irrelevance. Others, such as the XBB lineage accounting for most U.S. cases this year, outcompete the rest with their transmissibility and ability to infect — and reinfect. Nearly every announcement of a new variant came with reassurance from public health officials that it did not cause more severe illness.

But BA.2.86 stands out in the omicron family tree because of how much it has morphed. It has more than 30 mutations on its spike protein, the part of the virus that pierces through the cell and that vaccines train the body to fend off. Experts believe the antibodies forged through battles with earlier variants will have a difficult time recognizing this new foe.

“This is a radical change of the virus, like what happened with omicron, which caught a lot of people defenseless,” said Eric Topol, director of the Scripps Research Translational Institute. “Even if they had a vaccine or prior infection, it could still get into them and infect them again or for the first time. We are facing that again.”

The biggest unknown is whether the BA.2.86 will be transmissible enough to cause a surge. A variant adept at evading immunity would not take off in a population if it does not spread efficiently and multiply.

“It is still a possibility we either see this variant spread very widely as happened with the original omicron,” said Jesse Bloom, a computational biologist who monitors coronavirus variants at the Fred Hutchinson Cancer Center in Seattle, “or it doesn’t end up spreading very widely and we continue to have these XBB variants.”

Experts have paid close attention to Bloom’s analysis of BA.2.86, which stressed that the evolutionary jump is on par with the one that gave rise to omicron.

Officials say they should have a clearer understanding of the variant’s transmissibility in the coming weeks as surveillance ramps up in response to the threat.

On Aug. 12, virologists in Israel were the first to announce that BA.2.86 had been detected in a patient. Scientists in Denmark, Britain, South Africa, Switzerland and Thailand soon followed. Some of the samples were collected in late July. The sporadic reports add up to evidence of international transmission, but the magnitude is unclear.

In one Swiss town, roughly 2 percent of coronavirus particles sequenced in a wastewater sample taken in early August were BA.2.86 variants. That was the first sign of a variant spreading within a community.

“Finding BA.2.86 in yet an additional country — now in wastewater rather than a patient — is another piece of evidence that BA.2.86 is globally widespread by now,” Tanja Stadler, a professor at the Swiss Federal Institute of Technology who announced the findings, wrote in an email. “It is still too early to tell if this variant will cause a major wave.”

The United States is experiencing an uptick of cases believed to be driven primarily by XBB and the new EG.5 variant, but several BA.2.86 cases have been announced in the past week. One of the BA.2.86 cases was discovered in Michigan in an older adult who was not hospitalized, while another was detected in a traveler arriving at Dulles International Airport in Virginia. A third case was detected in an Ohio wastewater sample.

Areas where BA.2.86 have been detected have not seen disproportionate increases in hospitalizations, the CDC said, suggesting it’s not more likely to cause more severe illness than other omicron subvariants.

What to know about covid boosters, RSV vaccines and flu shots this fall

Even if variants are adept at escaping antibodies to enter cells, those antibodies are just the front lines of the immune system, which has other mechanisms to fight off the virus and keep the infection less severe. It’s like a teenager who can sneak past a bouncer to get into a club but gets thrown out by security before causing trouble. When omicron struck, a huge swath of the country lacked immunity because they never had covid or had not been vaccinated — but that’s no longer the case.

“Nearly all the U.S. population has antibodies to SARS-CoV-2 from vaccination, previous infection, or both, and it is probable that these antibodies will continue to provide some protection against severe disease from this variant,” the CDC said in its risk assessment of BA.2.86 this week. “This is an area of ongoing scientific investigation.”

BA.2.86 poses a public health messaging challenge. For a year and a half, headlines announced new omicron subvariants with alphanumeric names that resemble preset WiFi passwords, accompanied by similar descriptions of immune evasion without causing severe illness. Officials worry about a covid-fatigued public tuning out news of a variant that could pose a serious threat. It’s only been a few weeks since EG.5 captivated public attention, even though it’s not all that different from its XBB cousin.

The rise of BA.2.86 has raised concerns about declining visibility into the evolution of the virus. Genetic sequencing is necessary to track variants but these efforts have been pared back globally. GISAID, a global data sharing initiative for the coronavirus, has seen specimens collected for genetic sequencing plunge from 425,000 in August 2022 to 38,000 last month.
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