A new coronavirus variant is spreading in many parts of the world.
The variant NB.1.8.1 has been identified as the cause of the COVID-19 resurgence in China and several other Asian countries. Experts in Europe are predicting a possible increase in cases there.
A summer wave could also occur in the United States. According to the US Centres for Disease Control and Prevention, NB.1.8.1 already represents about one-third of new coronavirus cases as of June 7. This is a significant increase from just a month before, when the new variant represented just 5% of new coronavirus cases.
Could another summer wave occur? Do current vaccines still work, and if so, who should consider getting another dose now? And what precautions should people take to reduce their risk of contracting Covid-19?
According to a CNN Health report, wellness expert Dr. Leana Wen is an emergency physician and clinical associate professor at George Washington University. Wen previously served as Baltimore’s health commissioner.
What should people know about the new coronavirus variant?
The SARS-CoV-2 virus is constantly mutating, and new variants are expected. The more opportunities the virus is given to spread, the more opportunities it has to mutate.
Every time a new variant appears to be outcompeting previous strains, it’s important to ask three questions: Is it causing more severe disease, is it more contagious, and do existing vaccines still work against it?
This new variant, NB.1.8.1, also called Nimbus, is a descendant of the Omicron strain. The World Health Organisation has deemed the new strain a “variant under monitoring.” However, WHO also reports that surveillance data do not show increased severity compared with previously circulating variants. Given that this strain is outcompeting previous variants, it’s possible that it could be more contagious. Still, there is nothing to suggest that it is being spread differently compared with past variants.
The answer to whether existing vaccines work against this variant is not known. WHO cites laboratory data showing that it could have some immune escape, which means it may be less responsive to the immunity provided by vaccines or prior infection, suggesting a possible reduction in vaccine efficacy. At the same time, NB.1.8.1 is a close descendant of other strains against which the vaccines have efficacy.
I expect more data will be available in the coming weeks, as federal health officials will soon decide the formulation of this fall’s updated COVID-19 vaccine. Knowing that NB.1.8.1 constitutes a growing proportion of cases, they will most likely try to ensure that the formulation has efficacy against this variant.
Symptoms of N.B.1.8.1 infection
The symptoms appear to be similar to infection with other variants. There is an extensive range of symptoms and severity. Some patients may have allergy-like symptoms like a stuffy and runny nose. Others may have cold- or flu-like symptoms, with fever, sore throat, fatigue, headache, and muscle or body aches. Some people may develop a cough and difficulty breathing. Some may have nausea, vomiting, or diarrhoea.
While most people will recover, some could become severely ill and require hospitalisation. Some individuals contracting COVID-19 may also develop the post-viral condition known as long COVID.
Could another summer wave really happen again?
Yes. It could be triggered by a new variant that’s more contagious and has some degree of immune escape. A wave could also occur simply because of declining population immunity. Some experts believe this new strain, combined with less recent COVID-19 activity, could start a wave in the next few months.
From several years of experience with COVID-19, we have seen that infections tend to come in waves. A surge in cases leads to many people falling ill, then recovering and developing short-term immunity to infection. Infection rates decline for several months, then begin to increase again.
Summer waves of COVID-19 have occurred over the past few years. It’s certainly possible that the pattern repeats this year.
Who should consider getting the vaccine now instead of waiting for the fall formulation?
This is a difficult question because the landscape around Covid-19 vaccination has changed. Last month, US Health and Human Services Secretary Robert F. Kennedy Jr. announced that COVID-19 shots are no longer recommended for healthy children and pregnant women. These shots still appear accessible to children; for instance, the CDC’s guidance now reads that children can get them after consulting their health care provider. However, there are already reports of pregnant women having more difficulty obtaining these vaccines.
This and other guidance could soon change, as Kennedy has reconstituted the panel of external experts who advise the CDC on vaccine recommendations. This new panel could make different decisions during their upcoming meeting in late June. Another uncertainty is when a new round of vaccines will be made available.
One way to approach this decision is to consider your risk of severe outcomes if you were to contract COVID-19. If eligible, those 65 and over or with chronic underlying medical conditions should consider getting another dose of the vaccine now. That way, they have additional protection in case of a summer wave since the existing vaccine probably retains some efficacy against the new variant. And they can still get another dose in the fall when the new formulation is presumably released.
Younger and generally healthy people, some of whom have not yet received the 2024-25 formulation, may consider getting the vaccine before the guidelines change and may no longer be eligible. People should discuss their specific medical situations with their primary care physician.
What precautions should people consider to reduce their risk of contracting this variant?
The same precautions we’ve discussed throughout the COVID-19 pandemic still apply. This respiratory virus could be airborne, so be on guard, particularly in crowded indoor settings.
People especially vulnerable to severe disease should try to avoid these settings. If they need to go into a crowded train station, for example, they should consider wearing a well-fitting N95 or equivalent mask.
Those visiting vulnerable individuals may wish to avoid higher-risk settings in the days before the visit to reduce the chance of spreading not only COVID-19 but also other respiratory illnesses.
