Here’s what you need to know about the COVID XBB.1.5 “Kraken” variant.

Here’s what you need to know about the COVID XBB.1.5 “Kraken” variant.

Here’s what you need to know about the COVID XBB.1.5 “Kraken” variant.

The family tree of the omicron variant has grown significantly over the past year. The offspring now includes a sub-variant soup with alphanumeric names such as BA.2, BA.5 and BF.7. The U.S. Centers for Disease Control and Prevention estimates that two versions—BQ.1 and BQ.1.1—caused just over half of new infections in the United States in the week ending January 7.

Now, a newcomer dubbed XBB.1.5 seems poised to claim dominance. According to CDC estimates, it accounts for more than 80 percent of new cases in parts of the Northeastern United States. In the week ending January 14, it was responsible for 43 percent of new cases nationwide.

But while previous variants such as alpha, delta, and original omicron have been linked to massive surges of new infections, it’s not yet clear whether XBB.1.5 is destined to follow a similar path (SN: 21.12.21). Preliminary evidence suggests that the minor variant, dubbed Kraken in some circles, is more infectious than its predecessors. However, this feature is a hallmark of viral evolution – successful new variants must be able to outperform their siblings (Serial number: 26.05.20).

For now, experts from the World Health Organization are keeping a close eye on XBB.1.5. But it’s too early to say if it can take over the world. Most cases now come from the US, UK and Denmark.

Scientific news spoke with infectious disease specialist Peter Chin-Hong of the University of California, San Francisco about the latest variant of the coronavirus making headlines. The conversation has been edited for length and clarity.

SN: What is the difference between XBB.1.5 and earlier versions of omicron?

Chin-Hong: There are many variants that are produced all the time. This is normal for a virus because the virus makes more copies of itself. It’s not exactly precise or accurate, so it makes mistakes, [which are the variants]. It’s a bit like a bad photocopier in the office.

XBB, XBB.1.5’s sibling, was scary – and it was evident in fall 2022 – because it was one of the most immune-evasive variants. But the reason XBB never spread globally – it actually did in Singapore and India – was because it didn’t really infect cells that well.

XBB.1.5 has the immune immunity of XBB, but it also has this new mutation that makes it easier to infect cells. So it’s kind of like a bulldog that won’t let go of the cell. Whereas XBB was a bit invisible, as if he had an invisibility cloak Harry Potterhe had no bite. But XBB.1.5 has invisibility cloak and bite.

SN: Is that why it is spreading so effectively in certain areas?

Chin-Hong: We think so. Because being very effective at infecting cells is a really important superpower if you’re a virus.

You can be invisible [to the immune system] all you want, but if you’re not effectively infecting the cells, you probably won’t be as infectious. It could be [the reason] XBB.1.5 is spreading because it combines both. Seeing it crowding out other variants, we’re concerned that this is something to look out for. This is accompanied by a growing number of cases and hospitalizations.

SN: Previous variants were associated with large waves of infection. Can we expect the same from XBB.1.5?

Chin-Hong: It’s complicated. If this were March 2020, the answer would be a very simple yes. But in January 2023, you have such a wide variation in the amount of experience people have with COVID, even if it’s a different type.

You may have someone who has been infected two or three times and has also been vaccinated and given a booster. It will be someone who will be really well protected against serious illness. Maybe they’ll catch a cold. Maybe they wouldn’t even know they had an infection compared to someone who hasn’t been vaccinated and never been exposed, and they’re older. For them, it might as well be March 2020.

This [second] the type of person is, for example, in China. In China, XBB.1.5 can cause many problems. But XBB.1.5 going, you know, to the middle of Manhattan might not cause as many problems in a highly vaccinated and vulnerable group of people.

[Timing also matters] because we’ve seen a lot of BQ.1, BQ.1.1 lately and a lot of people got infected after Thanksgiving. This increase in XBB.1.5 comes after many people have been infected recently. So it probably won’t do as much damage as if you had a long break and suddenly you have this new thing.

Serial number: Do vaccines and treatments still work against it?

Chin-Hong: The new updated boosters generally perform slightly better than the old vaccines in terms of overall effectiveness and infection prevention. But with these new slippery variants like XBB.1.5…if you want to prevent infections, even mild infections, vaccines will probably last maybe three months.

But if you’re talking about preventing death or going to hospital, these vaccines will give me a shot of protection for many, many months, probably until next winter for most people. For the elderly, older than 65, if they are not strengthened today, it is a problem.

[Drugs such as] Paxlovid and remdesivir work independently of the spike protein [the part of the virus targeted by vaccines but where many of the defense-evading mutations are (SN: 3/1/22)]. So it doesn’t matter what invisibility cloak a variant has. They’re going to work because they’re working to shut down the virus factory, which is one of the first steps before the spike protein is created.

So they will work no matter what [spike] a variant comes up, which is a good thing. Even if you have not been vaccinated or have never been exposed, if you are diagnosed and given early treatment, it will significantly reduce the number of hospitalizations.

Now all monoclonal antibodies don’t work. [The virus has changed too much (SN: 10/17/22).]

Serial number: Why are there only omicron variants?

Chin-Hong: I think omicron hit on a magic formula. It will be hard to push him off the podium to the gold medal. He is so good at transmission and all the other aspects that are good for the virus.

in [earlier] days, two, three months have passed and a new variant of the coronavirus has appeared somewhere in the world. Now it’s an omicron from two Thanksgivings ago.

Serial number: With each variant more infectious than the previous one, is it inevitable that everyone will get COVID?

Chin-Hong: People who have not been infected before will have a really hard time escaping this. But it’s not impossible. It’s just going to get harder, not only because XBB.1.5 is so portable, but also because we don’t have so many constraints anymore. You go to the grocery store, no one wears a mask, or you don’t feel peer pressure to wear a mask. So you will be exposed as you are exposed to the common cold….

But you can reduce your risk in the short term by getting a booster if you haven’t already. And, of course [the booster] can reduce your risk of dying, especially if you are elderly or immunocompromised…

[People still wearing masks] they must wear really good quality masks [such as KN95s] because you can no longer rely on everyone wearing masks.

Serial number: How much should people worry about XBB.1.5?

Chin-Hong: The world is divided into two groups of people. People whose bodies are very, very experienced in the fight against COVID – they have received vaccines, boosters or … several infections. There are also people whose body is not well experienced with COVID. For it [latter] groups should be worried.

For someone, you look around and your neighbor has it and nothing happened, or your cousin or someone at work and it’s like it’s not a big deal. But in the United States, 500 people die every day [from COVID]. And for these people, it’s a big deal….

It’s a strange situation because it’s no longer universal and different people have different levels of risk.

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