How omicron subvariants are causing a surge in COVID infections

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• Geoff Bennett:

  COVID cases are spiking in many parts of the country and hospital admissions have doubled since May, that's according to the CDC. This latest COVID surge is being driven by two new Omicron subvariants. The CDC estimates that together the BA.4 and BA.5 subvariants represent more than 80% of U.S. cases. And vaccination or prior infection does not guarantee protection from the subvariants.

  Joining us now to discuss all of this and what role vaccines play in this latest surge is Dr. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. It's great to have you with us.

  And in the time since we've had a COVID vaccine, I think the only silver lining to catching COVID was that you likely wouldn't catch it again. But that seems to no longer be the case, especially with this latest Omicron subvariant. What accounts for that?

  Dr. Peter Hotez, Baylor College of Medicine: Well, what's happening, Geoff, is if you've had Omicron infection in the past and a lot of Americans have because during that big spike in January, there were roughly a million new cases a day according to some estimates, that is not conferring protection against the BA.5 reinfection. So the other name for Omicron is BA.1. BA.1 is not conferring protection against BA.5 necessarily unless you've been vaccinated on top of it, or unless you've also gotten vaccinated and boosted, preferably boosted twice. So that's what's really needed to combat this new BA.5 variant is to max out your vaccinations. And that does seem to be keeping people out of the hospital, even if it's not necessarily preventing you from still getting infection and keeping you at home for a few days.

• Geoff Bennett:

  So do the current vaccines available now? Are they targeted against the Omicron variant and the subvariants?

• Dr. Peter Hotez:

  Not specifically, all of the current vaccines, both in the United States and globally, including our vaccine and used in India are all developed against the original lineage that emerged out of Central China. But if you have a high enough levels of virus neutralizing antibody induced by the vaccine against the original lineage, there still seems to be significant spillover to the BA.5 enough to keep you from getting very, very sick.

  So for instance, the Centers for Disease Control put out some information in May among individuals over the age of 50. And there's a clear difference between those who are unvaccinated and those who are vaccinated. But there's even a clear difference to those who are vaccinated, but not boosted and those who are boosted. And those who are boosted twice have a mortality rate that's pretty close to zero. So that's potentially really good news. But what it means is that you have to be mindful of your vaccination status. So if you've only gotten, say, two doses of the vaccine, you're still pretty vulnerable. You need to get that boost. And by the way, if you're have been boosted once, and you're over the age of 50, and therefore eligible for a second boost, get that second boost because that will kind of lock in that you're not going to get very, very sick from this virus.

• Geoff Bennett:

  And Dr. Hotez, generally speaking, how do we stop playing catch up? I mean, first it was the Delta variant and then it was the Omicron variant and now it's the Omicron subvariants, will we ever get to a point where we're not sort of in this situation?

• Dr. Peter Hotez:

  We can but there's a couple of things has to happen. First of all, we have to do a better job of vaccinating globally because all of these new variants like Delta, BA.1 Omicron, or BA.5 are all arising out of low and middle income countries where vaccination rates have been low. And so Mother Nature is basically telling us until we vaccinate the whole world, she'll continue to hurl new variants of concern at us. That's problem one.

  Problem two, is, you know, there's a lot of hand wringing now about what we do for the next boost because the boost are not necessarily lasting as long as we'd hoped with mRNA. Do we not try to design a BA.5 specific boost, for instance, the problem there is by the time it's available and ready in the fall, BA.5 may already be in the rearview mirror. So there's a lot of interest including our group of developing a universal Coronavirus vaccine to handle this and other future variants and potentially other future coronaviruses because remember, this is the COVID-19 or third major Coronavirus of global concern. So that's the long term answer, is develop a universal Coronavirus vaccine.

  What we really need to figure out is how we proceed between now and say the next year or two when that universal Coronavirus vaccine becomes available. It's not clear to me that the BA.5 boost is going to be the answer for the simple reason that by the time it's ready in the fall, it'll be behind us. So we have to look at potentially boosting with different technologies. We need a an overarching strategy to really handle now the next few months.

• Geoff Bennett:

  Yeah. You know, one question I had for you is when we talk about reinfections? Are there long term consequences for people who get COVID-19 multiple times?

• Dr. Peter Hotez:

  I think what you're probably getting at is what's the situation with long COVID? And neurologic deterioration and exercise intolerance all those terrible things that go with long COVID. Is it more — is there a greater propensity of people who have at once or versus people who are getting reinfected? And the answer is I don't think we know that yet. And — but there's a lot of interest in trying to understand the circumstances that make you more vulnerable to long COVID. Among them, it turns out, women have a higher — seem to have a higher rate of long COVID than men underlying diabetes seems to be a risk factor. So we're still trying to sort out what are things that we can do to also mitigate the — against the effects of long COVID and likely one of them is going to be turning out to be vaccinated and well-boosted because severe illness seems to make you more susceptible to long COVID. So by reducing the severity of illness, vaccination and boosting may have that added benefit.

• Geoff Bennett:

  Dr. Ashish Jha, who you know, is the White House COVID Coordinator. This past week, he said that even in the face of this BA.5 Omicron subvariant, that the tools we have continue to work, basically he's saying we shouldn't let this subvariant disrupt our lives. Is that a fair assessment, do you think?

• Dr. Peter Hotez:

  It's partly right. I mean, he's absolutely right, we do have the tools. The problem is, as a nation, we're failing to convince the American people to use those tools. So for instance, only about 30% of the U.S. population has taken a single booster. And so that means 70% of the population is still highly susceptible to this BA.5 variant and hospitalization. And the number of Americans who are taking their second booster is likely far lower than that.

  I took my second booster and my colleagues and the medical and science professions have but we're not — we're doing a terrible job convincing the American people the need for that second booster. So yes, we do have a lot of tools in hand. But now the next step is really convincing people to use them.

  And by the way, we're even doing worse vaccinating our kids, only about 30% of the eligible five to 11 year olds are vaccinated and we've had some terrible news about the very slow uptake in the under-five, so there's a lot of work to do.

• Geoff Bennett:

  Yeah, absolutely. Dr. Peter Hotez, thanks as always.

• Dr. Peter Hotez:

  Thank you.