But other parts of the immune system can come to our defense, said Dr. Otto Yang, an infectious disease physician and immunology researcher at the University of California, Los Angeles David Geffen School of Medicine.
“The mutations defining these new variants are clustered in and around a key area for antibody interactions, but the overall spike sequence is not really changed enough to affect T cells that recognize any part of the sequence, and they are what prevent severe illness,” Dr. Yang said. “People who are up to date on their vaccines and who get treatment early with Paxlovid or with remdesivir are going to do fine for the most part.” (Paxlovid is an oral antiviral medication, and remdesivir is an injectable antiviral.)
Most experts are not concerned with the possibility of new subvariants causing mild illness. “If we see that deaths are reduced and if serious illness and hospitalizations are reduced, even if people do get infected, that’s still a big success,” said Michael Osterholm, an epidemiologist and the director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Immune evasion is a bigger concern for people who are immunocompromised or who don’t mount a strong immune response to vaccines. That includes people who have had stem cell or solid organ transplants, people receiving cancer treatments, people with autoimmune diseases and people who need immune-suppressive medication for various medical conditions, said Dr. Alpana Waghmare, an infectious disease expert at Fred Hutchinson Cancer Center.
Immunocompromised people often rely on preventive shots like Evusheld and intravenous Covid treatments like bebtelovimab, which are made from monoclonal antibodies and can fill in holes in the protection these patients may have from vaccines, Dr. Waghmare said. But the monoclonal antibody treatments are designed to act on one particular piece of the virus; if that piece is altered in the newer subvariants, these treatments may no longer be effective.
“That’s the concern for most clinicians, that we will lose this set of tools in our toolbox to fight Covid,” Dr. Waghmare said. As a result, immunocompromised people may have to deal with more severe disease without the option for monoclonal antibody treatment, even if other antiviral treatments will still keep overall deaths from increasing in this group.
What are the symptoms of a Covid-19 infection with one of the new subvariants?
There is no evidence yet to suggest that people who are infected with BQ.1, BQ.1.1 or any of the other subvariants experience any new or unusual symptoms, or that their illness is more severe than what we’ve seen with previous Omicron variants, Dr. Waghmare said.
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