[Note from BenIndy Contributor Roger Straw: Well, it finally ALMOST happened. My wife and I have been ultra careful, and so far are among the increasingly rare few who have not contracted the coronavirus. Mary Susan is immune compromised, so we still wear masks in the grocery and other crowded indoors places. But we were seriously exposed when close family members tested positive a day or two after celebrating a birthday in our own home. They got on Paxlovid right away, and are fine, but only after a really miserable 2 weeks. We isolated and tested negative every other day for 10 days – and whew, still have not got the bug. Thank goodness we celebrated with windows wide open and seated widely spaced at the long dinner table. Please know that COVID is back, it’s around you, and it is no fun when you get it! And… it can be really serious, even long-lasting. Read on….]
How to navigate renewed COVID threat in the Bay Area
A local theater troupe cancels a weekend of performances because cast members have COVID. A Sunday luncheon is postponed because the hostess has fallen ill. A colleague catches the coronavirus on a trip back from Italy. The nearby Walgreens is sold out of home test kits.
[Note from BenIndy Contributor Nathalie Christian: Between the Benicia Peddler’s Fair this weekend the start of school next week, we’re entering a period of high risk for COVID exposure. Please take a moment to read about the new, highly transmissible “Eris” variant below and make choices that match not just your risk level, but the risk level of those closest to you – especially the elderly and the immunocompromised. If you’re in a high-risk group, don’t hesitate to reach out to your healthcare provider if you are experiencing symptoms. Not only is Paxlovid plentiful, it is also very effective; in its initial trial involving unvaccinated, high-risk patients, Paxlovid reduced hospitalization or death by 86 percent. Stay vigilant, stay safe.]
What to know about ‘Eris,’ the new COVID-19 subvariant sweeping the US
The EG.5 “Eris” variant is now the dominant COVID-19 strain in the U.S. Here’s what to know about transmission and symptoms.
A new COVID-19 variant called EG.5 is sweeping across the United States as cases and hospitalizations rise. The fast-spreading new COVID subvariant, also referred to as Eris, is now the dominant strain circulating in the U.S., health officials say.
Eris is also on the rise in several other countries around the globe. On Wednesday, Aug. 9, the World Health Organization decided to classify EG.5 as a “variant of interest.”
The new subvariant, which experts nicknamed “Eris” on social media, started circulating in the U.S. earlier this spring. Last month, EG.5 quickly overtook the prevailing omicron XBB subvariants, which had been driving the largest share of cases in the country.
During a two-week period ending on Aug. 5, Eris accounted for an estimated 17.3% of new confirmed COVID-19 cases in the U.S., up from 12% two weeks prior, according to the latest CDC data.
Many are wondering if the EG.5 subvariant is more transmissible or severe, and whether it’s causing different symptoms.
What is EG.5 , aka Eris?
EG.5 is a descendant of the omicron XBB sublineage of the virus (specifically, XBB.1.9.2), but it has an extra mutation in its spike protein, according to a WHO risk evaluation report.
“When we look at its sequence, EG.5 is really similar to the other XBB variants that are circulating right now, with a couple of small changes,” Dr. Andrew Pekosz, a virologist at Johns Hopkins University, tells TODAY.com.
The WHO added EG. 5 to its list of variants under monitoring on July 19, 2023, but the variant was first detected in February 2023. “Scientists have known about this variant, and it’s been present in other countries, as well,” says Pekosz.
So far, EG.5 has been reported in 51 countries and there has been a steady increase in prevalence globally — the majority of sequences are from China, followed by the U.S., South Korea, Japan and Canada, per WHO.
XBB.1.16, also called the “Arcturus” variant, remains the most prevalent strain of COVID-19 worldwide.
WHO considers the public health risk posed by EG.5 to be “low” and similar to that of XBB.1.16 and other variants of interest.
Is EG. 5 more transmissible?
The EG.5 variant is very similar to other omicron variants, which means it’s highly transmissible, Dr. Albert Ko, an infectious disease physician and professor at Yale School of Public Health, tells TODAY.com.
However, EG.5 is likely more transmissible than other XBB variants, Dr. Sharon Nachman, chief of the division of pediatric infectious diseases at Stony Brook Children’s Hospital, tells TODAY.com.
“If it was equally transmissible, then we wouldn’t see it gaining strength number-wise compared to some of the other variants,” says Nachman, adding that EG.5 quickly pushed out other XBB variants in the U.S., which were dominant over the summer.
Why exactly EG.5 is more transmissible is not yet known, Ko says.
“Whether it’s escaping population immunity or it has some intrinsic factor that makes it better able to transmit from one person to another … it’s hard to separate,” he adds.
According to WHO, EG.5 has increased immune escape properties compared to other variants. “EG.5 may cause a rise in case incidence and become dominant in some countries or even globally,” WHO said in a report.
However, Pekosz notes that the EG.5 variant may not be the sole reason for the U.S. summer uptick. “When you have a new variants, and cases creeping up, there’s always concern about whether that variant could be driving the increase,” says Pekosz.
“Right now, it doesn’t look like that variant alone is driving the case increases (in the U.S.) … there’s still a lot of other variants co-circulating,” he adds.
According to CDC estimates, EG.5 accounted for about 17% of COVID-19 cases in the U.S. during the two-week period ending on Aug. 3. — after EG.5, the next most common variants were XBB.1.16, XBB.2.3, and XBB.1.5, which accounted for 15%, 11% and 10% of cases, respectively.
“We’re keeping an eye on (EG.5) because of the uptick in cases, but it doesn’t look like there’s anything particularly concerning about this variant,” says Pekosz.
More data is needed to understand how EG.5’s transmissibility compares to other strains. However, decreased levels of testing and genomic sequencing are making it harder to accurately track new COVID-19 cases and which variants are driving them, Pekosz notes.
“Right now, there’s an awful lot of guesswork,” he says.
Is EG.5 more severe?
The data available do not indicate that EG.5 causes a more severe infection compared to other variants, the experts note.
In its risk assessment of EG.5, WHO said, “There have been no reported changes in disease severity to date.”
“The people that are getting hospitalized often have lots of co-morbidities, and they’re at-risk no matter what COVID strain they get,” says Nachman.
However, it’s possible that hospitalizations could increase even more because of more people getting infected with EG.5, says Ko. “There’s no clear evidence of that at this point, but we have to keep on evaluating,” Ko adds
Population immunity from vaccination and prior infection should protect people from severe illness as EG.5 continues to circulate.
What are the symptoms?
There isn’t enough clinical data about the most common symptoms of EG.5 yet, NBC News previously reported.
“There’s no change in EG.5 symptoms right now,” says Pekosz. So far, the symptoms of EG.5 look very similar to the standard omicron symptoms, says Ko. These include:
Altered sense of smell
“It may progress to some more significant feelings of difficulty in breathing as the infection spreads into your lungs,” says Pekosz.
Certain groups are at higher risk of developing severe illness or complications, including people over 65 and those who are immunocompromised or have underlying medical conditions.
Can COVID-19 tests detect EG.5?
All COVID-19 tests — including PCR tests performed by a medical provider and rapid at-home antigen tests sold over-the-counter — should be detecting EG.5, says Pekosz.
The experts emphasize the importance of getting tested as COVID-19 cases increase, and especially during the fall when viruses that cause similar symptoms (such as flu and RSV) are circulating.
“If you’re in one of the high-risk groups for getting severe COVID, you really shouldn’t hesitate to get a test,” says Pekosz, adding that early detection and treatment is key. COVID-19 antivirals such as Paxlovid are effective against EG.5 and other variants, but they work best when taken early, he adds.
Whether your insurance covers COVID-19 testing may have changed since the end of the U.S. federal public health emergency in May, TODAY.com previously reported, so check with your insurer if you have questions about testing costs.
It’s also important to check the expiration date of at-home tests. The shelf life of rapid tests ranges from four to 24 months, according to the U.S. Food and Drug Administration, but the expiration dates of some tests have been extended.
Will I need a COVID-19 booster this fall?
The experts encourage everyone to stay up to date on COVID-19 vaccines, which may include a new booster dose in the coming months. In June 2023, the FDA advised vaccine manufacturers to update their boosters to target omicron XBB.1.5, which was the dominant strain at the time.
These shots haven’t been approved yet, but the FDA could authorize Pfizer’s booster shot by the end of August, NBC News reported.
Although the new boosters will not include the EG.5 strain, they may still provide protection, the experts note. “If I vaccinate you with the vaccine that contains XBB, you will make antibodies that are specific to XBB and pretty close to EG.5,” says Nachman.
“Right now, EG.5 looks like it’s very closely matched to the vaccine that’s going to be available this fall,” says Pekosz.
However, the CDC has not yet released any firm guidance or recommendations around booster doses for the fall.
“The message is to pay attention to the COVID vaccine program that’s going to come out in the fall. … It’s a vaccine that many people (especially high-risk individuals) should consider taking,” says Pekosz.
How to protect yourself from EG.5:
In addition to staying up to date on COVID-19 vaccinations, the experts emphasize taking precautions to protect yourself and curb transmission of COVID-19, including:
As people crowd movie theaters for “Barbie,” flock to stadiums to see sold-out Taylor Swift concerts and resume their annual trips to Europe, in what largely feels like a summer in the days before the pandemic, highly transmissible variants of the coronavirus have found ideal conditions to reemerge and infect people.
That’s why health officials say a subtle but sustained increase in key COVID-19 indicators is not unexpected. Emergency department visits, test positivity rates and wastewater virus levels in some areas signal a slight rise in infections, according to the latest figures from the California Department of Public Health and the U.S. Centers for Disease Control and Prevention. Meanwhile, hospital admissions across the United States are up by more than 10% from the previous week.
Kathleen Conley, a spokesperson for the CDC, said that the nation is still in a good place despite this increase.
“U.S. COVID-19 rates are still near historic lows after seven months of steady declines,” she said in a statement. “The U.S. has experienced increases in COVID-19 during the past three summers, so it’s not surprising to see an uptick.”
While the 7,109 hospital admissions nationwide reported for the week of July 15 marks the highest level since December, it remains significantly lower than the peak observed during the omicron surge last July, when weekly U.S. hospitalizations reached more than 44,000.
According to the state’s health department, as of Thursday, California reported an average of 858 COVID-related hospitalizations per day over 14 days, up by 7.4% since the beginning of the month, with an average of nine deaths per day over seven days, compared with five on July 1.
To date, nearly 1.14 million people in the United States have died because of COVID-19 since the onset of the pandemic. But the combination of vaccination and immunity from previous infections has driven down community transmission, while treatments such as the antiviral medication Paxlovid have helped significantly reduce the likelihood of severe illness and death due to COVID.
That progress led to the U.S. reaching a pandemic milestone last week as the rate of excess deaths — the number of Americans dying from any cause compared with statistical averages — fell to below 1% after growing to as high as 30% during previous virus surges, according to the CDC.
“The death rates are no longer different from the usual death rates at this time of year,” Dr. Bob Wachter, the chair of medicine at UCSF, said this week in a podcast interview for Medscape. “That is a remarkable achievement and says something about the state of the pandemic and the state of immunity, either from vaccines or from infection or both. And it’s worth celebrating. It’s worth going back to something that feels a little bit closer to normal than we’ve lived for the last three or four years. But you have to do it with your eyes open.”
In California, the coronavirus test positivity rate has jumped to 7.6% this week, compared with 4.1% a month ago. That figure is more indicative of trends than community penetration because so few people now get laboratory tests. Most now rely on home test kits whose results are rarely reported to authorities. Others have discontinued testing altogether.
“In the same way people stop wearing masks and throw caution to the wind, once they’ve run out of their home tests, are they going to go to Walgreens and spend $30 to buy some more?” said Wachter, who himself recently got COVID-19 after avoiding it for more than three years. “I’m guessing they’re not.”
There is no single variant driving the current increase in infections, as XBB.1.15 and XBB.1.16 have declined in circulation over the past two weeks, while newer omicron offshoots like EG.5, XBB.1.16.6 and XBB.2.3 are uniformly gaining traction. No individual variant accounts for more than 15% of the measured proportion.
The upturn is not limited to the U.S. Japan has experienced a rise in COVID-19 hospitalizations and emergency department visits for nine consecutive weeks, indicating the country may be entering its ninth waveof infections. But Europe is reporting flat numbers.
The World Health Organization continues to underscore that COVID-19 “remains a major threat,” as several countries grapple with high disease burdens. In its latest weekly update, the agency urged government leaders not to dismantle their pandemic response infrastructure.
The WHO noted that EG.5, a descendant of the XBB.1.9.2 variant, has an additional mutation that could aid its rapid global spread. However, it said there is “no evidence of rising cases and deaths or a change in disease severity associated with EG.5.”
“This is the new normal, and COVID will now be baked into the list of day-to-day risks that we all have,” Wachter said. “And all of us have to come to some sense of clarity of how we are going to live our lives in a way that’s fulfilling and maximizes joy.”
On Tuesday, the U.S. Food and Drug Administration authorized a second COVID-19 booster dose for older Americans and individuals with weakened immune systems to enhance their protection this spring.
Coronavirus map: How many COVID cases are in Bay Area and California
The move comes amid concerns over newer variants of the virus causing the number of COVID-19 cases and deaths to tick back up in the United States, particularly among vulnerable populations.
Individuals age 65 or older may opt for a second shot of the bivalent vaccine targeting the omicron strains of the coronavirus at least four months after their initial dose. For those who are immunocompromised, a second booster shot may be received at least two months later, with additional doses at the discretion of their physician.
The FDA also announced that the original versions of the Pfizer and Moderna vaccines are outdated and will no longer be used. Instead, individuals receiving these shots will be administered the newer omicron-targeted version. For those receiving their first-ever vaccine, a single combo dose will suffice.
According to Dr. Peter Marks, the FDA vaccine chief, “At this stage of the pandemic, data support simplifying the use of Pfizer and Moderna vaccines. The agency believes this approach will help encourage future vaccination.”
Although Britain and Canada have already recommended an additional spring booster for vulnerable populations, high-risk Americans who last received a dose in the fall have been eagerly anticipating another dose.
Booster doses continue to stave off severe disease and death, even as more contagious variants have emerged, while protection against mild infections is short-lived.
At least 250 people in the U.S. still die from COVID-19 each day, many of them older and at higher risk for the worst outcomes of the disease.
Yvonne Maldonado, an infectious disease expert at Stanford, said, “If you look at who’s dying or getting sick now, it’s people who are unvaccinated or unboosted.”
The Centers for Disease Control and Prevention must approve the latest round of boosters, and its advisers are scheduled to meet on Wednesday.
The Pfizer and Moderna boosters contain protection against both the original coronavirus strain and omicron variants known as BA.4 and BA.5. Recent studies show that the bivalent shots are still effective, even as newer omicron cousins circulate.
The FDA’s simplification also means changes for unvaccinated children. Children under 5 may receive two doses of the bivalent Moderna vaccine or three doses of the Pfizer-BioNTech bivalent vaccine.
People 5 and older may get a single bivalent Pfizer shot or two Moderna doses. Children already fully or partially vaccinated with the original Pfizer or Moderna shots may get a bivalent vaccine, but the number of doses will depend on their vaccination history, the FDA said.
While over 95% of the U.S. population aged 65 and older received at least one vaccine dose, only 42.1% of those eligible have received the latest boosters, which were authorized in August, according to the CDC.
The offering of a second bivalent booster will not interfere with the Biden administration’s previously stated plan of moving the nation toward an annual COVID vaccine similar to the flu shot.
But for eligible high-risk groups, a second booster in the spring is a reasonable choice, said Dr. Matthew Laurens of the University of Maryland School of Medicine.
“We do have vaccines that are available to protect against these severe consequences, so why not use them?” he said. “They don’t do any good just sitting on a shelf. So let’s give them to individuals who are at the highest risk and who can benefit the most.”