Published September 5, 2023
Health experts worldwide are monitoring a new Coronavirus variant due to its significant genetic differences from previous versions.
In mid-2022, BA.2.86, a subvariant of Omicron, evolved in Denmark and has also been found in other countries, including the United States. BA.2.86, named “Pirola” after variant tracers, has over 30 mutations to its spike protein compared to previous Omicron subvariants, which may make it more transmissible. However, it is still too early to know for sure if that is the case.
The BA.2.86 subvariant may also be more resistant to vaccines and other treatments than previous Omicron subvariants. Nonetheless, further investigation is required to validate this assertion. Despite limited evidence, BA.2.86 may become the dominant strain of COVID-19, but it may also fade away without causing a significant wave of infections.
Credit: Hindustan Times, 2023
Meanwhile, it's important to stay current on the latest information about BA.2.86 and to take precautions against COVID-19, such as getting vaccinated and boosted, wearing a mask in public indoor settings, and keeping a distance from others who are infected.
There are a few other things to keep in mind about BA.2.86:
Some early studies suggest that BA.2.86 is less severe than previous Omicron subvariants, but more research is needed.
In comparison to previous Omicron subvariants, BA.2.86 is more likely to spread from person to person.
Research is needed to confirm whether BA.2.86 is more resistant to vaccines and other treatments than previous Omicron subvariants.
The Center for Disease Control and Prevention (CDC) has recently published this risk assessment summary:
Current Risk Assessment: The CDC’s current evaluation indicates that tests designed to identify and medications meant to treat COVID-19 appear to be efficient when it comes to the BA.2.86 variant. Scientists are conducting further research to assess the updated version of the vaccine and its ability to reduce severe conditions and hospitalizations. At present, there is nothing to suggest that this particular strain leads to a more intense illness; however, as more evidence becomes available, this assessment may be adjusted. The CDC will keep everyone informed with new data.
Prevention Actions: Updated vaccines could be available at your local pharmacy or doctor's office as early as mid-September if they are approved or licensed by the FDA and recommended by the CDC. While we do not know how well the variant spreads, we do know how other earlier variants have spread. Consequently, the following actions can be taken to protect yourself:
Get your COVID-19 vaccines, as recommended
Stay home if you are sick
Get tested for COVID-19 if needed
If you have COVID-19 and are at high risk of getting very ill, seek treatment immediately.
If you elect to wear a mask, wear a high-quality one that securely covers your nose and mouth
Improve ventilation in your immediate area
Wash your hands
The CDC’s scientific assessment of BA.2.86’s risk profile based on current information is as follows:
Human cases: As of August 23, 2023, 9 BA.2.86 variant sequences have been identified across five global locations: Denmark (3), South Africa (2), Israel (1), the United States (2), and the United Kingdom (1). One of the cases from the United States was identified through the CDC's Traveler-based Genomic Surveillance. This is evidence of international transmission. However, it is noteworthy that worldwide SARS-CoV-2 genomic sequencing has decreased significantly in comparison to past years; this decline raises the possibility that other variants may go undetected for a sustained period. As of now, it appears that this particular variant is not responsible for an increase in hospitalizations in America, but this evaluation could change as more data becomes available.
Severity: It is too soon to determine if this variant may become something that causes more severe sickness than other variants. The CDC is keeping a close eye on hospitalization rates to identify any potential warnings regarding the BA.2.86 strain potentially causing worse illness. At present, there have not been noticeable increases in transmission markers (such as cases and emergency department visits) or hospitalizations compared to places near where it has been identified. That said, the emergence of this variant remains in its early stages, so it is still too soon to make determinations based on these indicators.
Transmission: As a consequence of the limited number of sequences detected, it is unclear whether or not this variant is transmissible. However, detection across multiple continents suggests some degree of transmission. As a result, scientists have not been able to detect the transmission of most other highly diverged lineages that can arise in immunocompromised individuals suffering from prolonged infections.
Wastewater Detection: The National Wastewater Surveillance System (NWSS) has preliminarily indicated the presence of the BA.2.86 variant in a U.S. wastewater sample collected for routine monitoring. Scientists are examining this sample and will stay vigilant in their search for further or more widespread evidence of BA.2.86 through NWSS and other monitoring systems used by the CDC to detect variants within the United States, as part of a larger effort to observe COVID-19's spread. Get more information on wastewater monitoring in the US here.
Viral Genomics: BA.2.86, a novel SARS-CoV-2 variant, has been identified with distinctive mutations compared to earlier Omicron variants such as BA.2, which was dominant in early 2022. Moreover, it is also notable for having more than 35 amino acid changes compared to XBB.1.5 that were prevalent throughout 2023 - a number comparable to the variations between BA.1 and B.1.617.2, two prior Omicron variants.
Immune Impacts: This variant carries a high number of mutations, raising questions as to whether it can escape existing immunity brought on by vaccines and previous infections. Analysis of these mutations suggests that this difference may be larger than between variants BA.2 and XBB.1.5, which spread almost a year apart; however, researchers do not yet have access to enough virus samples to definitively test the effects of antibodies at this time. Most people in the US hold some level of antibodies against SARS-CoV-2 from vaccination or prior infection, suggesting they will remain protected from severe illness caused by the variant. This is still an area that scientists are exploring further.
Therapeutics: The mutation profile of BA.2.86 suggests that current treatments like Paxlovid, Veklury, and Lagevrio will be effective against it. This document will be updated as human data on the impact of this variant on therapeutics becomes available.
Diagnostics (tests): The expected impact on molecular and antigen-based diagnostics is low, based on BA.2.86's mutation profile. Technically speaking, based on an analysis of the genetic mutations in this particular variant (BA.2.86), it is unlikely that these mutations will significantly interfere with the accuracy of diagnostic tests that rely on molecular or antigen-based techniques. This is reassuring information for public health officials and healthcare providers who use these tests to detect and monitor COVID-19 cases.
No conclusions can be drawn at this time. More information is needed. That said, precautions already known to the general public should be considered. As always, speak to your healthcare professional regarding these and other health related matters.
Written By: Lawrence D. Jones, Ph.D.