President Joe Biden might have declared, “The pandemic is over,” but a new Omicron subvariant is a reminder that COVID-19 is still with us.
The new culprit behind a rise in COVID-19 cases is the XBB.1.5 variant. According to the Centers for Disease Control and Prevention, XBB.1.5 represents over 27% of COVID-19 cases nationwide.
In Georgia, data from the state’s Department of Public Health shows more than 13,000 new confirmed cases in 2023. The World Health Organization has named XBB.1.5 as Omicron’s most transmissible subvariant yet.
Capital B Atlanta chatted with Dr. Quintin Robinson, an infectious disease expert with Avant Care in Atlanta, to learn more about XBB.1.5.
What is XBB.1.5?
XBB.1.5 is a subvariant of the highly transmissible Omicron variant. While the strain isn’t dominating new infections, it is the only one showing extensive growth, according to estimates from the CDC. What does that mean? It means XBB.1.5 could potentially begin dominating new cases.
According to Nancy Nydam with the DPH, XBB.1.5 represents 17% of new cases in Georgia. That puts XBB.1.5 just behind BQ.1 (20%) and BQ.1.1 (43%).
So how bad is it? Is XBB.1.5 more severe than other subvariants?
As far as symptoms go, Robinson says the effects of XBB.1.5 are mild compared to previous subvariants, which he theorizes may be because the majority of people in metro Atlanta are vaccinated against COVID-19.
“You still have the cough, the fever, the fatigue, but you don’t have this overwhelming immune response you saw with previous variants,” he said. “The fact that you have some previous immunization, I think, contributes to the mildness of the disease so far.”
I just got the booster shot, I should be good, right?
According to Johns Hopkins University, vaccines are still effective in preventing severe symptoms from XBB.1.5, but not necessarily preventing infection. The reason it can still help with severe illness is that the strain derives from the BA.2 variant, which the latest round of vaccines were created to fight. Since the XBB.1.5 strain still has some of the same proteins from BA.2, the vaccines still recognize it.
There aren’t any more monoclonal antibodies that can treat COVID-19. Monoclonal antibodies are synthetic versions of immune system protections that would be used to prevent COVID-19 instead of treating it. But now, none of them are effective, since COVID-19 strains have begun evading them.
What treatment is available?
Robinson says he hasn’t had any patients show up that are infected with XBB.1.5.
He says there are many antiviral treatments available if you contract any strain of COVID-19, such as Paxlovid and Lagevrio. Both medications are in pill form. Both can be prescribed by your doctor, but don’t delay in attempting to secure the treatment, since they’re most effective the earlier in the course of the illness.
You also must meet certain qualifications to get them.
For Paxlovid, people over the age of 12 who weigh at least 88 pounds are considered eligible if they’re at high risk of becoming severely sick.
For Lagevrio, you must be over 18 years old and considered at risk for developing serious complications from COVID-19 infection. Lagevrio is usually considered once it’s clear that Paxlovid or other antivirals aren’t an option.
There are barriers for people of color, specifically Black and Hispanic people, when trying to obtain Paxlovid. According to a CDC study, the percentage of COVID-19 patients over the age of 20 treated with Paxlovid was 36% and 30% lower among Black and Hispanic patients, respectively, than among white and non-Hispanic patients.
Robinson says if his patients ask for it, he usually will write the prescription, and he has been critical of his colleagues in the medical field for not utilizing Paxlovid.
“There are some of my health care colleagues who are hesitant to prescribe it because there are drug interactions and things that you need to be aware of,” Robinson said.
Paxlovid is known to have negative drug interactions with various medicines that treat high blood pressure, high cholesterol, and certain mental health conditions. “But it is still an effective therapeutic for right now,” Robinson said.
Wait, so are we still in a pandemic?
Robinson has one answer for that: yes.
“There is the COVID-fatigue. I think people are tired of hearing about it,” he said. “We are still in a pandemic. … Cases are up. Hospitalizations are up.”
Currently, every metro Atlanta county is experiencing a medium COVID-19 community level. What this means is that if you’re at high risk of becoming severely sick with COVID-19, you should wear a mask in indoor settings, like an N95 respirator or a KN95 mask (you can find where to get free masks here).
In March 2022, the CDC changed its criteria for community levels of COVID-19 transmission, shifting to a model that emphasized the transmission’s impact on health care infrastructure instead of the number of new cases.
CDC data shows the cases for the Delta and Alpha variants have gone down. Robinson warns that just because other strains are less prevalent, that doesn’t mean that you should let your guard down.
Where can I go to keep up with the latest COVID-19 info?
For state-specific COVID-19 data, the Georgia Department of Health updates its COVID-19 status report every Wednesday. There, you can check COVID-19 figures for your local county and the state.
Speaking of counties, Clayton, Cobb, DeKalb, Fulton and Gwinnett also have COVID-19 information websites for updates and guidance.