Is the COVID-19 Making a Comeback? Looks Like It, Unfortunately

In the week preceding the publication of this article, global COVID-19 new cases dropped by 35%, and the death toll decreased by 40%. Can we declare victory over this dreaded disease? Unfortunately, it's not that simple. While the number of new infections is indeed decreasing, the rise of new strains of the virus is a concerning development.

The Threat of New COVID-19 Strains is coming. Primarily, the danger lies in the novelty of these strains, particularly the so-called HV.1 variant. Our immunity, whether acquired through previous infections or vaccinations done a year or two ago, is more aligned with the older variants of the COVID-19 virus. Consequently, our resistance to these new strains is compromised, presenting a significant challenge. Although recent vaccine series perform quite well, having been developed primarily against the Omicron variant identified in the fall of 2021.

As for the danger in cases of infection, experts are not overly concerned. They announce two pieces of news—one good and the other not so good. The bad news is that, like with previous variants, the new COVID-19 HV.1 remains dangerous for the elderly and those with compromised immunity or various health issues, such as chronic illnesses. The good news is that there is no dominance of severe cases caused by COVID-19 HV.1 among those admitted to hospitals.

How It Spreads

The answer is "swiftly". In the United States, according to the latest data from the Centers for Disease Control and Prevention, HV.1 accounted for approximately 25.2% of new COVID-19 cases during the two-week period ending on October 28. Following HV.1, the next most prevalent variants in the U.S. were the familiar EG.5, representing 22% of cases, followed by FL.1.5.1 or "Fornax" and XBB.1.16 or "Arcturus." Globally, according to the World Health Organization, EG.5 remains the dominant strain.

All mentioned strains are "descendants" of the Omicron strain, which has been a concern since the fall of 2021. Fortunately, this is good news as it implies that previous vaccinations and naturally acquired immunity will help avoid or significantly alleviate the illness. There's a belief that HV.1 is a "descendant" of the Omicron strain, making HV.1 the "child" of XBB.1.9.2, which is a direct descendant of EG.5.

What is certain is the certainty of a faster spread for this new leader. "All people know at this point is that its representation is increasing," said Dr. Ross Kedl, a professor of immunology and microbiology at the Anschutz Medical Campus of the University of Colorado. The good news, as Mr. Kedl puts it, is that "There is no evidence that it is more serious." However, the speed of spread is increasing dramatically. If HV.1 accounted for 0.5% of detected cases in the U.S. at the end of July, 12.5% at the end of September, it's now approximately a quarter. This is amidst an overall decrease in the number of detected cases after the late-summer surge.

Photo: The rapid rise of the new strain's share. Source: CDC

What Lies Ahead in the New Landscape

At this juncture, it's worth elucidating why I specifically refer to statistics from the United States. They boast robust medical data, providing a rather transparent picture. As we recall, in 2020, among developed nations, there was a pattern where the spread of COVID-19 initially unfolded in the U.S., then echoed or, more precisely, manifested elsewhere.

What precisely we're facing at the moment remains decidedly unclear. This will become apparent with reports from pertinent agencies in a week or two. However, in the latter part of October, a situation unfolded in the U.S.: the overall number of infections was decreasing, but COVID-19 HV.1 was spreading rapidly.

A similar scenario is likely unfolding presently in Europe. This is reinforced by the fact that EU countries are somewhat delayed in entering the respiratory illness season after an unusually warm autumn. Consequently, the peak of infections seems poised for December-January, further intensified by the traditional Christmas holidays.

Photo: Parents, grandparents, great-grandparents of the new strain leader. Source: CDC

To Fear or Not to Fear?

The most widely distributed vaccine series against COVID-19 currently offers protection against XBB.1.9.2, if we're curious about which is the freshest strain acknowledged by pharmaceutical experts. I hope new vaccine series will be available soon. The relatedness of HV.1 to XBB.1.9.2 is reasonably good news—even existing vaccine versions somehow equip us to defend against it. The existing versions of test systems also remain effective, which is also positive news.

Judging by the fact that HV.1 spreads the fastest among identified strains, it's worth considering that it possesses increased "stickiness." Thus, the old advice will undoubtedly come in handy—vaccinate, avoid crowds, wear masks in crowded places, and diligently and frequently wash hands.

As HV.1 is a descendant of Omicron, it typically exhibits the same symptoms as its "grandparent," causing symptoms associated with Omicron infection, such as cough, fatigue, congestion, and malaise. "Congestion, sore throat, and dry cough seem to be the three most noticeable symptoms," explained Dr. William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center, to TODAY.com. Usually, cough is not a primary symptom, but it can persist post-recovery from COVID-19 HV.1. "The virus seems to induce a kind of chronic bronchitis, so you may have a lingering cough syndrome that lasts beyond the period when you recover from other symptoms," Mr. Schaffner added.

His conclusions are supported by NBC News, and its publication notes that symptoms of the latest version of COVID-19 focus on the upper respiratory tract, starting with a sore throat and accompanied by congestion or malaise.

There's no doubt that "grandchildren" of Omicron, such as HV.1, will continue to undergo mutations and changes. It appears humanity will coexist with COVID-19 for a while, but with a greater depth of knowledge about it and means to combat it. As the saying goes, forewarned is forearmed.