The antiviral drug Paxlovid can significantly reduce symptoms of covid-19 and dramatically lower the risk of severe illness or dying of the disease. Yet many eligible people arent using it, and some doctors still hesitate to prescribe it.
A recent study by the National Institutes of Health found that only about 15 percent of eligible people took the drug. Experts arent certain why some people decline to take Paxlovid, but anecdotally patients say they are worried about side effects or the risk of rebound covid.
Peter Chin-Hong, an infectious-disease specialist at the University of California at San Francisco, said that over time, people have become less fearful of getting covid. If youre over 75 and youre immune compromised, you hear all these stories of nothing happening to lots of people, Chin-Hong said. You just get lulled into this sense of complacency.
We spoke with several experts about Paxlovid, who should use it, its side effects and the risks of rebound covid. Heres what they had to say.
CHARLESTON, W.Va. (AP) A former West Virginia state health office manager who was indicted on charges related to coronavirus pandemic relief payments is due to enter a plea later this month.
Timothy Priddy is set to appear in federal court on Jan. 22, a day before his trial had been scheduled to start. Federal prosecutors said he is expected to plead guilty. U.S. District Judge Thomas Johnston scheduled the hearing on Tuesday.
An indictment filed in October charged Priddy with making false statements about the payments to federal agents in August 2022 and in grand jury testimony the following month. On both occasions, Priddy knew his statements were false because he made no efforts to verify the invoices before approving them, according to the indictment.
Priddy held various manager positions with the state Bureau for Public Healths Center for Threat Preparedness. He was promoted to deputy director in March 2021 and to director in January 2022, according to the indictment.
Prosecutors said the federal investigation was trying to determine whether one or more vendors providing COVID-19 tests and mitigation services to the state overbilled or otherwise received payment from federal funds disbursed through the states main health agency, the Department of Health and Human Resources. That agency was reorganized into three separate departments effective Jan. 1.
Prosecutors said the vendor reported the results of about 49,000 COVID-19 tests between October 2020 and March 2022 but submitted invoices reflecting the cost of about 518,000 test kits. Despite the discrepancy, Priddy certified at least 13 of the invoices totaling about $34 million, they said.
The indictment did not name the vendor but said the company was from out of state and provided test kits, laboratory analysis and community testing events throughout West Virginia.
The health agency had said previously that a contract with the company for diagnostic testing services ended in October 2022 and that the agency cooperated fully with federal investigators.
According to its contract, the vendor was required to provide nasal swab diagnostic testing for COVID-19 and upload test results immediately. The tests were for specific DHHR programs and initiatives, including residential youth facilities and hospice agencies, locations such as pharmacies where people go to get tested for COVID-19, and kits for emergency medical services workers who were required to be tested frequently.
Vendors contracted by the state were required to report the test results so that officials would have accurate information on the number of active COVID-19 infections and geographical areas experiencing outbreaks, the indictment said.
Nearly 8,900 people have died from COVID-19 in West Virginia since March 2020, according to the Centers for Disease Control and Prevention.
The political drama and the hysterics surrounding mask mandates during the height of the pandemic still linger, like the deadly virus that led to the necessity to don face coverings.
Last week, less than 24 hours after city employees in St. Louis were told theyd be required to wear masks indoors, officials stepped back and said the protective gear would no longer be compulsory but strongly recommended.Credit Republican Missouri Gov. Mike Parson, who was ready to step in and oppose new mask mandates, according to Newsweek.
Unfortunately, there will never be a shortage of unmasked crusaders championed by the many Americans who would rather get others sick than take a simple measure to keep them safe.
No one wants to relive 2020, and it is clear that the U.S. will never emulate the Asian countries whose citizens have been wearing masks for decades, whether to keep from breathing in pollution or sneezing on strangers.
But as cases of COVID-19, influenza and RSV, or respiratory syncytial virus, rise here and across the country, as was expected in the winter months, its not a big ask: Mask up when possible.
Several Chicago-area health care systems, including Rush, are among many U.S. hospitals that are once again requiring patients, visitors and staff to wear masks in interactive settings to keep respiratory viruses from spreading further.
Such a step can only benefit the public and help safeguard senior citizens, the immunocompromised and other vulnerable populations.
Being cautious doesnt have to be reserved for medical facilities. A mask is a good idea in crowded spaces like the CTA, especially considering that only a paltry 12.6% of Chicago residents are up to date on their COVID-19 vaccinations.
The uptick in COVID-19-related hospitalizations has, for the first time in a year, contributed to officials raising the risk level of the virus in Chicago from low to medium.
While the threat of COVID-19 has greatly diminished, the virus continues to circulate and still has the potential to cause serious illness to those with preexisting conditions and even to some who have no major health concerns.
People seem to think that COVID is gone, and its not, John Segreti, a hospital epidemiologist with Rush Medical Center, told the Sun-Times Violet Miller last week.
Wearing a mask probably wont become mandatory in most public spaces anytime soon. That doesnt mean we shouldnt keep one handy: Dont let masking up slip away completely.
The Sun-Times welcomes letters to the editor and op-eds.See our guidelines.
Tedros Adhanom Ghebreyesus, Director-General of the World Health Organisation. Photo / AP
The head of the UN health agency said holiday gatherings and the spread of the most prominent variant globally led to increased transmission of Covid-19 last month.
Tedros Adhanom Ghebreyesus said nearly 10,000 deaths were reported in December, while hospital admissions during the month jumped 42 per cent in nearly 50 countries - mostly in Europe and the Americas - that shared such trend information.
Although 10,000 deaths a month is far less than the peak of the pandemic, this level of preventable deaths is not acceptable, the World Health Organisation (WHO) director-general told reporters from its headquarters in Geneva.
He said it was certain cases were on the rise in other places that havent been reporting, calling on governments to keep up surveillance and provide continued access to treatments and vaccines.
Tedros said the JN.1 variant was now the most prominent in the world. It is an omicron variant, so current vaccines should still provide some protection.
Maria Van Kerkhove, technical lead at WHO for Covid-19, cited an increase in respiratory diseases across the globe due to the coronavirus but also flu, rhinovirus and pneumonia.
We expect those trends to continue into January through the winter months in the Northern Hemisphere, she said, while noting increases in Covid-19 in the Southern Hemisphere - where its summer.
Although bouts of coughs, sniffling, fever and fatigue in the winter are nothing new, Van Kerkhove said this year in particular, we are seeing co-circulation of many different types of pathogens.
WHO officials recommend getting vaccinated when possible, wearing masks, and ensuring indoor areas are well-ventilated.
The vaccines may not stop you being infected, but the vaccines are certainly reducing significantly your chance of being hospitalized or dying, said Dr Michael Ryan, head of emergencies at WHO.
STATEN ISLAND, N.Y. New York Citys Department of Health and Mental Hygiene will recruit up to 10,000 New Yorkers to study the long-term effects of the coronavirus (COVID-19), the department announced Wednesday.
Over several years, the Health Department will collect New York City-specific data on how the coronavirus impacts individuals over time, conducting multiple surveys with the studys recruits about the virus impact on their health.
City Health Commissioner Dr. Ashwin Vasan thanked the participants in the study, which will launch later this year and will focus on communities disproportionately impacted by the pandemic.
We know that the end of an emergency must also be the beginning of a process of learning and understanding so we are better prepared and can support COVID survivors over time, Vasan said. This work -- to study the long-term impacts of COVID on peoples health -- will inform the future of care people receive. It will also develop our understanding of the disease and expand our knowledge of what people are experiencing, which can be confusing and disorienting without this understanding.
The Health Department will work with community-based organizations and those supporting Long COVID research and advocacy. A panel assembled from those groups will provide subject-matter expertise and awareness of issues of importance to people living with Long COVID, according to the Health Department.
New Yorkers recovering from COVID-19 or Long COVID can get assistance by calling 212-COVID19 to reach NYC Health + Hospitals AfterCare program and be connected to one of its three COVID-19 Centers of Excellence, which are located in the Bronx, Queens and Brooklyn.
Dr. Amanda Johnson, director of AfterCare and assistant vice president of Ambulatory Care and Population Health at NYC Health + Hospitals, said the AfterCare work coupled with the Health Departments study will help city health experts better understand the long-term impacts of COVID-19.
I want to assure New Yorkers recovering from COVID-19 or living with Long COVID that you are not alone connections to care and other resources are a phone call away at 212-COVID19, Johnson said. AfterCares work contacting over a half million New Yorkers recovering from COVID-19 and the Health Departments launch of a comprehensive study of the complex, multi-symptomatic impacts of Long COVID will ensure no one in our city suffers in silence, and that New Yorkers have access to the most helpful resources available.
BY JULIE APPLEBY/KFF HEALTH NEWS
Its winter, that cozy season that brings crackling fireplaces, indoor gatherings and a wave of respiratory illness. Nearly four years since the pandemic emerged, people are growing weary of dealing with it, but the virus is not done with us.
Nationally, a sharp uptick in emergency room visits and hospitalizations for covid-19, influenza, and respiratory syncytial virus, or RSV, began in mid-December and appears to be gaining momentum.
Here are a few things to know this time around:
The covid virus is continually changing, and a recent version is rapidly climbing the charts. Even though it appeared only in September, the variant known as JN.1, a descendant of omicron, is rapidly spreading, representing between 39% to half of the cases, according to pre-holiday stats from the Centers for Disease Control and Prevention.
A new COVID booster is here. Will those at greatest risk get it?
Lab data indicates that the updated vaccines, as well as existing covid rapid tests and medical treatments, are effective with this latest iteration. More good news is that it does not appear to pose additional risks to public health beyond that of other recent variants, according to the CDC. Even so, new covid hospitalizations 34,798 for the week that ended Dec. 30 are trending upward, although rates are still substantially lower than last Decembers tally. Its early in the season, though. Levels of virus in wastewater one indicator of how infections are spreading are very high, exceeding the levels seen this time last year.
And dont forget, other nasty bugs are going around. More than 20,000 people were hospitalized for influenza the week ending Dec. 30, and the CDC reports that RSV remains elevated in many areas.
The numbers so far are definitely going in the not-so-good direction, said Ziyad Al-Aly, the chief of the research and development service at the Veterans Affairs St. Louis Healthcare System and a clinical epidemiologist at Washington University in St. Louis. Were likely to see a big uptick in January now that everyone is back home from the holidays.
Certainly, compared with the first covid winter, things are better now. Far fewer people are dying or becoming seriously ill, with vaccines and prior infections providing some immunity and reducing severity of illness. Even compared with last winter, when omicron was surging, the situation is better. New hospitalizations, for example, are about one-third of what they were around the 2022 holidays. Weekly deaths dropped slightly the last week of December to 839 and are also substantially below levels from a year ago.
The ratio of mild disease to serious clearly has changed, said William Schaffner, a professor of medicine in the division of infectious diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.
Even so, the definition of mild is broad, basically referring to anything short of being sick enough to be hospitalized.
While some patients may have no more than the sniffles, others experiencing mild covid can be miserable for three to five days, Schaffner said.
Am I going to be really sick? Do I have to mask up again? It is important to know the basics.
For starters, symptoms of the covid variants currently circulating will likely be familiar such as a runny nose, sore throat, cough, fatigue, fever, and muscle aches.
So if you feel ill, stay home, said Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. It can make a big difference.
Dust off those at-home covid test kits, check the extended expiration dates on the FDA website, and throw away the ones that have aged out. Tests can be bought at most pharmacies and, if you havent ordered yours yet, free test kits are still available through a federal program at covid.gov.
Test more than once, especially if your symptoms are mild. The at-home rapid tests may not detect covid infection in the first couple of days, according to the FDA, which recommends using multiple tests over a certain time period, such as two to three days.
With all three viruses, those most at risk include the very young, older adults, pregnant people, and those with compromised immune systems or underlying diseases, including cancer or heart problems. But those without high-risk factors can also be adversely affected.
While mask-wearing has dropped in most places, you may start to see more people wearing them in public spaces, including stores, public transit, or entertainment venues.
Although a federal mask mandate is unlikely, health officials and hospitals in at least four states California, Illinois, Massachusetts, and New York have again told staff and patients to don masks. Such requirements were loosened last year when the public health emergency officially ended.
Such policies are advanced through county-level directives. The CDC data indicates that, nationally, about 46.7% of counties are seeing moderate to high hospital admission rates of covid.
We are not going to see widespread mask mandates as our population will not find that acceptable, Schaffner noted. That said, on an individual basis, mask-wearing is a very intelligent and reasonable thing to do as an additional layer of protection.
The N95, KN95, and KF94 masks are the most protective. Cloth and paper are not as effective.
And, finally, if you havent yet been vaccinated with an updated covid vaccine or gotten a flu shot, its not too late. There are also new vaccines and monoclonal antibodies to protect against RSV recommended for certain populations, which include older adults, pregnant people, and young children.
Generally, flu peaks in midwinter and runs into spring. Covid, while not technically seasonal, has higher rates in winter as people crowd together indoors.
If you havent received vaccines, Schaffner said, we urge you to get them and dont linger.
Food and Drug Administration approves COVID boosters for upcoming season
People who have dodged covid entirely are in the minority.
At the same time, repeat infections are common. Fifteen percent of respondents to a recent Yahoo News/YouGov poll said theyd had covid two or three times. A Canadian survey released in December found 1 in 5 residents said they had gotten covid more than once as of last June.
Aside from the drag of being sick and missing work or school for days, debate continues over whether repeat infections pose smaller or larger risks of serious health effects. There are no definitive answers, although experts continue to study the issue.
Two research efforts suggest repeat infections may increase a persons chances of developing serious illness or even long covid which is defined various ways but generally means having one or more effects lingering for a month or more following infection. The precise percentage of cases and underlying factors of long covid and why people get it are among the many unanswered questions about the condition. However, there is a growing consensus among researchers that vaccination is protective.
Still, the VAs Al-Aly said a study he co-authored that was published in November 2022 found that getting covid more than once raises an additional risk of problems in the acute phase, be it hospitalization or even dying, and makes a person two times as likely to experience long covid symptoms.
The Canadian survey also found a higher risk of long covid among those who self-reported two or more infections. Both studies have their limitations: Most of the 6 million in the VA database were male and older, and the data studied came from the first two years of the pandemic, so some of it reflected illnesses from before vaccines became available. The Canadian survey, although more recent, relied on self-reporting of infections and conditions, which may not be accurate.
Still, Al-Aly and other experts say taking preventive steps, such as getting vaccinated and wearing a mask in higher-risk situations, can hedge your bets.
Even if in a prior infection you dodged the bullet of long covid, Al-Aly said, it doesnt mean you will dodge the bullet every single time.
The levels of the coronavirus detected in Bostons wastewater have been on the rise in recent weeks.
Authorities said levels are at their second highest point since the pandemic began and at their highest point since January 2022.
The amount of coronavirus per unit of wastewater is now ten times higher than in November.
According to experts, testing wastewater is the most accurate way to see how the virus is spreading.
Its winter, that cozy season that brings crackling fireplaces, indoor gatherings and a wave of respiratory illness. Nearly four years since the pandemic emerged, people are growing weary of dealing with it, but the virus is not done with us.
Nationally, a sharp uptick in emergency room visits and hospitalizations for covid-19, influenza, and respiratory syncytial virus, or RSV, began in mid-December and appears to be gaining momentum.
Here are a few things to know this time around:
Whats Circulating Now?
The covid virus is continually changing, and a recent version is rapidly climbing the charts. Even though it appeared only in September, the variant known as JN.1, a descendant of omicron, is rapidly spreading, representing between 39% to half of the cases, according to pre-holiday stats from the Centers for Disease Control and Prevention.
Lab data indicates that the updated vaccines, as well as existing covid rapid tests and medical treatments, are effective with this latest iteration. More good news is that it does not appear to pose additional risks to public health beyond that of other recent variants, according to the CDC. Even so, new covid hospitalizations 34,798 for the week that ended Dec. 30 are trending upward, although rates are still substantially lower than last Decembers tally. Its early in the season, though. Levels of virus in wastewater one indicator of how infections are spreading are very high, exceeding the levels seen this time last year.
And dont forget, other nasty bugs are going around. More than 20,000 people were hospitalized for influenza the week ending Dec. 30, and the CDC reports that RSV remains elevated in many areas.
The numbers so far are definitely going in the not-so-good direction, said Ziyad Al-Aly, the chief of the research and development service at the Veterans Affairs St. Louis Healthcare System and a clinical epidemiologist at Washington University in St. Louis. Were likely to see a big uptick in January now that everyone is back home from the holidays.
But No Big Deal, Right?
Certainly, compared with the first covid winter, things are better now. Far fewer people are dying or becoming seriously ill, with vaccines and prior infections providing some immunity and reducing severity of illness. Even compared with last winter, when omicron was surging, the situation is better. New hospitalizations, for example, are about one-third of what they were around the 2022 holidays. Weekly deaths dropped slightly the last week of December to 839 and are also substantially below levels from a year ago.
The ratio of mild disease to serious clearly has changed, said William Schaffner, a professor of medicine in the division of infectious diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.
Even so, the definition of mild is broad, basically referring to anything short of being sick enough to be hospitalized.
While some patients may have no more than the sniffles, others experiencing mild covid can be miserable for three to five days, Schaffner said.
How Will This Affect My Day-to-Day Life?
Am I going to be really sick? Do I have to mask up again? It is important to know the basics.
For starters, symptoms of the covid variants currently circulating will likely be familiar such as a runny nose, sore throat, cough, fatigue, fever, and muscle aches.
So if you feel ill, stay home, said Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. It can make a big difference.
Dust off those at-home covid test kits, check the extended expiration dates on the FDA website, and throw away the ones that have aged out. Tests can be bought at most pharmacies and, if you havent ordered yours yet, free test kits are still available through a federal program at covid.gov.
Test more than once, especially if your symptoms are mild. The at-home rapid tests may not detect covid infection in the first couple of days, according to the FDA, which recommends using multiple tests over a certain time period, such as two to three days.
With all three viruses, those most at risk include the very young, older adults, pregnant people, and those with compromised immune systems or underlying diseases, including cancer or heart problems. But those without high-risk factors can also be adversely affected.
While mask-wearing has dropped in most places, you may start to see more people wearing them in public spaces, including stores, public transit, or entertainment venues.
Although a federal mask mandate is unlikely, health officials and hospitals in at least four states California, Illinois, Massachusetts, and New York have again told staff and patients to don masks. Such requirements were loosened last year when the public health emergency officially ended.
Such policies are advanced through county-level directives. The CDC data indicates that, nationally, about 46.7% of counties are seeing moderate to high hospital admission rates of covid.
We are not going to see widespread mask mandates as our population will not find that acceptable, Schaffner noted. That said, on an individual basis, mask-wearing is a very intelligent and reasonable thing to do as an additional layer of protection.
The N95, KN95, and KF94 masks are the most protective. Cloth and paper are not as effective.
And, finally, if you havent yet been vaccinated with an updated covid vaccine or gotten a flu shot, its not too late. There are also new vaccines and monoclonal antibodies to protect against RSV recommended for certain populations, which include older adults, pregnant people, and young children.
Generally, flu peaks in midwinter and runs into spring. Covid, while not technically seasonal, has higher rates in winter as people crowd together indoors.
If you havent received vaccines, Schaffner said, we urge you to get them and dont linger.
Arent We All Going to Get It? What About Repeat Infections?
People who have dodged covid entirely are in the minority.
At the same time, repeat infections are common. Fifteen percent of respondents to a recent Yahoo News/YouGov poll said theyd had covid two or three times. A Canadian survey released in December found 1 in 5 residents said they had gotten covid more than once as of last June.
Aside from the drag of being sick and missing work or school for days, debate continues over whether repeat infections pose smaller or larger risks of serious health effects. There are no definitive answers, although experts continue to study the issue.
Two research efforts suggest repeat infections may increase a persons chances of developing serious illness or even long covid which is defined various ways but generally means having one or more effects lingering for a month or more following infection. The precise percentage of cases and underlying factors of long covid and why people get it are among the many unanswered questions about the condition. However, there is a growing consensus among researchers that vaccination is protective.
Still, the VAs Al-Aly said a study he co-authored that was published in November 2022 found that getting covid more than once raises an additional risk of problems in the acute phase, be it hospitalization or even dying, and makes a person two times as likely to experience long covid symptoms.
The Canadian survey also found a higher risk of long covid among those who self-reported two or more infections. Both studies have their limitations: Most of the 6 million in the VA database were male and older, and the data studied came from the first two years of the pandemic, so some of it reflected illnesses from before vaccines became available. The Canadian survey, although more recent, relied on self-reporting of infections and conditions, which may not be accurate.
Still, Al-Aly and other experts say taking preventive steps, such as getting vaccinated and wearing a mask in higher-risk situations, can hedge your bets.
Even if in a prior infection you dodged the bullet of long covid, Al-Aly said, it doesnt mean you will dodge the bullet every single time.
Covid Case In India: Amid the surge in COVID-19 cases in India, Odisha has identified two new cases of the JN.1 sub-variant of the virus, as confirmed by a senior official on Thursday.
Here are the top ten updates about the COVID-19 JN.1 sub-variant.
Covid-19 updates LIVE
1. As reported by ANI, the cases of the JN.1 sub-variant were identified in Sundargarh and Bhubaneswar in Odisha. Notably, one of the patients has fully recovered, while the other is currently undergoing treatment. Samples that tested positive for COVID-19 are now being sent for genome sequencing.
2. Director of Health Services Bijay Kumar Mohapatra, said, We are sending all the positives for genome sequencing. Two cases of JN.1 have come up in genome sequencing, while the total number of cases is 28. We will test the asymptomatic as per the ICMR guidelines and if they are found positive, they will be sent for genome sequencing."
Also Read: JN.1 variant cases cross 500 mark
3. "Out of two cases of JN.1, one is under treatment and the other is free of symptoms. One patient also has a travel history in Kerala. There is nothing to worry about; new variants are a viral phenomenon and they will keep coming up," Mohapatra added as reported by ANI.
4. As of the latest update from the Ministry of Health and Family Welfare (MoHFW), the total active caseload of the viral disease stands at 4,334, reflecting a decrease of 89 cases since Thursday morning. With this, the total count of coronavirus cases in India since its outbreak in January 2020 has reached 4,50,15,896. The death toll due to COVID-19 cases in India has risen to 5,33,385 reflecting an increase of two deaths.
5. Furthermore, 838 people recovered in the last 24 hours and the total number of recovered cases stood at 4,44,78,885, according to the health ministry.
Also Read: 2024 Portfolio Reboot: 3 essential investment insights from COVID-19 pandemic
6. Earlier, on Thursday, Maharashtra reported 171 new COVID-19 cases and two fatalities, as per a statement from a health department official. Meanwhile, Maharashtra Dy CM Ajit Pawar said, We are taking a daily review of the COVID situation in Maharashtra." He said, All officials of the administration and health department have been instructed to take precautionary measures, we expect people to cooperate like last time because, with the cooperation of everyone, we could control it...The current variant is mild in nature," as reported by ANI.
7. As of Wednesday, official sources have reported a total of 511 cases of the COVID-19 sub-variant JN.1 in the country. Here is the state-wise data:
Karnataka: 199 reported cases
Kerala: 148 cases
Goa: 47 cases
Gujarat: 36 cases
Maharashtra: 32 cases
Tamil Nadu: 26 cases
Delhi: 15 cases
Rajasthan: 4 cases
Telangana: 2 cases
Odisha: 1 case
Haryana: 1 case
8. Meanwhile, the World Health Organization (WHO) has designated JN.1 as a distinct variant of interest" due to its rapid spread. However, the global public health risk associated with this variant is categorized as low" by the WHO.
Also Read: JN.1 Covid variant 'more transmissible, more infectious': Ex-ICMR expert warns of more cases in India
9. Despite recent weeks seeing a sustained reporting of JN.1 cases across various countries, indicating a significant global surge in its prevalence, the Centre has urged states and Union territories to remain vigilant due to the rising number of COVID cases and the identification of the JN.1 sub-variant within the country.
10. States are also tasked with monitoring and reporting cases of Influenza-like Illness (ILI) and Severe Acute Respiratory Illness (SARI) on a district-wise basis across all healthcare facilities. JN.1 is a subvariant of Omicron. There were many cases in Kerala. Our state government has issued an alert to all hospitals in the state. If there are any cases of influenza-like illness or severe acute respiratory illness we need to monitor them, increase their testing, keep them in isolation wards, wear masks, and keep medication ready," Dr M Raja Rao, Additional Director of Medical Education (DME) and Superintendent of Gandhi Hospital in Telangana said speaking to ANI.
(With inputs from agencies)
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Published: 05 Jan 2024, 10:25 AM IST
A new COVID-19 subvariant, known as JN.1, has emerged and is now the prevailing strain across Canada, prompting health experts to caution that it may be more infectious and could even have extra symptoms.
Currently, the subvariant makes up the highest proportion of all COVID-19 variants, accounting for more than half (51. 9 per cent) of all infections in Canada, according to the latest data from the Public Health Agency of Canada (PHAC).
JN.1 was first detected in Canada on Oct. 9, and since then has rapidly increased.
If this virus continues to circulate at high levels, that means more virus, which means more mutations and more evolution, which means more of this same kind of issue happening repeatedly, warned Ryan Gregory, a professor of integrative biology at the University of Guelph, and evolutionary biologist.
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1:54 Low vaccine uptake fuels spike in respiratory illnesses: health officials
On Dec. 10, the JN.1 subvariant made up 26.6 per cent of all COVID-19 variants in Canada, but was not the dominant strain. At that time, HV.1 still made up 29 per cent of all subvariants, according to PHAC data. By Dec. 17, JN.1 made up the highest percentage (38.5 per cent) of all subvariants across Canada. Meanwhile, HV.1 fell to 24.4 per cent.
The World Health Organization (WHO) on Dec. 19 added JN.1 to its list of variants of interest, its second-highest level of monitoring. Despite the categorization, the health organization said JN.1 poses a low additional public health risk.
Two days later, on Dec. 21, PHAC labelled it as a variant of interest in Canada.
As the subvariant continues to circulate, here is what we know so far about JN.1.
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The JN.1 subvariant is a sublineage of BA.2.86 that emerged in Europe in late August 2023. It is another Omicron variant, according to PHAC. Gregory explained that JN.1 is a grandchild of BA.2.86. The original BA.2.86 probably evolved within a single person with a long-term infection over a year, he added.
So, somebody was infected. The virus continued to replicate and change within their body and then it reentered the rest of the population, he said. Once it gets back into the main population, its now evolving at the level of among hosts.
This in turn created the more competitive and successful JN.1. It featured a single alteration in the spike protein, enhancing its ability to effectively bind to cells, according to Gregory.
6:14 Holiday health update: Navigating the flu, RSV and COVID
It has massively managed to compete with the existing things that were out there, which suggests that its either very good at transmitting, and escapes immunity that is otherwise conferred by prior infection or previous vaccination, he said. So in other words, its different enough that your immune system, having been trained on older variants, doesnt recognize it as well.
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He also believes JN.1 may be the starting point for subsequent evolutions, much like the XBB variant. The XBB variant, another sublineage of Omicron, started circulating the world in late 2022. In 2023, some of its descendents, such as XBB.1.5 and EG.5, became dominating COVID-19 infections.
It is currently not known whether JN.1 infections produce different symptoms from other variants, health experts say.
The typical symptoms of COVID-19 according to the government are:
Additionally, Gerald Evans, an infectious disease specialist at Queens University in Kingston, Ont., said he has heard more people report gastrointestinal (GI) issues, such as diarrhea.
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The one thing I have been hearing about, they have GI symptoms, and these are not new, these have been recorded since COVID came out, he said. But anecdotally, the number of people having GI symptoms seems to be slightly higher, but you have to be careful with that because its an observational bias. But it does strike me that its becoming a bit more of a theme in the last month.
Gregory agreed with this observation but added that it may still be too early to tell if this is a hallmark symptom of the JN.1 variant.
He added that it is difficult to determine which symptoms go with what variant, especially when so many are circulating and there is less testing for COVID-19.
Trending Now
Due to JN.1s fast growth, experts like Gregory say its either more transmissible or better at evading our immune systems. However, PHAC said in an email to Global News on Dec. 19, there is no evidence of increased severity associated with this variant.
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The WHO also stated last month that it is anticipated that this variant may cause an increase in COVID-19 cases amid a surge of infections of other viral and bacterial infections, especially in countries entering the winter season.
Since the spike protein is also the part that existing vaccines target, current vaccines should work against JN.1 and other lineages of BA.2.86, explained Evans. Preliminary evidence shows that protection by the XBB recombinant vaccine also guards against JN.1, he added. However, he cautioned, If it has been a year since your last vaccine or COVID infection, you may be more susceptible.
Personal protective measures are effective actions to help reduce the spread of COVID-19, PHAC stated. They include things like staying home when sick, properly wearing a well-fitted respirator or mask, improving indoor ventilation and practicing respiratory etiquette and hand hygiene.
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These measures are most effective when layered together, PHAC stated in an email.
Laboratory studies also suggest that the current therapeutic antiviral options, such as Paxlovid, available in Canada are expected to be effective against SARS-CoV-2 sub-lineages, PHAC added.
In some parts of the country, COVID-19 cases have been steadily increasing since the fall, yet the numbers appear to be stable now, according to Evans. However, while infection numbers remain stable, they are still very high and very steep, he warned, well beyond influenza, RSV and all the other viruses.
4:50 Kingston pharmacist urging residents to get vaccinated to avoid getting sick this winter season
He believes there may have been a holiday spike in COVID0-19 infections for several reasons, but most importantly noting that the uptake COVID-19 vaccine has been very poor.
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As of Dec. 8, PHAC reported that 14.6 per cent of eligible Canadians have received the updated vaccines targeting XBB.1.5.
The second reason, of course, is were in the middle of the respiratory virus season, Evans said. And although there are still a fair percentage of people who are being careful, there are a lot of people really have just gone back to what life was like before 2020. And. Thats, of course, a moment of opportunity for all these viruses to kind of take off.
