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Healthful Hints: Brief perspective on omicron BA.5 variant

From the Collection: Recent Healthful Hints columns by Dr. Frank Bures series
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This Hint will be an effort to explain briefly the SARS-CoV-2 omicron BA.5 viral subvariant. (That’s a mouthful, especially after just finishing lunch.) In the last week I have found at least one article per day on BA.5 and its closely related BA.4 cousin. People are SOO done with COVID and the pandemic, but the viruses aren’t done with us yet.

An epidemiologist and viral scientist at Washington University, St. Louis, said, “It’s the wild West out there. There are no public health measures at all [being practiced]. We’re in a very peculiar spot, where the risk is vivid, and [the virus is] out there, but we’ve let our guard down, and we’ve chosen deliberately to expose ourselves and make ourselves more vulnerable.”

Testing has become untraceable with people doing the home tests which are not recorded in any public data. I personally know of 7 people who felt sick, did the rapid antigen home tests and tested positive. Nobody reported it to a health provider. Some felt mildly ill, and some have had certain protracted symptoms, especially fatigue. These tests don’t genetically type the virus. But when official tests have done that, the variants found are in the area of 54% BA.5 and BA.4 17%. One reference said 81% of the identified vermin were these variants. The pestilence persists.

Because of home testing or people just not testing, we have no true idea of the real number of infections. One estimate was a million a week now. The disease patterns are fortunately not as vicious as the prior delta, and original omicron BA.1 infections. Currently, death rates from COVID are running 300-350 a day, compared to 3,000 last winter with a mix of delta and BA.1 prevalent. But BA.5 may be the most contagious virus we have experienced in recorded viral annals, some experts say.

The coronavirus mechanism of cell invasion is to find host cells with an ACE2 membrane receptor. The infamous spike protein binds to that, like a lock and key image, and enters our cells to hijack them. But immune systems stimulated by vaccinations and infections have created cells to make antibody proteins that bind to certain places on the virus’s spike protein and prevent it from attaching. Well … BA.5 and 4 have around 15 new mutations in the spike protein. They do not permit the antibodies, naturally formed or made in labs as treatments, to inhibit cell attachment. One estimate is that BA.5 reduces their effectiveness threefold and another 4-5 times.

One often quoted cardiologist from Scripps Clinic, California, has recently written that BA.5 “is the worst version of the virus we’ve seen,” meaning contagiousness and not disease severity. It is driving increases in cases worldwide and hospitalizations, but not the nasty ones that send people to ICUs and morgues nearly as much. It is common to use influenza infections as a comparison to COVID. The COVID death rate even now is still higher than that of influenza and other contagious diseases.

Even if you have had a recent COVID infection with another variant, BA.5 can reinfect you as soon as 4 weeks later, per reports from Australia. And, re-infections, unlike vaccine boosters, do not really add greater immune protection. The Washington University epidemiologist, Ziyad Al-Aly, analyzed nearly 39,000 records from the St. Louis Veterans Administration Health Care System for effects of multiple COVID infections. He found a wide range of lasting medical symptoms in the months following infection: some respiratory conditions, cough, shortness of breath, fatigue, brain fog, and other medical conditions like heart or kidney disease, diabetes, etc. Those patients have a higher risk of severe illness or death.

Other viral experience has shown that the longer a virus can continue to grow and multiply in us, especially those with compromised immunity, the better chance it has of mutating to even wilder, yet unseen, forms. One new variant, BA.2.75, was first found in India in May, and more recently in other parts of the world. The belief that viruses evolve into milder versions is not holding here. What chaos this new critter may cause is yet to be assessed.

This is a brief discussion of the status of BA.5 in our world at this moment. Things keep changing in this viral world. Our St. Louis doctor said: “This virus keeps outsmarting us.” Or, this column’s refrain is it keeps teaching us. Wait a minute! It’s summer. Isn’t school supposed to be out for a while, so we can refrain from learning? Take a big breath and exhale, with a mask on if you are in a crowded place for your own sake, even if others aren’t! It’s not time yet for a completely bare naked face. Sorry.

Dr. Bures, a semi-retired dermatologist, since 1978 has worked Winona, La Crosse, Viroqua and Red Wing. He also plays clarinet in the Winona Municipal Band and a couple dixieland groups. And he does enjoy a good pun.


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