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# Understanding the Mythological Names of COVID Variants: Should We Be Concerned?

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Chapter 1: The Evolution of SARS-CoV-2

The ongoing evolution of SARS-CoV-2 has predominantly centered around the omicron lineage. Recently, new genetic subvariants have emerged, outpacing their predecessors. Initially, BA.1 spread across Europe, but it was soon replaced by BA.2. By June, BA.5 became the dominant strain. These variants have developed the ability to evade antibodies from both vaccinated individuals and those who have recovered from earlier infections, creating new groups of susceptible individuals—including those who had previously encountered earlier subvariants.

The issue of SARS-CoV-2's ability to escape antibody detection is only part of the concern. The cellular immune response is crucial in combating the virus, and it can be enhanced through booster vaccinations tailored to the omicron lineage. This approach can elevate antibody levels, thus lowering the infection risk, even if the circulating omicron subvariant differs from the one used in the vaccine.

Immunological response to COVID-19 variants

Section 1.1: The Future After BA.5

The dominance of BA.5 is expected to decline, having peaked in late August when it accounted for 95% of SARS-CoV-2 infections in Europe. Meanwhile, the BA.2.75 subvariant, a descendant of BA.2 with nine additional mutations affecting the viral spike protein, has begun to emerge. This variant was particularly successful in India, where it comprised over 60% of infections before giving way to XBB, a recombinant strain derived from BA.2.

At present, XBB represents over 30% of infections in India but is far less prevalent in North America and Europe. In these regions, the BQ.1 and BQ.1.1 variants are gaining traction, now constituting 13% of infections—a significant rise from the 5–6% observed earlier in October.

Emerging COVID-19 variants

Section 1.2: Mythological Creatures in COVID-19 Nomenclature

As we discuss these SARS-CoV-2 subvariants, it's important to note that they all belong to the omicron lineage. The evolution of these variants can be visualized as a branching tree, where some branches thrive while others diminish. Since November 2021, no new major evolutionary branches have arisen, which means that the WHO has no grounds to classify a new variant under a different Greek letter, such as "pi."

This lack of a new major variant is beneficial, as the emergence of an entirely new strain could introduce numerous uncertainties regarding its clinical implications. Omicron infections tend to be milder, especially with vaccination, but a controversial study has shown that a recombinant virus with omicron's spike protein and features from the original Wuhan strain was highly pathogenic in animal models.

Viral evolution and its implications

Chapter 2: Naming Variants After Mythical Beasts

The trend of naming new omicron versions after mythological creatures has emerged, with the XBB recombinant dubbed "gryphon," BQ.1 referred to as "typhon," and BQ.1.1 called "cerberus." These names, while unofficial, often create misconceptions that these are entirely new variants rather than subvariants of omicron. This confusion is exacerbated by sensational media headlines that suggest an imminent threat from these namesakes.

Media portrayal of COVID-19 variants

Section 2.1: The Impact of Mythological Naming on Public Perception

This naming convention raises questions about public fear and understanding of these subvariants. While some argue that such names help in simplifying communication about variants, the reality is that they can instill unwarranted fear regarding the virus's evolution.

Experimental data indicate that BQ.1 and BQ.1.1 can be neutralized by antibodies from vaccinated individuals, but the effectiveness is significantly reduced compared to BA.5. This reduced efficacy is largely attributed to unique mutations present in these subvariants.

Understanding variant neutralization

Section 2.2: Should We Fear These New Variants?

Despite some concerning characteristics of BQ.1 and BQ.1.1, such as increased fusogenicity, preliminary studies suggest that these variants do not exhibit greater pathogenicity compared to their predecessors. Current data show that the risk of hospitalization associated with BA.5 is comparable to that of earlier omicron variants.

Rather than succumbing to fear over these mythologically named variants, it is crucial to focus on vaccination as a proactive measure. Receiving booster doses that are aligned with the evolving omicron variants is the best strategy to maintain immunity and reduce infection risk.

In conclusion, while the names "typhon" and "cerberus" may sound intimidating, the actual threat posed by these variants does not warrant panic. Continuous monitoring and vaccination remain essential in navigating the ongoing evolution of SARS-CoV-2.

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