Covid-19: Should we really be panicking over the emergence of the Kraken variant?

His name, which he used informally Attributed to Ryan Gregory, a biologist at a Canadian university, in social networks, is also that ofa devastating monster from Norwegian mythology. The sub-variant of Omicron, also known as “Kraken” (officially referred to as XBB.1.5), was noisy in circulation the World Health Organization (WHO)in thirty-eight countries by mid-January 2023, particularly in United Stateswhere it was the majority and represented more than 80% of the sequences performed.

This variant, which would have appeared at the end of October 2022, has already landed in Europe and is even evolving quite quickly there: it accounts for 8.1% of sequences in the UK and 2.2% in Denmark. In France and acc Data from Public Health Franceit has been circulating quietly for a few weeks, representing only about 2% of the contamination, during the peak of the ninth epidemic wave reached and that a sharp decline had largely begun.

A kraken looks like this in mythology. But the variant we’re talking about is actually a lot less scary. | public domain via Wikimedia Commons

Should we be worried about the arrival of octopuses today? Yes, but without reason to fear it more than necessary. The emergence of a new epidemic wave is never good news. We know today that it will come with a sad procession of new cases and long covidbut also new hospitalizations and new deaths of vulnerable people. So don’t panic, but don’t be complacent fatalism either. We’ve been asked to ‘live with’, we’ll suggest you try to ‘live better with’ – more like ‘live without’, besides, now you know us.

X.BB.1.5, who are you?

Since we have already become a little familiar with the large Omicron family, we will take the liberty of addressing the youngest of the siblings right away – forgive us, we have the impression that we already know the offspring quite well. What do we know about Kraken (XBB.1.5) today?

Let’s first assume that it is a subvariant of Omicron, more specifically a descendant of the recombinant XBB subvariant of Omicron. In fact, the prefix “X” in the naming convention for variants and subvariants of SARS-CoV-2 denotes a family tree resulting from recombination genetically of two sub-variants. Thus, the XBB lineage most likely arose as a result of natural co-infection of a human host with two Omicron subvariants, namely BA.2.10.1 and BA.2.75. It was first identified by health authorities in India in the summer of 2022. And XBB.1.5 is the “fifth grandson” of the parent XBB sub-variant.

In fact, XBB.1.5 is part of the soup of more than 650 Omicron subvariants listed worldwide so far. Lots researcher they consider to be the most genetically mutation-rich and transferable variant to date. The same scientists accuse the International Virus Taxonomy Committee WHO, for a year, stopped naming the new variants of the Greek letter omicron and disguised its subvariants with a sequence of letters and numbers that was incomprehensible to the general public. They therefore decided, as loners and quite unofficially, to give them nicknames.

Don’t panic: more transmissible doesn’t mean more virulent

All of these nicknames are meant to be easier to remember, so with good intentions. The choice of these nicknames makes sense nonetheless. Ryan Gregory did not name names Flower or painters, but monsters designed to provoke fear. However, if some like to get scared and fear the consequences of an insane twist and suggest disaster movie scenarios, we must be right.

Indeed, remember that RNA viruses are known to mutate frequently, and the coronavirus, whose circulation is planetary and massive, has accustomed us for three years to see the emergence of many subvariants. The variants that emerge and prevail, replacing their predecessors, are expected to win these tournaments precisely because they are more portable.

Admittedly, we experience the classic evolutionary processes in the biological world at an accelerated rate because they are planetary. As long as SARS-CoV-2 has not been eradicated or even contained, the increased transmissibility of a variant that takes over other variants, even those that are circulating strongly, is not a surprise.

We can almost say that every new variant that becomes dominant in the current context is more transferrable and inevitably more escapes immunity hybrid, yes very common in the population. There is therefore no reason today to believe that the succession of epidemic waves that we have been facing for the past three years, and which even accelerated in 2022, will soon end spontaneously.

Increased portability means a reproduction rate higher, the latter being the number of secondary cases per infected person. But the degree of transmissibility of a strain says nothing about its virulence. However, as mentioned above, a disaster scenario would consist of the emergence of a new variant that is both more transmissible and more virulent.

Obviously, the increased virulence of a new variant would worry us. But nothing today indicates that XBB.1.5 causes more complications and severe forms than its predecessors. In fact, when looking at the hospitalization curve for Covid in New York, where there is a majority, we can clearly see an increase in admissions between late November 2022 and early January 2023 (with a subsequent curve of deaths). But these values ​​fortunately remain very low compared to those reported during the January 2021 and even January 2022 waves (due to Omicron’s first BA.1 variant).

Hospital admissions are on the rise but are a long way from the winters of 2022 and 2021. | screenshot The State of New YorkAs of January 23, 2023.

These hospital admissions, a true reflection of the severe forms of Covid-19, we now know affect the older if they are not very old and therefore particularly vulnerable to infections because of their age and immunosenescence what follows. However, the peak of the Kraken-linked New York wave seems to have been reached in recent days: the curve of hospitalizations is declining. In other words, let’s stop predicting a “devastating surge.” new York hasn’t seen it, Western Europe has no reason to watch it.

And if we were inspired by the rich?

It is difficult to distinguish between the intrinsic increase in transmissibility and that associated with immune escape due to mutations in the strain. We recognize that today there are still questions about XBB.1.5’s ability to evade vaccines and to monoclonal antibodies. Again, the New York experience stands us in good stead because we have yet to see properly vaccinated youth flocking to hospitals.

Vaccines continue to offer strong protection against severe forms of Covid-19. Unfortunately, in the face of these new variants, monoclonal antibodies have gradually lost their potency and become unusable. Good news on the antiviral side, including the paxlovid is leading: There are no pharmacological reasons for their activity to be altered by the mutations observed in Omicron subvariants. Therefore, to this day it is not legitimate to wave further red flags.

Instead of toying with scaring ourselves, let’s expend our energy instead
and our resources to try to get better in terms of prevention
and risk reduction.

But make no mistake, the idea is in no way meant to say that we should sit idly by. You know us well enough not to even suspect that we would imply it. We believe that those who constantly yell wolf run the risk of being counterproductive. Continued dramatization might even lead us to become mithridat, creating a kind of fatalism that robs us of our agency, collectively and individually. It may not be the time to stay indoors this form of permanent emergency we knew, but to focus from now on on using what we are less good at, namely prevention and anticipation.

Whether XBB.1.5 is looming and taking advantage of the doldrums in France to tumble noisily in a few weeks or a few months, or whether it’s the work of another more competitive variant emerging from the soup of the 650 candidates in the running, we know that we will not be powerless to respond appropriately when the time comes. The risk is always there and as said on 16.01the pandemic is not over yet.

Rather than hesitantly fearing the arrival of these new variants, we should instead focus our energy and resources on achieving better prevention and risk reduction. No contamination is trivial, those who suffer from Covid for a long time, or who are hospitalized for serious complications, know about it. It is in all of our interests to avoid reinfection as far as possible.

The efforts that should be made today are aimed at reducing the risks Contamination in closed rooms. Look at what the rich are doing, the ones who think their importance keeps them from getting sick. at World Economic Forum Davoswhich took place from January 16th to 20th, 2023, all participants wore masks and were tested, and those who were positive saw their badge immediately deactivated and no longer have access to forum activity. The meetings took place in rooms equipped with air cleaner and many interiors were equipped with UV-C lampswith proven virucidal effect.

Yes, this is how you should behave in closed, crowded places where you are staying. Due to the cold, the organizers could not ventilate all the rooms effectively, so resorted to risk reduction methods. Perhaps we will soon have epidemiological results from the PCR carried out in Davos and can evaluate these different protective measures.

We repeat it again: air quality is important

What the leaders of this world are demanding is exactly what each of us needs today schoolsHospitals, Prisons, Bars, Restaurants, Clubs, public transportation and meeting rooms. Wherever we are in closed places, we want to be able to benefit from air of acceptable microbiological quality, that is to say significantly reducing the risk of contracting Covid. fluRespiratory syncytial virus (RSV) or tuberculosis.

If the virus circulates heavily in the community, we will also remind about it how important it is to wear a mask in closed public places, including public transport. We will repeat how important it is Stay up to date with your vaccination reminders and the importance of being able to prescribe antiviral treatments to those most at risk as soon as possible after their infection. For that, we must continue to test them at the slightest symptom. Finally, we will insist on the need for quality health surveillance in each country, so that the authorities can better anticipate the evolution of this pandemic.

Whether it’s XBB.1.5 unleashing a tenth epidemic wave or some other variant, whether they’re called Kraken or Daisy, the question that should rather be asked is whether we’re doing everything we can to say without boasting or complacency: “I, not even scared!”

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