COVID variant XBB.1.5 remains ‘crazy infectious’

Oklahoma has implemented strategies to combat the highly contagious XBB.1.5 variant that threatens another wave of infections.

The new variant has quickly jumped to the top of the list for new cases across the country, and the Oklahoma State Department of Health has identified two cases of XBB.1.5.

Although still well below what was experienced in 2022 with the omicron surge, there has been an uptick in state hospitalizations. Almost 6,000 new cases of COVID-19 have been reported by the OSDH, but that number only represents those whose tests were reported. State officials caution that the number of cases could be even higher, because at-home tests are not reported and, therefore, aren’t included in official counts.

Medical experts warn that essentially, everyone is now at risk for infection, even if they’re super careful, up to date on vaccines or have caught COVID-19 before.

“It’s crazy infectious,” says Paula Cannon, a virologist at the University of Southern California. “All the things that have protected you for the past couple of years, I don’t think are going to protect you against this new crop of variants.”

Despite the high level of infections, Cannon credits the relatively low number of severe infections and deaths to vaccinations and, probably, previous infections.

While renewing and committing to protective measures observed during the height of the pandemic are helpful, experts say the lack of universal masking means that even those who wear masks are vulnerable.

XBB.1.5 is receiving particular attention because of how quickly it has become the nation’s most prevalent COVID- 19 variant. The Centers for Disease Control and Prevention estimates that the variant comprises about 28% of cases nationwide, which is up about 18% in recent weeks.

In the Oklahoma region, which also includes Arkansas, Louisiana, New Mexico and Texas, the CDC estimates XBB.1.5 makes up about 17% job current cases.

Part of what’s enabled XBB.1.5 to spread so quickly is that it doesn’t seem to be affected much by antibodies developed through a recent infection or vaccination.

“People who’ve previously been infected with COVID, or who have received the vaccine, even the most recent bivalent booster, this particular subvariant doesn’t seem to be as susceptible to the antibodies that you developed when you were either infected or got vaccinated,” says Dr. Dale Bratzler, the University of Oklahoma’s chief COVID officer. “So it’s spreading quite rapidly.”

Vaccination for COVID-19 is still effective at preventing severe disease or death from the virus, though you can still be infected even if you were vaccinated.

For now, however, two other omicron subvariants — BQ.1 and BQ.1.1 — remain dominant in Oklahoma.

Combined, they make up about 63% of cases in the region.

Additionally, the Food and Drug Administration is finding that some treatments used for COVID-19 in the past won’t work against newer variants. Two monoclonal antibody therapies previously used to treat COVID-19 patients are unlikely to work against newer variants.

“Because now more than 80% of the strains that are circulating would not be expected to be prevented with [previously effective therapies], we’ve elected to stop offering it to our patients,” Bratzler says.

But there are still treatment options to help prevent severe disease and death from COVID- 19. Antiviral drugs Paxlovid and remdesivir are still available and aren’t affected by the virus’ mutations.

Bratzler says he’s seen some troubling cases of high-risk COVID-19 patients being treated with “all sorts of stuff,” including antibiotics and steroids, instead of antivirals proven to work against COVID- 19.

“I’m trying to get the message out to providers that antiviral drugs are the agents of choice when a high-risk individual tests positive for COVID,” he says. “I continue to see providers giving things that have not been shown to be useful and could even be harmful.”

The CDC has reinstated distribution of free at-home COVID-19 tests. Every U.S. household is eligible to order four no-cost COVID-19 tests. To order, visit COVIDTests. gov, or call 800-232-0233.