COVID on the rise and what you need to know about the newest omicron subvariants

Teddy Rosenbluth

If you’ve been following COVID trends for the last three years, the most recent state data might give you deja vu.

Just as in years prior, hospitals are seeing a resurgence of people, counties throughout the state are shaded orange on the CDC’s risk map, and experts are urging booster shots.

Dr. Cameron Wolfe, a Duke infectious disease expert, breaks down what to expect in the coming weeks and what to know about the newest omicron variants:

2023’s winter surge

There is good news and bad news.

The bad news is that most COVID-19 metrics point to an impending surge. Maybe most alarmingly, the number of people testing positive for COVID-19 in hospitals has risen sharply from 1,081 the week of Christmas to 1,586 the next week.

The good news is that Wolfe expects this surge to be less severe than in years past.

North Carolina is in much better shape than it was in 2020, when vaccines weren’t widely available or 2021, when delta filled emergency rooms and sickened health care staff.

“There’s no reason to expect that this would be as bad as last year,” he said. “These are not markedly new variants.”

In North Carolina, the surge is still being driven by omicron subvariants, which most people have some level of immunity to.

To Wolfe, the most shocking statistic was the low percentage of North Carolinians who have received the bivalent booster.

“Good grief, we’ve done this two years running and we still only have 20%?” he asked. “That’s just so disappointing.”

What we know about the XBB variants

The state’s data shows the rise in the new “XBB” subvariants.

Right now, the XBB variants make up about 5% of cases in North Carolina. However, experts expect them to take over as the dominant strains in the coming months.

Here’s what you need to know about the variants:

  • The XBB subvariants are better at evading natural immunity from prior COVID infections and vaccine-generated immunity than were previous variants. That means those who have had COVID-19 before — even recently— could be vulnerable to reinfections, Wolfe said.

  • The subvariants appear to have a mutation that makes them more infectious than prior variants, Wolfe said.

  • Like the BQ variants, these variants are more resistant to monoclonal therapies, which doctors prescribe to immunocompromised patients to avoid infection and to COVID-positive patients who are at a higher risk of developing complications from the virus.

  • Doctors still have many antiviral medications that work well against the new variants, like Paxlovid, Remdesivir and Molnupiravir, Wolfe said.

  • The XBB variants do not appear to cause more severe illness than previously dominant variants, Wolfe said.

Teddy Rosenbluth covers science and healthcare for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.

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