Future COVID Variants Will Likely Reinfect Us Multiple Times a Year, Experts Say

For more than a year now, the original COVID-19 vaccines have held up remarkably well — even miraculously so — against a Greek alphabet of new variants: Alpha, Beta, Gamma, Delta.

But now experts say something is changing. Since the start of 2022, the initial version of Omicron, known as BA.1, has been spinning off new sublineages — BA.2, BA.2.12.1, BA.4, BA.5 — at an alarming pace.

Earlier variants did this too. But it never really mattered, because their offshoots “had no functional consequence,” according to Eric Topol, founder of Scripps Research Translational Institute. “They did not increase transmissibility or pathogenicity.”

Today’s rapidly proliferating Omicron mutants are different, however. They all have one worrisome trait in common: They’re getting better and better at sidestepping immunity and sickening people who were previously shielded by vaccination or prior infection.

The virus, in other words, is now evolving faster — and in a more consequential way — than ever before. Given the increasing speed of immune evasion, and what this pattern portends for the future, experts warn that the time has come to rethink our reliance on the vaccine status quo and double down on next-generation vaccines that can actually stop infection.

“As difficult [as] it is to mentally confront, we must plan on something worse than Omicron in the months ahead,” Topol wrote on May 15. “We absolutely need an aggressive stance to get ahead of the virus — for the first time since the pandemic began — instead of surrendering.”

The brewing storm of BA sublineages isn’t all bad news. COVID cases have been rising nationwide since the beginning of April, nearly quadrupling over the last six weeks to more than 90,000 per day on average. Yet both COVID deaths (about 300 per day) and ICU patients (about 2,000 total) are still at or approaching record lows — even though other countries with bigger gaps in previous exposure or vaccination have been hit hard, and even though new research shows that Omicron and its spinoffs are not, in fact, intrinsically less severe or deadly than prior variants, contrary to early assumptions.

By: Andrew Romano

Source: Future COVID variants will likely reinfect us multiple times a year, experts say — unless we invest in new vaccines

Critics by: Apoorva Mandavilli

The new variants have not altered the fundamental usefulness of the Covid vaccines. Most people who have received three or even just two doses will not become sick enough to need medical care if they test positive for the coronavirus. And a booster dose, like a previous bout with the virus, does seem to decrease the chance of reinfection — but not by much.

At the pandemic’s outset, many experts based their expectations of the coronavirus on influenza, the viral foe most familiar to them. They predicted that, as with the flu, there might be one big outbreak each year, most likely in the fall. The way to minimize its spread would be to vaccinate people before its arrival.

Instead, the coronavirus is behaving more like four of its closely related cousins, which circulate and cause colds year round. While studying common-cold coronaviruses, “we saw people with multiple infections within the space of a year,” said Jeffrey Shaman, an epidemiologist at Columbia University in New York.

If reinfection turns out to be the norm, the coronavirus is “not going to simply be this wintertime once-a-year thing,” he said, “and it’s not going to be a mild nuisance in terms of the amount of morbidity and mortality it causes.”

Reinfections with earlier variants, including Delta, did occur but were relatively infrequent. But in September, the pace of reinfections in South Africa seemed to pick up and was markedly high by November, when the Omicron variant was identified, Dr. Pulliam said.

Reinfections in South Africa, as in the United States, may seem even more noticeable because so many have been immunized or infected at least once by now.

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