What Is XBB? New Infectious Omicron Variant, COVID

  • XBB is a new version of Omicron that evades existing treatments and immunity.
  • It is spreading rapidly in Singapore, and virus watchers are worried it could spread to the US.
  • BQ.1.1 is also under development. Experts say: brace yourself for more COVID infections this winter.

As Halloween approaches, murmurs of another variant of the COVID “nightmare” on the way are spooking Wall Street reporters and analysts alike.

The new variant is called XBB and is already triggering a new wave of infections and hospitalizations in some South Asian countries, including India and Singapore.

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XBB is just one of “multiple more immune-evasive Omicron subvariants on the rise worldwide,” infectious disease expert Dr. Celine Gounder, a senior fellow at the Kaiser Family Foundation, told Insider.

But “among the new variants, XBB has the most significant immune evasion properties,” market experts at Morgan Stanley said in a note on Thursday.

Given that we’ve now seen almost three full years of COVID variants – and almost a year of different Omicrons before XBB came out of them – how worried should we really be about this new version of the virus?

Experts say we should expect many more infections this fall and winter, including infections in vaccinated and boosted Americans. But there are some simple things you can do to prepare to fight XBB and other elusive variants of COVID on the horizon.

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What is XBB?

XBB is a recombinant variant – meaning it is a combination of two other Omicron BA.2 subvariants (specifically, BA.2.10.1 + BA.2.75).

Like other Omicrons we’ve seen before, XBB “finds ways to circumvent how we get immunity from previous vaccines and infections, with changes to the spike protein,” said UC infectious disease expert John Swartzberg Berkeley, for the San Francisco Chronicle.

It remains to be seen if XBB will truly dominate the US COVID infection landscape this winter, or if it will be just one option among the wide buffet of Omicron subvariants.

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So far, it doesn’t even make a dent on the radar of US virus watchers compared to other Omicrons. It is possible that the BA.5 subvariant, BQ.1.1., which is already on the rise in Europe, will prove to be a bigger concern to Americans than XBB ever will be.

Professor Moritz Gerstung, a computational biologist from Germany, he recently said on Twitter that we may have a “close race” between BQ.1.1 and XBB in the next few months. Both have a slight growth advantage over BA.5, which is the dominant version of COVID right now in the US.

Why is everyone scared of XBB?

cases rising rapidly Singapore

Our World in Data/CSSE COVID-19 Data from Johns Hopkins University

In Singapore, reinfections and hospitalizations are on the rise, driven by XBB – although local trends suggest that this version of the virus may also be somewhat milder than BA.5, with a 30% lower risk of hospitalization.

Both XBB and BQ.1.1 also show resistance to monoclonal antibodies, a treatment used for COVID patients.

That’s why Gounder insists that, whatever happens next, “it’s really important that those most at risk, including people 50 and over and people who are immunosuppressed, get boosted right away if they haven’t been already this autumn”.

The new bivalent booster shots should hold up against XBB

Remember: this is still Omicron, and the new pushes from Pfizer and Moderna target BA.4 and BA.5, which are related to XBB.

That means existing vaccines should “protect against severe disease, hospitalization and death,” Gounder said. “But I expect a lot of breakthrough infections despite vaccination” in the coming winter months, she added, whether it’s XBB or another elusive new variant.

According to CDC data, fewer than 15 million Americans have received an updated booster so far this fall — that’s less than 5 percent of the country, so there’s room for improvement with both:

Gounder said he knows Americans are tired of mitigation measures, but says “high-quality masks will be important to reduce transmission, especially in indoor public spaces” this winter.


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