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SALT LAKE CITY — Nearly 30% of Utah's COVID-19 cases are likely being caused by what the state's chief scientist called a "nasty" pair of fast-spreading and treatment-resistant descendants of an omicron subvariant that's dominated in the United Staes since mid-year.
Known as BQ.1 and BQ.1.1, the latest versions of the virus are even more transmissible than their predecessors, said Kelly Oakeson, chief scientist for next generation sequencing and bioinformatics for the Utah Department of Health and Human Services,
"Anytime you see a variant start to grow in proportion over other variants, that means it's better at infecting you. So, yeah, the 'BQs' are more effective," Oakeson said, also noting they don't respond well to monoclonal antibody treatments, often used for those at high risk of hospitalization or death.
'Variant soup'
What's troubling, too, is that the pair are among several versions of the virus vying to topple the BA.5 omicron subvariant now believed to be responsible for less than 40% of COVID-19 cases in the region that includes Utah, according to the latest forecast from the Centers for Disease Control and Prevention.
"That's kind of the weird, scary part," Oakeson said. "Previously, we had big waves of a single variant, right? This variant came in to take over. ... We're not seeing that same pattern with this. We're kind of starting to see a handful of them that are equally as good as the other one at infecting us."
Reuters reported last week that BQ.1 and BQ.1.1 are among the more than 300 sublineages of the original omicron variant that sent cases soaring to record levels in the United States last winter that are now circulating globally, 95% of which are direct descendants of BA.5, according to the World Health Organization.
What Oakeson called a "variant soup" is something new and not what health experts had hoped would happen.
"Now, we're just seeing these omicron lineages all kind of, if you will, playing the lottery to find out which one is going to hit that right constellation of mutations that's going to drive it over the top," leading to a COVID-19 version that is not only more transmissible but also more severe than what's been seen, he said.
"It's almost like playing Russian roulette," said Oakeson, the state's chief scientist responsible for sequencing COVID-19 test samples to determine what variants are circulating. "The more we keep letting this thing keep circulating and evolving, eventually one of them is going to hit that combination. And that's not good."
The 'nightmare variant' is also in Utah
Last week, Oakeson said well over 300 test samples mostly collected in mid- to late October that were sequenced turned out to be from BA.5, while nearly 100 were from BQ.1 or BQ.1.1. putting Utah in line with the CDC's variant forecast for the region that also includes Colorado, Montana, North and South Dakota, and Wyoming.
There are another half-dozen versions of the virus circulating, according to the CDC's weekly forecast, last updated on Thursday, but so far, none are believed to account for more than 5.4% of COVID-19 cases. Oakeson said there's another version in Utah not showing up yet on the CDC forecast, XBB.
But even though XBB, a recombination of existing versions of the virus that came from omicron, is being labeled a "nightmare variant," he said he "wouldn't call it more powerful in some ways. It's just another way the virus is evolving."
Still, Oakeson said, "between BQ and BA.5 and XBB, I think there's plenty for us to worry about, for sure."
Nationally, BQ.1 and BQ.1.1 now make up 35% of COVID-19 cases, according to the CDC forecast for the United States. The BA.5 subvariant, targeted in the updated COVID-19 booster shot, now accounts for less than 40% of cases around the country.
What Utahns can do
The constant evolution of the virus isn't likely to result in an end to COVID-19, Oakeson said, advising Utahns to protect themselves and others by taking preventive measures including getting the updated booster shot that should still prevent hospitalizations and death from even the newer versions of the virus.
"I don't think it's going to wipe itself out," he said. "I think we're probably going to be in this ongoing cycle of waves and surges of COVID. We'll have a new lineage come through. It'll make us sick and cause an increase in cases, stress our hospital systems," before people develop some immunity from vaccines and infections.
"Then," Oakeson said, "the next one will happen and we'll see this same kind of pattern."
