Intended for healthcare professionals


Covid-19: BA.5 variant is now dominant in US as infections rise

BMJ 2022; 378 doi: (Published 18 July 2022) Cite this as: BMJ 2022;378:o1770
  1. Janice Hopkins Tanne
  1. New York

The BA.5 omicron subvariant of SARS-CoV-2 is now causing about two thirds of infections in the US, with cases now rising in almost every state.

Rochelle Walensky, director of the Centers for Disease Control and Prevention, told a White House press briefing on 12 July that the seven day average number of hospital admissions for covid-19 was now about 5100, double the number in early May.1

In the past 14 days (to 14 July) data collated by the New York Times show a daily average 132 928 cases, a 17% increase in cases. In the same period, the daily average of hospital admissions was 39 053, an 18% increase, the average number of covid patients in intensive care was 4411, a 22% increase, and the average number of deaths a day was 415, a 10% increase. The number of infections is thought to be higher than these figures show because positive tests taken at home are often not reported. The number of deaths may also be higher because of delayed reporting over the 4 July holiday.2

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said, “We’ve seen each successive variant have a bit more transmission advantage over the prior one. Right now we’re with BA.4 and 5, and we don’t know what the future will hold. We might get even more subvariants. We need to keep the levels of virus to the lowest possible. If a virus is not very robustly replicating and spreading, it gives it less of a chance of a mutation, less of a chance of evolving another variant.”

Fauci said BA.5 “substantially evades neutralising antibodies induced in people by vaccination and infection. But the vaccine effectiveness against severe disease, fortunately for us, is not reduced substantially or at all compared to other omicron subvariants.”

Walensky said, “We do not know yet about the clinical severity of BA.4 and BA.5 in comparison with our other omicron subvariants, but we do know it to be more transmissible and more immune evading. People with prior infection, even with BA.1 or BA.2, are likely still at risk for BA.4 or BA.5.” She said there was no evidence available to suggest the variants caused more severe disease.

Americans are undervaccinated, Walensky said, and she urged everyone to make sure they are up to date with their vaccines and boosters. Soon another vaccine may be available: Novavax. It was approved by the Food and Drug Administration on 13 July and will be considered for approval by the CDC on 19 July.

Ashish Jha, the White House covid-19 response coordinator, said, “We are at a point in the pandemic where most covid-19 deaths are preventable. First, vaccines remain our single most important tool to protect people against severe illness, hospitalisations, and death. Staying up to date [on vaccinations and boosters] is essential as we see BA.5 rise across the country.” Jha also noted that the oral antiviral Paxlovid was available and also advised people to consider taking a covid test before attending large indoor gatherings or if visiting indoors with a high risk immunocompromised individual.

But Eric Topol, founder and director of the Scripps Research Translational Institute, said in an interview with the Public Broadcasting System that he was concerned that many people were not following advice on vaccination, masks, and other precautions. “It’s sad, because we basically have capitulated to the virus,” he said. “It’s very likely things will get worse because of our unwillingness to keep up our guard.”3

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