COVID-19 Continues: BA.4, BA.5 Drive Rise in Hospitalizations

Cleveland.com

Local and national public health officials are closely tracking the emerging BA.4 and BA.5 omicron subvariants, which make people feel sick longer and spread the illness to others more easily.

The subvariants are also able to evade immunity based on prior infection, said Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention.

Those who are hit with BA.4 or BA.5 will likely be infectious longer, have a higher viral load and transmit the coronavirus to others more easily, said Jana Rush, director of epidemiology, surveillance and informatics for the Cuyahoga County Board of Health.

“It’s more transmissible because it’s a new variant that has found ways to evade the immune system,” Rush said.

People who have had prior infections “are likely still at risk for BA.4 or BA.5,” Walensky said during a White House press briefing last week.

Vaccination is less effective against the BA.5 variant, the Ohio Department of Health said in a statement. “Currently, there is no evidence to suggest that BA.5 makes you more sick,” ODH said.

In Cuyahoga County, overall COVID-19 cases have been increasing since April, Rush said. Average daily cases have increased from 250 per day to 300 cases per day.

However, the new omicron subvariants are not contributing to increased hospitalizations, intensive care unit admissions or deaths in Cuyahoga County, Rush said. She pointed to vaccines as the reason why hospitalization rates are not going up.

Overall, COVID-19 cases are underreported because many people take at-home tests, or have mild symptoms and don’t get tested, Rush said. “We can be anywhere three to five times higher than what our current rate is showing,” she said.

The BA.4 and BA.5 subvariants now make up 80% of circulating virus in the United States, according to federal data, and are driving a new wave of COVID-19 cases across the country. Nationally, hospital admissions for COVID-19, while far lower than they were in January, have doubled since early May, according to federal health data.

Local health officials began detecting BA.4 and BA.5 in early June, and it became the dominant variant by late June. Currently, about 65% of our total cases are due to BA.5, according to the CDC, Rush said.

In Ohio, BA.5 was first detected by the state’s Coronavirus Wastewater Surveillance System on May 8. Currently, the variant accounts for about 60% of the COVID-19 virus statewide, but is 40% of the virus found in the Cleveland area, ODH said.

ODH does not compile variant data by county, but BA.5 is increasing in all regions.

Below are questions and answers about BA.4 and BA.5, from Rush and Erika Sobolewski, Summit County Public Health medical director.

Q: Do current vaccines protect against these subvariants?

Researchers are still collecting data on vaccine effectiveness against BA.4 and BA.5, Walensky said. “We know that vaccine effectiveness against severe disease and death remains high for other omicron sublineages and likely also for BA.4 and 5,” Walensky said.

Q: Do the current vaccines work against BA.5?

COVID-19 vaccines do provide protection, which is why the BA.5 and BA.4 surge isn’t causing an increase in hospitalizations and deaths.

Q: Is it a good idea to get a booster shot to protect against the BA.5 variant?

“We absolutely recommend a booster dose for the population as a way to boost up immunity against COVID-19 and any other future variants that will likely come as a result of the coronavirus,” Rush said.

Q: Will drug companies produce a new COVID-19 booster that is effective against new versions of omicron?

New booster shots are expected to arrive in early October, the White House said recently. The booster doses will be rolled out through December, officials said.

Q: How can people protect themselves and their families from this new variant?

Wear a mask, especially in large crowds, social distance, wash hands frequently, and test for COVID-19 as soon as symptoms are noticed.

“We want people to go back to the tried and true things that we know work to help prevent the spread,” Rush said.

Q: Should we expect a fall COVID-19 surge fueled by BA.4 and BA.5?

Northeast Ohio is experiencing a surge now, fueled by the new omicron variants, but it’s too early to say if the surge will continue into the fall, Rush said.

However, Sobolewski thinks we should prepare for a fall surge.

Q: Will these new variants jolt people out of pandemic fatigue?

“My job and my passion is to try to keep the fire alive for people to continue to fight against that pandemic fatigue, and still be cognizant of their risks, the dangerous to themselves the dangers that they might carry,” Sobolewski said. Pandemic fatigue is “the reality of the situation, but I also think it’s important for people to keep up the good fight.”