Omicron subvariants resistant to major antibody treatments will soon make up the majority of new Covid infections in the United States, according to the Centers for Disease Control and Prevention.
Omicron BQ.1 and BQ.1.1 subvariants now account for 44% of new Covid cases compared to 32% last week, according to CDC data. These sub-variants will likely become dominant next week.
The once-dominant omicron BA.5, meanwhile, has been displaced and now accounts for 29% of new infections.
BQ.1 and BQ.1.1 pose a particular threat to people with severely weakened immune systems, such as organ transplant patients and people undergoing cancer chemotherapy.
People with weakened immune systems often do not respond sufficiently to Covid vaccines and therefore need additional medication to protect them from the virus.
Many people with moderate or severely weakened immune systems take an antibody cocktail called Evusheld to protect them against serious illness. It is given as two injections every six months.
But BQ.1 and BQ.1.1 are likely resistant to Evusheld, according to the National Institutes of Health. This makes people with weakened immune systems increasingly vulnerable as these subvariants become dominant.
BQ.1 and BQ.1.1 are also likely resistant to bebtelovimab, a monoclonal antibody that people with weakened immune systems can take to prevent severe Covid illness after infection.
Although Pfizer’s antiviral drug Paxlovid remains effective, organ transplant patients often cannot take the pill because of how it interacts with other medications they need.
White House chief medical adviser Dr. Anthony Fauci in a radio interview last week said the United States is at a pandemic crossroads as the more immune-evasive BQ subvariants increased every week.
“What concerns us is that some of our tools in our arsenal could be negated if, in fact, these new variants become much more dominant than they are,” Fauci said.
And there are no substitutes for drugs like Evusheld on the way. The White House’s Covid response coordinator, Dr Ashish Jha, has accused Congress of failing to pass additional funding for the country’s response to the pandemic. Republicans have blocked more Covid money since the spring.
“We had hoped that over time, as the pandemic continued, as we fought this virus, we would expand our medicine cabinet,” Jha told reporters at the House. White last month.
“Because of the lack of congressional funding, that medicine cabinet has actually shrunk and that puts vulnerable people at risk,” Jha said.
Last month, President Joe Biden made it clear to people with weakened immune systems that they faced a particular threat from Covid this winter. The president urged them to speak with their doctors about precautions.
Fauci said people who are at high risk from Covid should wear masks indoors in public this fall and winter, and people who have vulnerable people in their homes should do the same when they go out.
People should also consider taking rapid Covid tests before going to indoor social gatherings where vulnerable people will be present, Fauci said. He encouraged everyone who is eligible to get their flu shot and their Covid booster this fall.
“It’s a really good way to make sure you don’t spread infections, so use tests, wear masks where appropriate and get vaccinated,” he said.
US health officials believe that omicron BA.5 boosters should provide sufficient protection to the general population against BQ.1 and BQ.1.1 because these subvariants are related to BA.5.