Emory’s Dr. del Rio discusses concerns over a new, unique COVID variant

This variant, BA.2.86, could dodge a person’s immunity and be more infectious and possibly cause more severe illness
Here's what to know about BA.2.86

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Here's what to know about BA.2.86

Only 11 confirmed cases of the new coronavirus variant BA.2.86 have been reported around the world — but the highly mutated virus has generated intense monitoring by scientists and public health experts.

This variant appears vastly different from its predecessors. Most widely circulating omicron variants feature a small handful of mutations that make them slightly different from the last. But the BA.2.86 features at least 30 mutations on its spike protein that separate it from other omicron strains — potentially giving the virus greater infectivity by being able to dodge a person’s existing immunity from vaccines and previous infections.

The Centers for Disease Control and Prevention said this latest variant doesn’t now appear to make people sicker than earlier iterations, and that antiviral treatments such as Paxlovid should still be effective, according to a risk assessment published by the CDC. COVID tests should also still detect it.

The coronavirus uses a spike protein to gain entry into the cells of people and start the replication process that makes people sick. These mutations could help the variant dodge the body’s immune defenses from prior infections or vaccines. Researchers say it is too soon to know how immunity will be affected.

The CDC said the number of cases is likely higher. Preliminary findings from routine wastewater surveillance in the U.S. are also indicating the presence of this strain with a striking number of mutations.

There have only been a few cases detected in the U.S. — and none yet in Georgia.

Georgia and the U.S. are experiencing a steady uptick in COVID hospitalizations, which the CDC believes are likely caused by other omicron variants.

In this file photo, Dr. Carlos del Rio speaks at the press conference.   Bob Andres / robert.andres@ajc.com

Credit: Bob Andres

Credit: Bob Andres

The Atlanta Journal-Constitution interviewed Dr. Carlos del Rio, the interim dean of the Emory University School of Medicine and professor of medicine, epidemiology and global health, about this latest variant and what to do to stay protected against COVID. Some of del Rio’s comments were edited for length and clarity.

Q: Why is this particular variant getting so much attention?

A: What makes this variant very unique is how different it is from previous variants.

There are significant mutations on the spike protein and this is going to give the variant a level of immune escape that people are concerned about. What we don’t know yet is whether this variant is as transmissible as the others.

There is concern this variant is so different the new, updated vaccine may not offer much protection against it.

Q: How worried are you?

A: I think we need to be realistic. Unless something dramatic happens, it doesn’t look like this variant causes more severe disease. Early in the pandemic, like very early on, you had a totally naive population (which means having an immune system that had never been exposed to the virus). So people who got infected had no defenses. They got really sick and many people died. As time has progressed, we are at a very different place. We have more immunity — 97% of the population has some degree of immunity either from vaccines or from infection or both. When people say a pandemic is over, they think it would be like closing a door.

In this file photo from August 2021, Emory infectious diseases expert  Dr. Carlos del Rio addresses rising cases of the delta variant of COVID-19 during a press conference. (Jenni Girtman for The Atlanta Journal-Constitution)

Credit: Jenni Girtman

Credit: Jenni Girtman

But COVID needs to become part of our everyday respiratory viruses, just like you’re worried about the flu, you worry about RSV — COVID is now one more thing to worry about.

The flu has been with us and yes, it’s a very significant threat, it kills 30,000 to 50,000 people in the U.S. a year, and yet we have learned to live with it.

The big unknown with COVID is long COVID. But not as many people infected with COVID today are getting long COVID. It’s a lot lower but we really don’t know what it will be like over time.

But how do we deal with COVID? It is an important question. Is it time to go back to the restrictions of the past, like closing schools and businesses? Absolutely not.

But we have to figure out how to deal with outbreaks. Schools are going to have to figure this out, and I think for example, improving air quality indoors is really important. How do we interrupt transmission in the general population? Is it even possible?

Q: So what should people do or what changes should they make or not need to make?

A: We are probably not going to stop what we are doing. Most people are not going to stop going to restaurants or going to large indoor events. But if you are immunocompromised, if you are elderly, you are going to make very different decisions, right?

Most people who are dying are over the age of 85. So we have to figure out how to protect our vulnerable populations and what can we do. What can society do?

Q: Do you think it’s just a matter of time before it’s detected in Georgia?

A: It’s already been detected in several countries and already in Michigan. So I think it’s going to be here unless it doesn’t, doesn’t spread as easily, and we don’t know the answer to that yet.

Q: The monovalent XBB vaccine for fall isn’t yet ready and already we have this new variant that seems significantly different from earlier lineages … is this telling us we need a different tactic for developing COVID vaccines?

A: We cannot continue chasing variants. I think that we need to be realistic that yes, a new a new vaccine is being developed and it may not work against the variant that is now circulating. And that’s why again, the investment the government is making in developing better coronavirus vaccines I think is really important because we need a more broad coronavirus vaccine that is less specific than the vaccine we have right now. I would put these in the category of first-generation vaccines.

We cannot continue using the same tools and get better results.

Hopefully, we will get better vaccines later on. I think we are still a ways off from having this.

Q: What about the vaccine coming? Who should get it?

A: Predicting the future is hard, but I suspect what’s going to happen is the vaccine is going to be recommended for everyone over the age of 6 months. I think the people who really, really need to receive it are the people who are over the age of 65. If you look at who received the last booster, it was only 16% of the population. It was only about 45% of people over 65. So we need to get more older people vaccinated.

Q: How are you feeling about where we are in the pandemic at this moment and whether people should change their behavior with this latest uptick in cases?

A: People are going to have to make their own risk assessment. If you start hearing your friends and family and others are getting infected, that means that there’s a lot of COVID out there in the community. Then I’ll need to decide: Do I wear a mask when I’m around a lot of people like when on public transportation?

I definitely stay up-to-date on my vaccinations. If I test positive, if I feel symptoms, I go ahead and get tested quickly.

I think the most important thing that people need to do, honestly, is if you if you don’t feel well, stay home.

Stay away from people who live in your home so you don’t infect them if you have COVID.

Staying home from school or work if you are sick is really so important.

People need to stay alert. People need to realize that COVID is not done. It’s going to become a part of our lives and we are going to have to learn how to live with COVID. It’s a big challenge for everyone because we would all like to say I am done this. But COVID is not done with us.

What you need to know about COVID testing and treatments


The Georgia Department of Public Health is still providing free COVID tests at locations throughout the state listed here. But hours are limited.

Home test kits are harder to come by now, but they’re still important.

Home test kits also have expiration dates, and many of the free tests distributed in the pandemic have now expired. However, some of those expiration dates have been extended. You can check your test kit’s current expiration date here.

Seeking treatment for COVID

Antiviral medications can help your immune system fight of the coronavirus infection by stopping the virus from multiplying in your body, with a goal of preventing you from becoming more seriously ill. There is a narrow window, typically five days from when you begin feeling ill, to begin this treatment so speak with your healthcare provider as soon as possible if you test positive for COVID.

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