Weekly coronavirus-related chat, questions, and minor updates - week of October 3

COVID State of Affairs: Oct 5 (Your Local Epidemiologist)

Eyes are on Western Europe, as hospitalizations are uniformly increasing. As we’ve seen throughout the pandemic, some are hospitalized “with COVID19,” but it’s important to note that the Germany’s numbers are reported purely as “for COVID19.” In other words, not only are infections increasing, but so is severe disease.

Interestingly, no new subvariant is driving this wave, as the majority of cases are still the “old” BA.5 subvariant. This means changing weather, waning immunity, and/or changing behaviors are the culprit. This theory is only solidified when we see patterns are not changing in neighboring country Israel, for example, whose weather hasn’t started changing yet.

This is concerning because subvariants are brewing. They only make up a small percentage of cases for now, but they are gaining ground; historically, we feel their impact when they make up ~30-50% of cases. These subvariants will eventually add fuel to the fire.

Currently, we have a “subvariant soup” on the horizon—a mix of many different Omicrons trying to dominate the space. Below is a figure of the Omicron subvariants we are closely tracking. Each subvariant has ~10% growth advantage over BA.5, meaning it has the ability to create a wave, but not a tsunami.

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If we combine five of the top new subvariant leaders in the U.S. (referred to as “Pentagon”), it’s clear that case acceleration is brewing below the surface. Given the current growth, we will likely see an impact on national metrics in mid-November.

The height of a U.S. wave is partially dependent on the number of people who get a fall booster. Unfortunately, it looks like the majority of Americans will be going into the winter ill-prepared.