Q&A about Omicron Subvariant from Johns Hopkins University

Johns Hopkins University professor and virologist Andy Pekosz, PhD has been tracking coronavirus variants since the early days of the pandemic. He spoke recently on a podcast and below is an edited transcript of that podcast.

Q. What’s happening now with omicron’s subvariants?
A. When a variant emerges, it never stops mutating and changing. And omicron, being a really transmissible virus, amplified how quickly we see these mutations emerge. We went from one version to five [in a relatively short period of time].

These [subvariants] are different from one another. Some scientists say that what we call omicron subvariants now are equivalent to what we referred to as different variants earlier in the pandemic. There’s a lot of diversity in omicron, which is contributing to issues with COVID-19 vaccine efficacy and treatments.

Q. How are these subvariants impacting vaccine efficacy and treatments?
A. First, all these omicron variants are good at evading some portion of the vaccine-induced immunity. Vaccines are still protecting against severe disease, but even if you are vaccinated, if you’re exposed, you should expect to have a symptomatic infection. We’re seeing case numbers go up, but we’re not seeing hospitalizations, disease severity, or death go up anywhere close to that same rate. Vaccines are working against severe disease, not against infection.

The other important thing is that these variants of omicron have different susceptibilities to different monoclonal antibody treatments. It becomes tricky to figure out which treatment you can take. We don’t have the capability to quickly tell someone, “You’re infected with BA.4,” yet the efficacy of the treatment is completely dependent upon which variant you’re being infected with.