The advent of a novel strain within the SARS-CoV-2 virus lineage, identified as the BA.2.86 variant, has cast a ripple of disquiet through the ranks of epidemiologists worldwide. Emanating from its inception in Israel, this variant has garnered the World Health Organization’s (WHO) close scrutiny, propelling a clarion call for nations to bolster their early warning, surveillance, and reporting systems. The WHO’s clarion request coincides with its dedicated mission to gauge the current risk level posed by COVID-19, emphasizing an imperious priority of vigilance and preemptive response.
Indeed, on the 17th of August, the BA.2.86 variant, marked by its intricate genetic signature, was christened a subject of intense surveillance by the WHO. This distinction followed the WHO’s meticulous analysis of sequences originating from five diverse countries. Of these sequences, three emanated from the European Region, while one each emerged from the African Region and the Region of the Americas. The preponderance of genetic modifications within the spike protein of BA.2.86, numbering over thirty when compared against the prevailing XBB variants, including the ubiquitous XBB.1.16 and the noteworthy EG.5, which has been bestowed the name “Eris,” remains an irksome aspect that scientists are grappling to fathom.
A prominent feature of the WHO’s vigilance strategy resides in the graduated categorization of variants. The EG.5 variant, having demonstrated noteworthy attributes meriting scrutiny, was recently elevated to the status of “variant of interest” (VOI), an elevation beyond its prior designation as a “variant under monitoring” (VUM). However, the BA.2.86 variant’s conspicuous inscrutability due to an insufficiency of empirical data mars the ability to decipher its impending implications.
“The sustainment of early warning, surveillance, reporting, variant tracking, clinical care facilitation, judicious administration of vaccine boosters among high-risk cohorts, amelioration of ventilation, and incessant communication forms the nucleus of our strategy,” resonated the WHO’s most recent weekly update, casting the spotlight on an exhaustive roadmap aimed at taming the evolving crisis.
The aforementioned update, encapsulating the virus’s trajectory through the chronicle of a 28-day interval, culminating on the 20th of August, remarkably omits the WHO’s Region of the Americas. This omission is fraught with perturbation, serving as a stark reminder of the heed that must be exercised as nations endeavor to extricate themselves from the pandemic’s grip.
Although the WHO ceremoniously heralded the conclusion of the pandemic’s emergency phase on the 5th of May, the omnipresent specter of COVID’s potency persists. Across the global landscape, countries have dismantled much of their supervisory apparatus, leading to a precipitous decline in testing and data compilation efforts.
A recent briefing by the U.S. Centers for Disease Control and Prevention (CDC) unveiled the global footprint of the BA.2.86 variant. Its prevalence spans Denmark, South Africa, Israel, the United States, and the United Kingdom. This pervasive dispersion attests to the international fluidity of pathogen propagation, underscoring a concomitant increase in the challenges of epidemiological surveillance.
A sobering note emerged from the CDC’s articulation, elucidating the dwindling scope of genomic sequencing for SARS-CoV-2. This decline in vigilance ushers in the unsettling possibility of novel variants infiltrating undetected, their gradual propagation hidden behind the veil of inadequate observation.
Within the CDC’s narrative emerges an intriguing concern regarding heightened hospitalizations within the United States. Albeit not firmly attributed to the BA.2.86 variant, this escalation remains an enigma demanding careful consideration.
The uncertainty surrounding the variant’s potential to induce more severe illness is palpable, with the CDC asserting its inability to provide certitudes at this juncture. Pertinently, the broader question of whether BA.2.86 can effectively elude preexisting immunities, be they vaccine-induced or stemming from prior infections, looms large.
Intriguingly, an exploration of the variant’s genetic makeup suggests the potential for a substantial divergence in immune evasion, rivaling that witnessed between the BA.2 and XBB.1.5 variants, separated by nearly a year of evolution. Yet, empirical validation of these suppositions remains elusive, as the real-world impact on immunity stands suspended in a flux of uncertainty.
As the United States primes itself for an anticipated annual COVID vaccine booster rollout, the CDC assuages apprehensions by affirming the forthcoming vaccines’ tailored capacity to neutralize all subvariants of the prevailing XBB lineage, including the evasive Eris.
The CDC tentatively concludes that the collective immunological bulwark amassed through infections and vaccinations is likely to extend its protective mantle against BA.2.86. Nonetheless, the provisional nature of this prognosis underscores the ongoing quest for empirical verification.
Eric Topol, occupying the post of Chair of Innovative Medicine at Scripps Research, contributes a salient perspective on the challenge presented by BA.2.86. He delineates the significance of neutralizing antibodies in quelling the virus, anticipating a diminishment in effectiveness when countering this new variant. Furthermore, Topol underscores the broader genomic turmoil, emphasizing that BA.2.86’s genetic perturbations extend beyond the spike protein, potentially aggravating the predicament.
Simultaneously, the CDC’s regular attempts to chart the circulation of variants stumble upon the perennial impediment of data scarcity. The “Nowcast” projections, informed by modeling, falter in their predictive precision due to the scarcity of sequences required for accurate assessments. Kathleen Conley, an articulate representative of the CDC, elucidated the intricacies of this challenge, attributing the accuracy of projections to the availability of a requisite corpus of sequences.
In a parallel strand, the CDC amplifies its observation of an augmented surge in COVID hospitalizations and fatalities in the U.S. This unsettling surge, unveiled in the week concluding on the 19th of August, signifies a resurgent struggle against the insidious pathogen.
The advent of the BA.2.86 variant, rife with genetic nuances and unpredictabilities, reverberates across the global medical community. The WHO’s clarion call for unwavering vigilance and relentless surveillance resonates as a testament to the ever-evolving nature of this pandemic. As the world navigates the intricate corridors of viral evolution, the imperative remains clear: to adapt, observe, and persevere in the face of an adaptive adversary.
