Everything you need to know about the easily spread BQ omicron variants rising in NC

A new set of Omicron subvariants, BQ.1 and BQ 1.1, are poised to become the dominant strains in North Carolina in the next few weeks.

The BQ variants, which are already the dominant strain in the United States as a whole, make up about 41% of cases in the Southeast, according to Centers for Disease Control and Prevention data.

Here’s what we know — and don’t know — about the new immunity-evading variants from Dr. David Weber, an infectious diseases expert at UNC Health.

What we know:

• The BQ subvariants are better at evading natural immunity from prior COVID infections and vaccine-generated immunity than were previous variants. That means those who have had COVID-19 before — even recently— could be vulnerable to reinfections.
• Still, Weber said getting the bivalent booster, which targets Omicron variants, still reduces the risk of severe illness substantially. This is especially important for those who haven’t had a recent booster shot, as immunity wanes over time. Just 14% of eligible North Carolinians have received their bivalent booster, according to the most recent data from the North Carolina Department of Health and Human Services.
• The new variants do not appear to cause more severe illness. However, they are more resistant to monoclonal therapies, which doctors prescribe to immunocompromised patients to avoid infection and to COVID-positive patients who are at a higher risk of developing complications from the virus, Weber said. That means these variants could be particularly worrisome for people whose immune defenses are not strong.
• COVID symptoms from these variants are similar to those of previous variants, though the severity can be impacted by vaccination status, age and other health conditions.
• Antiviral medications like Paxlovid work “perfectly well” against the BQ variants, Weber said.
• If you have stopped masking in public, maybe it’s time to reconsider, Weber said. Masks protect you against COVID-19 and other respiratory viruses that are spreading rampantly this season, like the flu and RSV. Flu activity in North Carolina is considered “very high,” the most severe category possible, according to the Centers for Disease Control and Prevention.

What we don’t know:

• It’s unclear whether these new variants will set off a surge in cases, which the delta variant did this time last year. Weber said he thinks it’s unlikely— more than 90% of the population has some level of immunity from a vaccine or infection. However, a winter surge is still possible if another variant with a stronger ability to evade immunity crops up, he said.
• It’s too soon to know whether the BQ infection is more or less likely to cause long COVID symptoms than earlier variants. A study published this month in Nature Medicine found that reinfections in general increases the risk of both short and long term complications, including long COVID symptoms.

Teddy Rosenbluth covers science and healthcare for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.

This story was originally published November 15, 2022 at 12:59 PM.

Teddy Rosenbluth

The News & Observer

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Teddy Rosenbluth covers science for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. She has covered science and health care for Los Angeles Magazine, the Santa Monica Daily Press, and the Concord Monitor. Her investigative reporting has brought her everywhere from the streets of Los Angeles to the hospitals of New Delhi. She graduated from UCLA with a bachelor’s degree in psychobiology.