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COVID-19 isn’t going away. Just ask Mayo Clinic Drs. John O’Horo and Matt Binnicker. 

“As we’re looking at where we’re at in the pandemic right now, the key question I think on everyone’s mind is what does BA.2 (subvariant) really mean, especially since we’re all starting to see some things relax here,” O’Horo said.

But, according to O’Horo, the new variant hasn’t looked anything like previous ones.

“This is, in some ways, a sibling or a child of the original omicron variant that was first identified in November of 2021,” Binnicker said. “It has a number of unique mutations that distinguish it from the original omicron variant.”

Binnicker said the variant had a higher transmission rate over other variants, and because of that transmission advantage he has seen an increase in cases in certain parts of the world.

“Somewhat difficult to tease apart the causes for this,” he said. “Probably, partially due to the virus itself but also many of these locations — including in the U.S.— have eased many of the COVID restrictions. So I’m sure that’s contributing as well.” 

O’Horo said cases were decreasing in the Midwest and across most of the country, but cautioned if the country follows the same path as Europe, there could be a rise in cases over the next several weeks.

According to Binnicker, BA.2 is now the predominant strain in the country.

“[That] means that if there’s going to be a substantial increase in cases due to that particular variant, it’s going to likely occur in the next one to two weeks,” he said. “We’re already seeing somewhat of a marginal increase in certain areas of the country.”

But because the country is coming off the wave of the omicron variant, he stressed there were high levels of natural and vaccine-induced immunity which could keep variants at bay.    

O’Horo stressed the significance of vaccines, and also said there were some areas where mask-wearing was still important.

“It’s felt that the differences between BA.2 and the original omicron variant are leading to this virus being able to be transmitted more efficiently,” Binnicker said. “… There’s also some specific mutations in this BA.2 variant that might allow it to evade existing immunity more efficiently. And that can be from vaccine-induced immunity or from natural immunity.” 

In other topics:

• O’Horo stressed the importance of vaccinations for the roughly one in three Americans who haven’t received a shot. He also pointed to significant improvement in protection for those who have received a booster, especially in its effectiveness against the delta variant. 

“Vaccination delivers a much more standardized, consistent … immune response versus natural infection, which is just a range of immunity-generated [responses] after you’re just naturally exposed to the virus,” Binnicker said. 

• According to O’Horo there’s been a consistent trickle of people receiving the vaccination over the past few months, but nothing drastic.
• There isn’t enough evidence to show different blood types produce greater or weaker responses to COVID than others. 

Both O’Horo and Binnicker work at Mayo Clinic, O’Horo as an infectious disease expert, Binnicker as a microbiologist and director of the clinical virology laboratory. 

In other news:

• As they did against omicron, Paxlovid and other oral antivirals have sustained efficacy against BA.2.
• At-home testing, if done too early (three to four days after exposure), can produce negative tests.

“In the early days after exposure there’s not a lot of virus present in a person’s nasal passage,” Binnicker said. “That makes those tests more susceptible to being falsely negative.”      

• O’Horo said it was too early to say if COVID shots would need to be administered annually. Binnicker added that he didn’t think a combined COVID/flu vaccine would be available for at least a year.
• As COVID-19 funds dry up, O’Horo cautioned about at least one foreseeable bump in the future.

“There’s going to be a need for continued vigilance and response, whatever form that might take,” he said. “As much as we would all like to say that this is behind us it very clearly isn’t.”

• O’Horo said there was substantial improvement among patients who received the Johnson and Johnson vaccine with an mRNA booster shot (Pfizer or Moderna).
• O’Horo and Binnicker stressed the importance of a geographic approach for lifting COVID-19 restrictions.

“We’re not going to see surges or increases in cases across the entire country at the same time,” Binnicker said. “We’re going to see it scattered in different states and communities.

“I think one thing we’ve learned from COVID is we have the tools now both to measure case counts and also the tools to help prevent transmission.”