What should we expect from #SARSCoV2 this autumn?
I think it would be smart to prepare for both an increase in #COVID19 due to seasonal (behavioural) change & a new variant.
As so many others have elegantly illustrated, new lineages of SC2 are sparking interest.
1/17
I think it would be smart to prepare for both an increase in #COVID19 due to seasonal (behavioural) change & a new variant.
As so many others have elegantly illustrated, new lineages of SC2 are sparking interest.
1/17
Up front, I want to give a huge shout-out to @CorneliusRoemer who does a fantastic job keeping an eye on variants, particularly for @nextstrain & #Switzerland. But also for fantastic tireless work by @PeacockFlu @theosanderson @siamosolocani @SolidEvidence & more
2/17
2/17
Since the dominance of BA.5 (22B), most of the world hasn't seen much else move in (though in some places BA.4/22A hangs on), with the exception of India & BA.2.75 (22D).
covariants.org/per-country?co…
3/17
covariants.org/per-country?co…
3/17
However, in the background #SARSCoV2 hasn't stopped changing, & recently a spate of new variants have been identified that seem to have converged on similar sets of mutations.
A fantastic illustration of this by @SolidEvidence:
4/17
A fantastic illustration of this by @SolidEvidence:
https://twitter.com/SolidEvidence/status/1572665374067535873
4/17
Another great, tree-based illustration of this (specific mutations of interest marked on the tree) by @theosanderson :
5/17
https://twitter.com/theosanderson/status/1572590726696894468
5/17
Why does this matter?
Mutations themselves are random, but what ends up sticking around isn't - things that give a fitness advantage.
When see something appear multiple times in a short period, it can be a sign that this is something that's working well for the virus now.
6/17
Mutations themselves are random, but what ends up sticking around isn't - things that give a fitness advantage.
When see something appear multiple times in a short period, it can be a sign that this is something that's working well for the virus now.
6/17
The two variants under most discussion at the moment are BQ.1.1 (comes from BA.5/22B) & BA.2.75.2 (comes from 22D). @PeacockFlu & @EricTopol give nice illustrative overviews:
Both have predicted growth advantages.
7/17
https://twitter.com/EricTopol/status/1572687765405564929
https://twitter.com/PeacockFlu/status/1572535494088749056
Both have predicted growth advantages.
7/17
We've learned in the past that predicting impact from a list of mutations alone isn't completely straightforward. However, the mutations we see in BQ.1.1 & BA.2.75.2 (& others, as noted above) are in locations that could impact immune evasion & receptor binding.
8/17
8/17
Currently, we expect that selection pressure on the virus is largely to get around immunity, with so much of the world having a level of protection due to vaccination, infection, or both. This is a long-term game for many endemic viruses. So it's not surprising, but...
9/17
9/17
The big questions are ⏲️ When? and ⚖️ How much?
⏲️ WHEN might a new variant start to sweep through & dominate?
⚖️ HOW MUCH will it matter in terms of cases & clinical severity?
And these aren't easy questions to answer at the moment.
10/17
⏲️ WHEN might a new variant start to sweep through & dominate?
⚖️ HOW MUCH will it matter in terms of cases & clinical severity?
And these aren't easy questions to answer at the moment.
10/17
So, question 3 - 🤷🏻♀️ What should we do?
Given the time of year and what we are seeing in mutations & growth, I think we may well face a double-impact of autumn & a new variant in the next couple of months. We should prepare for this, & hope we don't need those preparations
11/17
Given the time of year and what we are seeing in mutations & growth, I think we may well face a double-impact of autumn & a new variant in the next couple of months. We should prepare for this, & hope we don't need those preparations
11/17
We don't know & can't currently predict 'how bad' such a wave might be.
But, even if it's fairly 'not bad', we saw a notable impact of BA.5 (which was 'not bad') this summer due to absences 🤒, particularly in hospitals & airlines 🏥🛫.
12/17
But, even if it's fairly 'not bad', we saw a notable impact of BA.5 (which was 'not bad') this summer due to absences 🤒, particularly in hospitals & airlines 🏥🛫.
12/17
While hospitalizations & deaths are obviously the most critical of outcomes, we do seem to be stuck in a bit of a black-&-white that if these are low, everything else is fine 🙈
I think we need to change that. Huge workplace absences can really impact our society.
13/17
I think we need to change that. Huge workplace absences can really impact our society.
13/17
So, 🤷🏻♀️ WHAT should we do?
- Start & encourage booster roll-out💉
- Decide our 'thresholds of action'📈
- Make a plan for how to react🗒️
- Publicise so people are prepared📢
If the 'plan' part sounds familiar...
14/17
- Start & encourage booster roll-out💉
- Decide our 'thresholds of action'📈
- Make a plan for how to react🗒️
- Publicise so people are prepared📢
If the 'plan' part sounds familiar...
https://twitter.com/firefoxx66/status/1461631776246452224
https://twitter.com/firefoxx66/status/1555526544218529799
14/17
No govt is keen to encourage masks or homeoffice again, I know!
But in my opinion, it's better to have these on the table to prevent disruptions to schools, transport, infrastructure & deliveries, if cases & absences start to threaten those this autumn/winter.
15/17
But in my opinion, it's better to have these on the table to prevent disruptions to schools, transport, infrastructure & deliveries, if cases & absences start to threaten those this autumn/winter.
15/17
In a personal way, you can help too:
When cases rise and/or you're in a crowded, ill-ventilated place, wear a mask! 😷
If you're sick (with anything at all!) stay home if at all possible. Even if not COVID, nobody wants your cold! 🙅🏻♀️🤧 (And those cause absences too!)
16/17
When cases rise and/or you're in a crowded, ill-ventilated place, wear a mask! 😷
If you're sick (with anything at all!) stay home if at all possible. Even if not COVID, nobody wants your cold! 🙅🏻♀️🤧 (And those cause absences too!)
16/17
We've got a lot of experience (& immunity!) under our belt now - we'll never be back to those first pandemic times. But at the same time, it's smart to stay alert & prepared. This winter will be tough in many ways - let's do what we can to stop #COVID making it tougher! ✊🏻
17/17
17/17
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