Wastewater Analysis Update On BA.2.86 In The United States: It’s Here, Be Careful

(Posted on Friday, August 25, 2023)

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This article was originally published on Forbes on 8/25/23.

In a previous article, I described the BA.2.86 SARS-CoV-2 variant in detail. Here, I provide an update on its status in the United States.

The latest iteration of Omicron, BA.2.86, is here, and we must be ready for its arrival. As of writing, the highly mutated variant of SARS-CoV-2 has been officially sequenced nine times worldwide in five countries, including the United States. Nearly identical sequences spread so far from each other combined with minimal sequencing efforts three and half years into the pandemic suggests that BA.2.86 is far more prevalent than nine cases.

A common tactic by public health services for monitoring Covid-19 spread is wastewater analysis. Sampling wastewater allows for mass surveying a building, area, or city for variants, but may sacrifice the specificity of its origin.

Wastewater monitoring in Switzerland detected BA.2.86 in low volumes in wastewater but has not identified a source. The same can now be said for the United States.

The Centers for Disease Control and Prevention released a statement saying that samples of BA.2.86 were detected during routine monitoring of the National Wastewater Surveillance System. Further specification on where the samples were from is not yet available.

At present, just two official sequences of BA.2.86 are available from the United States. Wastewater identification would suggest the true case number figure is far higher.

The BA.2.86 virus stokes concern as the variant contains roughly 30 more mutations than its BA.2 predecessor, which fueled the highest spike of cases in the United States to date.

While we cannot know the exact impact of each mutation on viral fitness, on the whole, the variant is likely to be highly immune resistant, highly infectious, and perhaps more disease intensive, though further data would be needed before confirming these claims. The CDC notes that “BA.2.86 may be more capable of causing infection in people who have previously had COVID-19 or who have received COVID-19 vaccines.”

CNN reported that most of the nine sequenced cases of BA.2.86 had only mild symptoms, though information on patient vaccination, infection, and medical history is unavailable, so it would be an overstep to conclude that BA.2.86 is a mild virus.

While BA.2.86 has yet to fuel a massive wave of cases akin to Omicron variants of the past eighteen months, it certainly is capable of doing so. We have yet to see whether the updated vaccine boosters set to be released this fall, which were designed for the XBB.1.5 variant, will be effective against BA.2.86. The hope is that the viruses are similar enough to maintain protection, though the new variant could easily evade vaccine protection. We will have to wait and see.

My recommendation is to return to mask use in crowded areas. Mask use early in the pandemic was one of the most effective mitigation strategies worldwide for protecting yourself and others. As this new Covid threat rises, we should revive strategies that work to prevent what could be another Omicron-like event.

Read the original article on Forbes.