At the end of March, the KP.2 variant was causing about 4% of infections in the U.S.,according to the CDC, while its parental strain, JN.1, was causing over 50% of infections at that time. As of early May, KP.2 makes up about 28% of infections, overtaking JN.1 as the dominant variant.
KP.2 is one of several variants being referred to as FLiRT variants, named after the technical names for their mutations. The prevalence of these variants comes at a critical time, when experts are deciding how to formulate the fall COVID vaccine.
In this Q&A,Andy Pekosz, PhD, a professor inMolecular Microbiology and Immunology, explains what virologists like him are seeing, whether these variants might cause a summer wave of infections, and how people can protect themselves.
What are these FLiRT variants?
This is the term being used to describe a whole family of different variantsincluding KP.2, JN.1.7, and any other variants starting with KP or JNthat appear to have independently picked up the same set of mutations. This is called convergent evolution. They are all descendants of theJN.1 variant that has been dominant in the U.S. for the past several months.
The particular mutations that people refer to as FLiRTs or FLips refer to specific positions in the spike proteinin this case, positions 456, 346, and 572.
Viruses like SARS-CoV-2 mutate frequently, and when they mutate to evade recognition by antibodies, this often weakens their ability to bind to the cells they want to infect. We then see mutations appear that improve that binding ability. This is a cycle we have seen many times with SARS-CoV-2. The fact that these different variants are picking up the same mutations tells virologists that this combination of mutations is helping the virus accomplish these goals most efficiently.
How do these mutations help the virus bind to cells while evading antibodies?
Two of these mutations456 and 346eliminate binding sites for antibodies that neutralize SARS-CoV-2. However, those same antibody binding sites are also important for the virus to bind to and enter cells. So in evading antibodies, these FLiRT variants may have also lost some ability to bind to their receptor. At the same time, the 572 mutation appears to allow the virus to more tightly bind to cells and ultimately cause an infection.
Do people who recently had COVID have any protection against infection from FLiRT variants?
A JN.1 infection should provide pretty strong protection against all the FLiRT variants. The difference between JN.1 and these variants is only one or two amino acid changes, so there are still a lot of other places antibodies can bind to. Infection from a variant older than JN.1 is less likely to offer as much protection.
Do we know yet how well the current COVID-19 vaccines work against the FLiRT variants?
Against JN.1, the vaccine designed around XBB.1.5 does generate some cross-reactive antibodies. Studies have not been yet done with some of these newer variants, but those are likely to be a little less cross-reactive. Its also been several months since many people received their last dose of the vaccine, and that immunity wanes over time.
Back in February, the CDC recommendedan additional dose of the current COVID vaccine for adults 65 and older who received theirs in the fall. There is a question now of what the guidance will be going into the summer. Weve seen fairly low uptake of these additional boosters when theyre recommended, even in high risk populations, so its unclear whether a third dose of the current vaccine will be recommended. If case numbers remain relatively low, it may not be necessary.
Should we anticipate these variants to drive a surge in cases this summer?
Its certainly possible. The FLiRT variants would be high on my list of viruses that could cause another wave of infections in the U.S. That said, our definition of a wave has changed; while we still see case rates rise and fall throughout the year, we see much lower numbers of cases of hospitalizations or deaths than we saw in the first couple years of the pandemic.
And yet, while these waves are becoming smaller, they are still having the greatest impact on our susceptible populations: the elderly, people who are immunocompromised and those with other secondary medical conditions. Everyone can play a role in protecting those populations that remain the highest-risk when new variants cause an uptick in cases.
How might these variants impact plans for the COVID vaccine formula that gets updated for the fall?
This is the time of year when governing bodies like the WHO and FDA recommend a formulation for updated COVID vaccines that will roll out in early fall. Last year, thevaccines were based on the XBB.1.5 variant, and only a few months later, theJN.1 variant became the dominant variant in the U.S.
At the end of April, theWHO announced that their COVID vaccine advisory group advises using the JN.1 lineage as the antigen for the upcoming formulations of the vaccine. All of these FLiRT variants are within the JN.1 family of variants.
Here in the U.S.,the FDA has postponed its meeting to determine the fall 2024 COVID vaccine from mid-May to early June. That gives them more time to see which of the FLiRT variants is becoming the dominant one so they can fine-tune the WHO recommendation to what they anticipate will be most prominent in the fall.
New COVID variants are likely to crop up after a decision is madejust as it did last summerbut the goal remains to select a formulation that, come fall, will match the circulating variants as closely as possible.
What are the usual symptoms and transmission timeline for FLiRT variants?
When it comes to symptoms, were not seeing anything new or different with these variants. We continue to see more mild disease, but thats likely not because the virus is milder, but because our immunity is so much stronger now. After years of vaccinations and infections, most of the population is better able to fight off an infection without as much concern for severe disease.
The period of infectiousness for these FLiRT variants remains the same as with JN.1 and previous omicron variants: After exposure, it may take five or more days before you develop symptoms, though symptoms may appear sooner. You are contagious one to two days before you experience symptoms and a few days after symptoms subside. And as with previous variants, some people may have detectable live virus for up to a week after their symptoms begin, and some may experiencerebound symptoms.
At-home testing remains a really important tool for knowing whether you could potentially infect others.
Are antivirals like Paxlovid effective against FLiRT variants?
Yes, the good news is thatPaxlovid is still recommended for high risk individuals. It still works against variants up to JN.1, and based on the sequencing of the FLiRT variants, they should still be susceptible to Paxlovid, as well as to antiviral drugs like molnupiravir and remdesivir. The companies that produce these drugs are always testing them against new variants to ensure they continue to be effective.
How can people protect themselves and their loved ones as we head into summer?
As with any respiratory virus, even when case rates nationally are low, its common to see infections increase in one area of the country but not another. Keep an eye on case rates in your region or anywhere you plan to travel, to know whether you should take additional precautions, like wearing a mask or gathering in well-ventilated areas. Some local health departments report on virus levels in wastewater, which can signal an upcoming rise in cases. This is particularly helpful as people experience more mild illness; those cases may not require hospitalization, but theyll still be detected in wastewater data.
Its always a good idea to keep a few COVID tests around the house in case you start to feel sick. Testingwhether at home or in a health care settingwill make sure you know what you're infected with, which can inform the best treatment plan if you are in a high risk group or your symptoms progress to more severe illness.
If you do feel sick, follow the CDCssimplified guidance for respiratory illnesses. This is especially important if you plan to spend time with friends or family who are at higher risk of severe illness.
Aliza Rosen is a digital content strategist at the Johns Hopkins Bloomberg School of Public Health.
If media reports are to be believed, COVID-19 has not completely gone away. It keeps on lurking around the corner and can unleash the mayhem again. After JN.1, the latest variety of COVID-19 variants is KP.2. It is an offshoot of the omicron variant. The Centers for Disease and Prevention has said that currently, it accounts for an estimated 28.2% of COVID cases after making up just 1.4% of cases in mid-March, reports ABC News'.
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Will COVID-19 cases increase in the summer?Virologists in the US have predicted an increase in Covid cases during this summer also, as has been noticed since 2020. If KP.2 continues to gain prevalence, it may happen again, but it would be less dangerous and less dramatic.
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In a recent study published in The Lancet Regional Health Western Pacific, a team of researchers from China and the Netherlands used resting-state functional magnetic resonance imaging or rs-fMRI to examine the long-term impact of coronavirus disease 2019 (COVID-19) on brain function, based on reports of persistent neurological, cognitive, and psychiatric symptoms in individuals recovering from the disease.
Study:Brain abnormalities in survivors of COVID-19 after 2-year recovery: a functional MRI study. Image Credit:Aleksandar Malivuk/Shutterstock.com
Although concerted global efforts in medicine have helped contain the spread of the COVID-19 pandemic, there is substantial evidence indicating that a significant portion of individuals recovering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections experience long coronavirus disease (long COVID) or post COVID syndrome.
The symptoms of long COVID are varied and impact a wide range of organ systems. While the most common symptoms include fatigue, dyspnea, and post-exertional malaise, individuals experiencing post-COVID syndrome also report experiencing cognitive, neurological, and mental health symptoms such as brain fog, anxiety, inability to concentrate, sleep disturbances, and depression.
Studies have confirmed deficits in specific domains of cognition as long-term impacts of SARS-CoV-2 infections.
Research also indicates that individuals who were infected with the original strain of SARS-CoV-2 or the alpha variant and required hospitalization experienced larger cognitive deficits than other COVID-19 patients.
However, the underlying mechanisms or pathophysiology of the neuropsychiatric or cognitive deficits in long COVID patients remain unclear.
The present study aimed to understand the long-term cognitive, neurological, and psychiatric impact of COVID-19 and the brain alterations in long-term COVID patients two years after SARS-CoV-2 infections using rs-fMRI.
The study included adults between the ages of 18 and 65 and included individuals previously infected with SARS-CoV-2, as well as healthy controls.
Medical records confirming a COVID-19 diagnosis were required to categorize a participant as a COVID-19 survivor, while the healthy controls were defined as individuals with no history or medical records of a positive SARS-CoV-2 polymerase chain reaction (PCR) or antigen test.
Individuals with a current history of neurological or psychiatric diseases, stroke, or brain injury, pregnant or lactating women, or individuals with metallic or electronic implants, claustrophobia, or any other contraindications for the MRI were excluded.
A wide range of measurements, including demographic characteristics such as age, sex, and education levels, as well as information on comorbidities, smoking behavior, mental disorder history, vaccination status for COVID-19, hospitalization duration, and time between COVID-19 diagnosis and follow-up, were obtained from all participants.
The Cognitive Failures Questionnaire was employed to assess cognitive function, and tasks assessing memory recall were used to evaluate working memory.
Additional questionnaires were used to assess mental and physical health fatigue, depression symptoms, anxiety symptoms, insomnia severity, post-traumatic stress disorder (PTSD) symptoms, as well as self-reported symptoms of headaches, dizziness, and taste and smell disorders. A magnetic resonance scanner provided scans of the brain at various slice thicknesses and angles.
The study found that individuals who experienced mild to moderate and severe to critical acute symptoms during the SARS-CoV-2 infection had significantly higher cognitive complaints of mental fatigue and cognitive failure compared to healthy individuals in the control group.
However, no significant differences were observed in the cognitive complaints between the individuals who had mild to moderate COVID-19 symptoms and those with severe to critical COVID-19 symptoms.
Furthermore, the two COVID-19 survivor groups and the healthy control groups had similar scores in the Montreal Cognitive Assessment questionnaire, as well as the working memory assessment and simple reaction time tasks.
However, the rates of psychiatric symptoms such as depression, insomnia, PTSD, anxiety, and smell and taste disorders were higher in the two COVID-19 survivor groups as compared to the control group.
Additionally, the results from the rs-fMRI showed that among individuals recovering from COVID-19, the amplitude of low-frequency fluctuation values were significantly higher in the right inferior temporal gyrus, left putamen, and right pallidum of the brain and lower in the left superior temporal gyrus and right superior parietal gyrus.
The regional homogeneity values were also lower in the left postcentral gyrus, right precentral gyrus, left calcarine fissure and left superior temporal gyrus of COVID-19 survivors.
Low regional homogeneity values in the left superior temporal gyrus were also correlated with lower scores on the cognitive fatigue questionnaire and higher mental fatigue.
Overall, the findings indicated that long COVID patients continue to experience persistent cognitive symptoms and neurological and psychiatric complaints and exhibit brain alterations even two years after recovering from the SARS-CoV-2 infection.
The study reported brain function changes in various regions of the brain that could be contributing to the persistent and long-term cognitive complaints experienced by long COVID patients.
Journal reference:
The present study was conducted with the aim of comparing the trend of demographic changes, mortality, clinical and paraclinical findings of patients admitted to the corona ward, before and after the start of general vaccination of COVID-19. The most important findings of the present study indicate that before the start of general vaccination for COVID-19, the majority of patients were hospitalized in the Corona Intensive Care Unit (59.3%), aged between 51 and 65 years (47.3%), hospitalized for more than 3 days (54%), required intubation (49.3%), had SPO2<93% (60.7%), and exhibited common symptoms such as cough, shortness of breath, and loss of consciousness. Paraclinical findings included positive CRP, decreased lymphocytes, and ground glass opacity (GGO). After the start of general vaccination for COVID-19, most patients were hospitalized in the general care department of Corona (68%), aged between 36 and 50 years (47.3%), hospitalized for less than three days (66%), required intubation (20%), had SPO293% (77.3%), and exhibited common symptoms such as weakness, headache, and body pain. Paraclinical findings were within the normal range.
The findings of the present study showed that before the general vaccination of COVID-19, most of the patients hospitalized in corona wards were in the age range of 5165 years. However, after the start of general vaccination against COVID-19, most of the patients hospitalized in corona wards were in the age range of 3650 years.
In line with this finding of the present study, the results of the studies A. Christie et al. (2021) [19], M. L. Salomo et al. (2022) [20] as well as Emre zgen et al. (2023) [21] showed that general vaccination of COVID-19 was associated with a change in the age range of patients hospitalized in corona wards. So that after the start of general vaccination of COVID-19, most of the patients hospitalized in corona wards were in the age group of less than 50 years.
But the results of the study K. Dooling et al. (2021) [22] as well as the results of the study by H. Rossman et al. (2021) [23] are not in line with this finding of the present study. So that the results of their studies showed that the general vaccination of COVID-19 is not related to the change in the age range of hospitalized patients. Also, most of the patients admitted to the Corona wards were elderly people over 60 years old. This discrepancy in research findings can be related to the different geographical environment in the studies as well as the type and number of hospitalized patients.
The findings of the present study showed that most of the patients were hospitalized in the Corona Intensive Care Department before the general vaccination of COVID-19. After the start of the general vaccination of COVID-19, most of the patients were hospitalized in the normal care department of Corona. The results of the study of M. Moffa et al. (2022) [24] as well as the results of the study M. Fogolari et al. (2022) [25] is in line with this finding of the present study. The results of their studies showed that after the start of general vaccination of COVID-19, most of the patients were hospitalized in the general care departments for corona patients. So that the number of patients hospitalized in the special corona wards has decreased.
But the results of the study of M. zsoy et al. (2023) [26] as well as the results of the study of B. Ngo et al. (2021) [27] is not in line with this finding of the present study. So that the results of their study showed that there is no connection between the start of general vaccination of COVID-19 and the type of inpatient department of corona patients. This discrepancy in research findings can be related to the different geographical environment in the studies as well as the type and number of hospitalized patients.
The findings of the present study showed that before the general vaccination of COVID-19, most of the patients were hospitalized for more than 3 days in the care units for corona patients. Also, the findings showed that after the start of general vaccination for COVID-19, most of the patients were hospitalized in the care units for corona patients for less than three days.
In line with this finding of the current research, the results of the study of M. Tenforde et al. (2021) [28] and the results of the study by Aakashneel Bhattacharya et al. (2021) [29] showed that the start of general vaccination of COVID-19 is related to the number of days of hospitalization of patients in corona wards. so that after the start of the general vaccination of COVID-19, the number of days of hospitalization of patients in corona wards has decreased.
However, the results of the study of G. Suleyman et al. (2022) [30] and the results of the study of Anshuman Srivastava et al. (2022) [31] are not in line with this finding of the present study. So that the results of their study showed that there is no relationship between the start of general vaccination for COVID-19 and the number of days of hospitalization of patients in the care departments for corona patients.
The findings of the present study showed that the number of patients requiring intubation had decreased after the start of general vaccination against COVID-19. In line with this finding of the present study, the results of the study by C. Bezzio et al. (2020) [32] as well as the results of the study by Cristiane de Freitas Paganoti et al. (2022) [33] showed that the start of general vaccination of COVID-19 has been associated with a decrease in the need for intubation and also a decrease in the need for hospitalization in special corona wards.
The findings of the present study showed that the percentage of oxygen saturation (SPO2) in most patients was less than 93% before the start of the general vaccination of COVID-19 and more than 93% after the start of the general vaccination of COVID-19. In line with this finding of the present study, the results of Linzy Houchen-Wolloff et al. (2021) [34] as well as the results of the study of Ulfa Husnul Fata et al. (2022) [35] showed that the start of general vaccination of COVID-19 was associated with an increase in the percentage of oxygen saturation in patients hospitalized in corona wards.
The findings of the present study showed that the mortality rate in patients hospitalized in the care units for Corona patients decreased after the start of general vaccination for COVID-19. The results of the study by R. Kempker et al. (2022) [36] and the results of the study by P. Moreno-Nunez et al. (2022) [37] are in line with this finding of the present study. The results of their study showed that the start of general vaccination for COVID-19 was associated with a decrease in mortality in patients hospitalized in COVID-19 wards.
The findings of the present study showed that before the general vaccination of COVID-19, cough, dyspnea, and loss of consciousness were among the common symptoms of patients hospitalized in corona wards. However, after the start of the general vaccination of COVID-19, general weakness, headache, and body pain were among the common symptoms of patients hospitalized in corona wards. The results of the study of Zunaira Khan et al. (2022) [38] are in line with this finding of the present study, as the results of their study showed that: after the start of the general vaccination of COVID-19, general weakness, headache, and acute myelopathy were among the common symptoms of patients hospitalized in corona wards.
Also, the results of the study by L. Bonifcio et al. (2022) [39] are in line with this finding of the present study. The results of their study showed that: before the general vaccination of COVID-19, common symptoms like cough, dyspnea, and loss of consciousness were common, but after the vaccination, general weakness, headache, and muscle weakness emerged.
The findings of the present study showed that the laboratory results of most of the patients hospitalized in the care units for corona patients before the start of general vaccination of COVID-19 included positive CRP and a decrease in lymphocytes. However, after the start of the general vaccination of COVID-19, the laboratory findings of most of the patients hospitalized in the care units for corona patients were normal.
The results of the study of H. Fu et al. (2020) [40] are in line with this finding of the present study, in such a way that the results of their study showed that: after the start of general vaccination, CRP levels decreased significantly and lymphocyte counts increased in COVID-19 patients. Also, the results of the study of H. Akbari et al. (2020) [41] are in line with this finding of the present study. The results of their study showed that: before the start of general vaccination, most COVID-19 patients had a decrease in lymphocytes and an increase in CRP, but after the start of vaccination, these results reversed.
The findings of the present study showed that the radiology results of most of the patients hospitalized in the care departments of Corona patients before the start of general vaccination of COVID-19 were ground glass opacity (GGO). However, after the start of general vaccination against COVID-19, the radiology results of most of the patients hospitalized in the care units for corona patients were normal.
The results of the study of Mamatha Reddy D. Cozzi et al. (2021) [42] are in line with this finding of the present study in such a way that the results of their study showed that: before the start of general vaccination against COVID-19, most hospitalized patients had ground-glass opacities (GGO) on CT, but after the vaccination, GGO results decreased. Also, the results of the study of Jufriadif Naam et al. [43] (2021) are in line with this finding of the present study in such a way that the results of their study showed that: before the start of general vaccination against COVID-19, most hospitalized patients had radiology results showing ground glass opacity (GGO) in their thorax.
Among the limitations of the study were the short study period and the small number of samples under investigation. It is suggested to conduct future studies over a longer period of time and with a larger sample size. Another limitation of the current study was the newness of the MCMC system, which was associated with limitations such as not recording a number of variables. Therefore, access to all demographic, clinical, and paraclinical variables of the patients was not possible.
By Louis Goss
Struggling Novavax struck a $1.4 billion deal with Sanofi on Friday to commercialize its existing COVID-19 vaccine and develop a combined jab to protect against both the coronavirus and influenza - causing its share price to more than double.
The agreement saw Novavax lift the going concern notice it issued in 2023, when the Gaithersburg, Maryland company warned that plunging COVID-19 vaccines sales could push it into bankruptcy.
Novavax (NVAX) shares surged 137% on the news, having lost 50% of their value in the 12 months prior to the announcement of the Sanofi deal. Shares of the French pharmaceutical group (FR:SAN) rose 1%, down 5% over the previous 12 months.
Under the deal, Sanofi agreed to pay $500 million upfront, alongside a further $700 million in launch, development and regulatory milestone payments, to sell Novavax's standalone COVID-19 vaccine worldwide, and develop and sell a new combined influenza/COVID vaccine.
Novavax will also be entitled to a further $200 million in additional launch and sales milestone payments, alongside mid-double digit royalties on vaccines developed by Sanofi using its Matrix-M adjuvant technology, which helps vaccines stimulate an immune response.
In a statement, Novavax CEO John C. Jacobs said the deal, which is worth more than double the value of Novavax's $628 million market cap, marks "the beginning of an exciting new chapter" for the biotech.
Novavax has seen its sales collapse over the previous two years, due to plummeting demand for its COVID-19 vaccines. In February 2023, the firm said it had "substantial doubt" about its ability to continue operating.
Analysts at Barclays, led by Emily Field, said Sanofi's interest in Novavax largely relates to the potential boost its COVID-19 vaccine could provide to sales of the French company's own flu vaccine, via creation of a combined jab.
"Given declining uptake of COVID vax timing raises some questions, but angle seems to be protecting incumbent flu business," the Barclays' analysts said.
Novavax, which was started in 1987, first gained regulatory approval for its non-mRNA COVID-19 vaccine in the U.S. in July 2022, almost two years after Pfizer (PFE) obtained approval for its own mRNA-based vaccine in December 2020 at the peak of the pandemic.
At the time, there were hopes the more conventional protein-based vaccine would help persuade vaccine skeptics to get their shots.
In April, activist hedge fund Shah Capital, which owns a 6.7% stake in Novavax, called for an "urgent shakeup" of Novavax's board over claims it had failed to highlight fears surrounding mRNA vaccines to boost sales of its non-mRNA alternative.
In a statement sent to MarketWatch, Shah Capital founder Himanshu H. Shah said: "The deal announced concurs with Shah Capital's prior comments on their superior respiratory vaccine technology platform as well as marketing failings. A step in the right direction for shareholders."
Even with Friday's gains, Novavax's $1.48 billion market cap remains well below its peak at $10.8 billion which it hit in 2021, according to the website CompaniesMarketCap.
-Louis Goss
This content was created by MarketWatch, which is operated by Dow Jones & Co. MarketWatch is published independently from Dow Jones Newswires and The Wall Street Journal.
(END) Dow Jones Newswires
05-10-24 1021ET
The Covid family tree is a confusing one. But JN.1 was like a big, strong branch. And now, it is dense with twigs. (Illustration image) Photo: 123RF
If you have caught Covid-19 in Aotearoa New Zealand in 2024, chances are you were infected with Omicron subvariant JN.1.
The subvariant made headlines just before Christmas, and by March accounted for 98 percent of sequenced cases.
But its reign is coming to an end, as one of its descendants has given rise to a new subset of variants, referred to as "FLiRT" or, in some cases, "FLip" (based on the technical names for their mutations).
The Covid family tree is a confusing one. But JN.1 was like a big, strong branch. And now, it is dense with twigs.
We know SARS-CoV-2, the virus which causes Covid, has a propensity for big, evolutionary leaps.
In early 2022, the Omicron variant replaced Delta as the dominant strain. On an individual level, Omicron was less dangerous, but more transmissible.
Omicron subvariants have circulated since then, thanks largely to advantageous spike protein mutations. (The spike proteins, protruding like needles from a pincushion, help the virus infect human cells.)
From Omicron came BA.2.86, nicknamed Pirola, and then JN.1. It did not take long for the fast-spreading JN.1 to out-compete other lineages in New Zealand, as it had overseas.
Environmental Science and Research's (ESR) latest Covid-19 genomics report, from 12 April, noted 98 percent of sequenced cases were JN.1 or a JN.1-derived lineage. The only other subvariant detected in the last fortnight was BA.2.86 - JN.1's parent.
The latest wastewater results also showed almost complete replacement of older lineages by JN.1.
ESR has been tracking FLiRT mutations in its public report for about a month, science leader, genomics and bioinformatics Dr David Winter told RNZ.
"In the last few weeks, emerging lineages have both been rising reasonably quickly as a proportion of all cases, with the fastest growing of these having a growth advantage of about 5 percent per day over JN.1."
This meant the lineage was about 5 percent better each day than JN.1 at infecting people. (This is still below the level expected to have a substantial impact on caseloads.)
While JN.1 was still dominant, JN.1.16, KP.2 and KP.3 were creeping onto surveillance charts.
At the week ending 5 May, the three named variants accounted for just over 20 percent of all Covid viruses sequenced from wastewater.
"It's a contributing pressure to case numbers, but not enough by itself to spur a variant-driven wave," Winter said.
The presence of SARS-CoV-2 in wastewater has spiked since 21 April. Hospital admissions have also increased, with the rolling seven-day average at 27 on 5 May, up from 22 the Sunday prior, and 20 the one prior to that.
Covid-19 modeller Professor Michael Plank said it looked as though FLiRT variants were driving "a bit of growth" in Covid numbers internationally. "There are signs in the latest data that this is probably starting to happen in New Zealand as well."
While the growth rate of these variants was not as large as that of JN.1 around Christmas, the colder weather could give the virus a "helping hand", Plank said.
"It's possible we'll see a wave that is similar in size to the summer one, but still much smaller than the waves we had in 2022 and 2023."
About the new names? Not really, said epidemiologist Michael Baker.
"It's still the same virus. Don't get caught up in the clever names," he said.
The takeaway was that this was how the virus would behave in the human population for the foreseeable future, he added. "The virus only cares - not that it has consciousness - about one thing: making more copies of itself."
It is obvious at this point the virus is going to "keep creating waves".
"There's not much evidence it's getting more dangerous or more infectious necessarily. The driver [of mutations] is evading existing immunity, meaning it becomes more infectious at a population level. But it's not changed how it's transmitted in the air."
It is impossible to say whether the new subvariants cause different symptoms from prior ones.
"The greatest variability isn't between lineages, it's between people," Baker said. "It's more about your state of immunity when you get infected. I don't think it's helpful to try to assign different symptoms to different lineages."
A Covid wave ends when the susceptible population decreases, making it harder for the virus to find a host. People get immunity from either prior exposure to the virus, or vaccination.
"Obviously, it's preferable to get immunity from vaccination, which is why people need to keep getting boosters, particularly if they're at-risk," Baker said.
As we head into winter, more people will be getting sick in general, thanks to other common coronaviruses and influenza.
Covid would remain an additional burden on the health system, Baker said. Covid patients in hospitals must be managed more intensely, and pose a risk to other, at-risk patients.
"A lot of people are acquiring Covid in hospital, and people are dying with Covid in hospital when they didn't go in with it."
Long Covid - when the effects of the disease last longer than 12 weeks - remained one of Baker's biggest concerns.
Free Covid rapid antigen tests (RATs) were available to collect until at least 30 June, 2024.
A vial labeled "Novavax V Covid-19 Vaccine" is seen in this photo taken Jan. 16, 2022.
Dado Ruvic | Reuters
Shares of Novavax closed nearly 50% higher on Monday as Wall Street cheered the company's new multibillion-dollar deal with French drugmaker Sanofi that sparked a dramatic turnaround for the struggling vaccine maker.
Novavax's stock almost doubled on Friday after it announced the licensing agreement with Sanofi. Novavax on Friday said the deal allows the company to remove its "going concern" warning, which it first issued in February 2023 due to major doubts about its ability to stay afloat.
"It really does help our business. It keeps us well capitalized, it takes the going concern off, it gives us the chance to pivot our strategy more toward what we're best at to bring additional value to all of our stakeholders, including our shareholders," Novavax CEO John Jacobs told CNBC in an interview.
Under the agreement, Sanofi will take a less than 5% stake in Novavax. The deal also entitles Novavax to an upfront cash payment of $500 million and future payments contingent on certain milestones, as well as royalties.
Sanofi, one of the world's largest vaccine makers, will co-market Novavax's Covid vaccine in most countries starting in 2025. The deal also allows Sanofi to use Novavax's Covid shot and flagship vaccine technology, Matrix-M adjuvant, to develop new vaccine products. The shots include combination jabs targeting Covid and the flu.
A logo on the Sanofi exhibition space at the Viva Technology conference dedicated to innovation and startups at Porte de Versailles exhibition center in Paris, France, on June 15, 2022.
Benoit Tessier | Reuters
In a note Sunday, Jefferies analyst Roger Song said the deal will provide significant capital to Novavax and support the company's growth.
"Economically, the deal is highly lucrative and impactful," Song wrote.
He said the upfront payment helps remove investor worry about Novavax's going concern warning, and that milestone payments are "significant and relatively near-term" for the company since they are not tied to sales. Meanwhile, royalties will provide a steady revenue stream each year, Song said.
He added that the deal "validates" the company's protein-based vaccine platform.
Novavax's shot is the first Covid vaccine to use protein technology, a decades-old method for fighting viruses used in routine shots against Hepatitis B and shingles. Health officials view the vaccine as a valuable alternative for people who do not want to take messenger RNA jabs from Pfizer and Moderna.
In a note on Sunday, Leerink Partners analyst David Risinger said he is interested to see how effective Sanofi is at raising consumer awareness about how the side effects of Novavax's Covid vaccine are easier for patients to tolerate compared to competing shots from Pfizer and Moderna.
Risinger noted that consumer hesitancy around Covid boosters has come in part from fears about the fatigue and discomfort associated with Pfizer's and Moderna's shots.
The firm expects Sanofi "to drive greater commercial success of [Novavax's] vaccine starting in 2025, due to its commercial scale and contracting abilities, but it is difficult to predict the magnitude of impact," Risinger wrote.
He added that there could be "further upside" for Sanofi and Novavax if they develop a combination Covid and flu vaccine that has advantages over the mRNA combo shots being developed by Pfizer and Moderna.
The first study of COVID-19 vaccine effectiveness in a large population of adult heart-failure patients suggests that vaccinated participants are 82% more likely to live longer than their unvaccinated peers, according to ananalysis presented over the weekend at the Heart Failure 2024 scientific congress of the European Society of Cardiology (ESC) in Lisbon, Portugal.
Researchers from theNational Health Insurance Service Ilsan Hospital in Goyang, South Korea,analyzed information on vaccinations and clinical outcomes among 147,118 heart-failure patients from the Korean National Health Insurance Service database, which covers nearly all Koreans.
To control for potential confounding factors, vaccinated patients (who received at least two COVID-19 vaccine doses) were matched in a 1:1 ratio to their unvaccinated counterparts (those who received one or no dose), for a total of 73,559 participants each. Participants were followed for a median of 6 months. The average patient age was 69.5 years, and half were women.
Worldwide, more than 64 million people have been diagnosed as having heart failure, a life-threatening syndrome. Previous studies have shown that COVID-19 vaccination is safe in patients with cardiovascular diseases such as heart failureand that COVID-19 outcomes tend to be more severe in patients with the condition.
Relative to one or no vaccination, COVID-19 vaccination was tied to an 82% lower risk of death from any cause,a47% lower risk of hospitalization for heart failure,and a 13% reduced risk of infection over 6 months. Vaccination was also linked to significantly lower risks of stroke, heart attack, myocarditis/pericarditis, and venous thromboembolism.
"This was the first analysis of COVID-19 vaccine effectiveness in a large population of heart failure patients, and the first to show a clear benefit from vaccination," study coauthor Kyeong-Hyeon Chun, MD, said in the ESC news release.
"The study provides strong evidence to support vaccination in patients with heart failure," he added. "However, this evidence may not be applicable to all patients with heart failure, and the risks of vaccination should be considered in patients with unstable conditions."
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