These 2 COVID-19 Subvariants Are The Most Dominant in the U.S.—What You Need to Know
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Omicron has been the dominant COVID-19 variant in the U.S. for months, but it’s spawned several subvariants that have caused spikes in cases. While data from the Centers for Disease Control and Prevention (CDC) once showed that the Omicron subvariant BA.2.12.1 (Stealth Omicron) was the dominant form of COVID-19 circulating in the U.S., now, there are two new subvariants infectious disease experts are keeping an eye on: BA.4 and BA.5.
Federal estimates show the rapidly spreading COVID-19 subvariant BA.5 has become the dominant variant, making up about 54% of new cases in the United States, and the BA.4 subvariant is responsible for about 16% of recent cases. Additionally, data from The New York Times from the Center for Systems Science and Engineering at Johns Hopkins University shows that cases of Omicron subvariants BA.4 and BA.5 have risen in Europe by 70% over the last two weeks.
Omicron subvariants are nothing new but, historically speaking, the rise of a new subvariant—let alone two subvariants—seems to correlate with an increase in COVID-19 cases.
Here’s what you need to know about Omicron subvariants BA.4 and BA.5, including where the dominant subvariants first appeared, the symptoms, and how concerned you should be.
What are the symptoms of BA.4 and BA.5?
As a whole, the symptoms of COVID-19 have stayed fairly consistent, and BA.4 and BA.5 don’t seem to be a big departure from other Omicron symptoms, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. “They also seem to cause no more or less severe disease than earlier renditions of Omicron,” he adds.
A CDC report published in December found that patients with Omicron generally have these symptoms:
Cough
Fatigue
Congestion
Runny nose
The most common symptoms of COVID-19, per the CDC, include:
Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
BA.4 and BA.5 outdoor transmission risk
You can get BA.5 outdoors, but you could also contract other COVID variants outside, Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York, recently told Prevention. “Outdoors has never been a 100% safe zone,” he says. “You’re much less likely to get infected outdoors than you are indoors—that’s unequivocal. However, if you’re in close quarters with an individual in close quarters for a longer period of time, you’re still at risk of getting infected.”
COVID-19 typically spreads through droplets from an infected person’s breathing, according to the CDC. Currently, the CDC still recommends wearing a well-fitted mask if you are sick or around others who are sick. In general, the CDC says you do not need to wear masks outdoors.
Where did BA.4 and BA.5 originate?
It’s not entirely clear where BA.4 and BA.5 originated, but they’ve been detected in several countries in Southern Africa and Europe, according to the World Health Organization (WHO).
WHO’s technical lead on COVID-19, Maria Van Kerkhove, said in May that the variants have been spotted in Botswana, South Africa, Germany, and Denmark, among other countries.
Do tests detect the new subvariants?
Yes, COVID-19 tests are able to detect the new variants, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine.
One thing to note, per Dr. Russo: While BA.2 had certain genetic traits that made it harder to classify as Omicron on polymerase chain-reaction (PCR) tests, that doesn’t seem to be the case with BA.4 and BA.5.
“That’s a quick and dirty way to find out if BA.4 and BA.5 are circulating if you’re in a BA.2-dominant region,” he says.
Additionally, because the popularity of home testing has increased and become more accessible, experts believe the total count of new infections is much larger than we even know.
How do these subvariants differ from BA.2.12.1?
Research from South Africa indicates that the country’s earlier surge of BA.4 and BA.5 variants did not cause any more severe illness compared to the first Omicron wave, but they are significantly more contagious, according to recent research published in the journal Nature. The study indicated BA.4 and BA.5 are four times more resistant to antibodies from three vaccine doses compared to BA.2.
BA.4 and BA.5 have mutations that make them slightly different from BA.2.12.1. “There’s a pattern here,” Dr. Schaffner says. “We had Omicron and then there are Omicron mutations that were as contagious or even more contagious than Omicron. It’s a continuing story.”
BA.4 and BA.5 “are more closely related to BA.2 and its subvariants than to BA.1,” Dr. Russo says. BA.4 and BA.5 have an amino acid change that was present in the Delta variant, Dr. Russo says. “Because of this, there’s some speculation that, if you were infected with Delta, it may help you out with BA.4 and BA.5,” he says.
What can people do to protect themselves?
Dr. Russo recommends sticking to “the usual” prevention methods. That means getting vaccinated against COVID-19, if you haven’t already, and making sure you’re up to date on your boosters.
The Food and Drug Administration (FDA) recently issued a statement assuring the American public that any COVID-19 vaccine authorized or approved by the FDA meets the standards for safety and effectiveness, and they continue to encourage getting your booster doses of the COVID-19 vaccine. Manufacturers are currently working to update their vaccines to add an omicron BA.4 and BA.5 spike protein component (to help address the contagious subvariants) that is expected to be available in mid-fall 2022.
“Vaccine-induced immunity seems imperfect at preventing infection, but it looks like it will do a good job at keeping people out of the hospital with severe disease,” he says.
And, if you’re considered at high-risk for complications from COVID-19, he also suggests wearing a “high-quality, well-fitting mask” in indoor settings.
Overall, experts say that public health officials are keeping an eye on BA.4 and BA.5. “These variants are something that we in public health are watching,” Dr. Schaffner says.
This article is accurate as of press time. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the novel coronavirus develops, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC, WHO, and your local public health department to stay informed on the latest news. Always talk to your doctor for professional medical advice.
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