Even as new omicron subvariant spreads, speck of light may be emerging for Maryland at end of pandemic tunnel

Another version of the coronavirus is spreading around the globe and causing high rates of COVID-19 infections, along with angst — but also a small measure of optimism.

BA.2, as it’s known, is a subvariant and closely related to the omicron variant that spread rapidly around the world after its discovery in November. Some studies suggest BA.2’s even more transmissible and just as dangerous.

Cases have been found in dozens of countries and are rising rapidly in Denmark and elsewhere, according to the World Health Organization. It’s already been found in at least half of the United States, with Maryland reporting five cases so far in random sampling.

But here’s the not-so-negative part: Early research also suggests vaccines are protecting people from severe cases stemming from this and other new omicron subvariants. And because so many people have their shots and boosters, or already were infected with the original omicron variant, there may be enough community immunity to give the weary public a springtime pandemic break.

“We’ve paid a very high price for that natural immunity, the infections, with so many deaths,” said Dr. William Moss, an infectious disease expert and executive director of the Johns Hopkins International Vaccine Access Center. “But as a consequence of vaccination and infection, and barring any wild card here with a new, very different variant emerging that can escape our protections, we should be in good shape going forward.”

Moss and other Hopkins and state experts emphasized this week that the pandemic is not over, even though cases and hospitalizations are dropping quickly from their mid-January peaks. Deaths lag behind infections and are rising still.

The state recorded more than 2,000 cases and 37 deaths Thursday. And each day across the country, there are hundreds of thousands of new cases and more than 2,000 deaths.

The positivity rate among those tested for COVID-19 remains above an internationally accepted threshold of 5%, indicating community spread remains significant.

Moss said the new omicron subvariant is more like a sibling than a distant cousin, such as the delta variant that dominated infections during the previous wave. It and other omicron subvariants have enough mutations to behave somewhat differently but not enough to warrant new names along the Greek alphabet.

He said those who were infected with omicron aren’t likely to be reinfected by such close relatives, though that’s still under investigation.

Moss and other Hopkins experts say much remains to be learned about BA.2, and that more subvariants and variants are likely so the public should continue taking precautions for now. That includes masking indoors, distancing, hand-washing, and, most importantly, getting vaccinated and boosted.

Further, those with immunity from vaccines still are getting infected, and, in fact, such “breakthrough” infections are now a hallmark of the evolving virus, said Andy Pekosz, a virologist and professor of molecular microbiology and immunology in the Johns Hopkins Bloomberg School of Public Health.

The difference now is that BA.2 and other omicron subvariants are far less likely to cause severe cases of COVID-19 that lead to hospitalization or death for those with the shots, he said.

“At the end of the day, if there is a silver lining, it’s that those vaccinated, boosted and infected look to have an immune response broad enough that it recognizes variants,” said Pekosz, speaking Thursday during a Hopkins webinar on the pandemic.

That could mean the coronavirus begins to run out of human targets, making the virus “more like seasonal flu than the pandemic it is today.”

For now, the virus still has a lot of targets because so many Americans have refused vaccines. About 64% of the country is fully vaccinated, and almost 73% of the state.

State health officials say they remain vigilant and are monitoring the rise of the subvariant and others that are evident or undoubtedly on the horizon.

“As always, we encourage Marylanders to act prudently and follow established public health measures for COVID-19,” said Andy Owen, a spokesman for the Maryland Department of Health. “Getting a vaccine and a booster shot remains the most important thing that all eligible Marylanders can do to protect themselves and others.”

Gov. Larry Hogan also emphasized safety measures in his State of the State address Wednesday, even as he cited positive trends and ended the state of emergency in Maryland.

“With swift and decisive actions and the vigilance of Marylanders, I’m pleased to report that we have turned back another dangerous variant of COVID-19, and tomorrow, the state of emergency will end in Maryland,” he said. “Our long-term public health response will continue. Our surge capacity, our testing and tracing operations, our vaccine clinics — all those things will remain in place as part of the ongoing operations of government.”

Moss and others say getting authorization to use vaccines on young children also will be important. Pfizer/BioNTech has submitted data to the U.S. Food and Drug Administration about its two-dose vaccine in children 6 months to 4 years old.

The move confounded some scientists, who noted the companies said the doses, smaller than those for older kids, did not work as well as expected in children 2 to 4. The shots did not produce as many virus-fighting antibodies as the vaccine did in older children, or even in the youngest, 6 months to 2 years. The smaller doses seemed to work well enough for that age group.

Instead of testing larger doses for the 2- to 4-year-olds, the companies are testing a third dose, and some scientists expect that to be the final recommendation.

Moss said there is urgency in gaining emergency authorization for using the vaccine in the youngest children now, even if another dose is added later. He also said he does not expect the FDA to authorize use of the first two shots if the data doesn’t show they provide at least some protection.

If the FDA authorizes use in the coming weeks, the U.S. Centers for Disease Control would have the final say.

Vaccine makers have said the vaccines continue to work well in preventing severe disease, though inoculations do not stop all infections from omicron. The same is expected for the subvariant BA.2. Nonetheless, vaccine makers are looking into omicron-specific vaccines.

Moss said natural immunity will help fill the gap for those who still refuse vaccinations despite the safety shown over the past year as millions of doses have been administered.

That is a risky gambit, however, as those in hospital beds remain overwhelmingly unvaccinated or without a booster shot. Many of the remainder are older adults or immunocompromised by a health condition.

Conditions will improve, and the masks can come off, at some point, said Crystal Watson, a senior scholar at Johns Hopkins Center for Health Security.

“I’m looking for a sustained reduction in transmission,” she said.

“And I’m looking for protections from vaccinations and prior infections, and I don’t see large surges in hospitalizations and deaths like we’ve seen with omicron,” Watson said. “That’s when we can start to take a deep breath and think about how to treat this virus going forward.”