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Q: Is it possible to know what variant I have?

A: There are no clinical settings in the US that can provide the information to patients as to what variant they have. The reasons for that are: 1) there are really no clinical reasons for you to know - the treatment for COVID is the same whether you have BA4, BA5 or one of the newer variants; and 2) genomic sequencing is expensive, it is only done at specific, specialized laboratories. As a country, the US only samples a small percentage of positive tests.

But we can kinda make an educated guess! In the latest CDC weekly data on variant proportions, the BA4 and BA5 omicron subvariants comprise about 50% of all infections detected by PCR (as of 10/29), and as of 10/22 nearly 90% of our US wastewater testing sites detected BA4 & BA5. That's why it's very good to get the bivalent booster, because that's a perfect match for variants circulating right now. There are other emerging variants on the list, such as BQ.1 and BQ.1.1 which comprise roughly 27% of the newly sequenced samples. These variants have been reported to contain more mutations that could give them a growth advantage over BA4 & BA5. so it is likely you have either BA5 or BQ1/BQ1.1

One thing that is important to know is that all currently circulating variants on the CDC report are still subvariants of omicron, and specifically all came from BA.5 (the one the booster is targeting!). There is a hope that, while more immune evasive with respect to infection, the vaccine would still protect against severe disease from BQ.1 and BQ.1.1, as has been the case thus far with all the other subvariants.

Q: I am boosted and dodged COVID for 2.5 years but now I have it! Was all my effort for nothing?

A: First off - congratulations for dodging COVID for 2.5 years! While this bout with COVID may make you feel like your efforts were in vain, it's great that you protected yourself from repeated infections. Each infection was a chance for severe disease in pre-vaccine days, and repeated infections increase the chances for long COVID and even theoretically the creation of a new variant. Preventing all of that was good!

The COVID-19 vaccines and boosters you got should help you to fight off this infection without serious complications. Vaccines do prevent infections, but especially these vaccines are not 100% effective against them. We do expect breakthrough cases, but these vaccines work best by preventing severe infections, hospitalizations and deaths. Feel better!

Q: I tested negative on a home test this morning and positive on PCR. How is that possible?

A: The PCR test tends to detect a positive result sooner in clinical course of disease than the rapid antigen home tests do. PCR is really sensitive because it works by detecting viral genetic material. The home test should turn positive in the next couple of days. (also important note: if you want to test to see if you can be back around people, the home test will be the one to use because the PCR is so sensitive that it continues to detect inactive viral particles in the nose up to 90 days after an infection).

THANK YOU for the Qs!

Dr Kat


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