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Update on COVID-19, variant EG.5, and new fall vaccine booster

What is EG.5?

The SARS-COV-2 EG.5 variant is another omicron sub-variant, and is a descendent of XBB.1.9.2, but with an additional mutation in the spike protein. It is estimated to be 17.3% of sequenced COVID cases, which would make it the dominant variant in the US currently. The previous dominant variant, XBB.1.5, had been dominant since the spring. Now XBB.1.5 is decreasing in proportion and we're seeing a variety of new omicron sub-lineages springing up. The characteristics of all the sub-lineages of omicron are very similar; they all spread easily and evade antibodies, hence why they keep emerging.

Are COVID cases increasing?

It may seem like everyone is getting COVID again right now, and that's because of this variety of new variants that are circulating. We have seen an uptick in the wastewater data nationwide. Other indicators that have been increasing are hospitalizations and ER visits, but they are still low relative to other times during the pandemic.

What about tests, medications and vaccines against this new variant?

COVID tests still work against this variant, as does Paxlovid, the antiviral medication available by prescription.

An updated vaccine will be available in the fall (scheduled for the end of September) which includes XBB.1.5. While there are more variants that have emerged since XBB.1.5, XBB.1.5 is still circulating, and the new omicron variants remain closely related, and thus the updated vaccine is expected to produce broadened immunity (effectiveness data for the new vaccine has not yet been released by either Pfizer or Moderna).

While the COVID-19 fall booster will be helpful to boost everyone’s immunity to the virus, it is especially important for vulnerable groups to get it, such as: the elderly, nursing home residents, pregnant people, immunocompromised people, and those with heart and lung conditions.

Why did EG.5 get media attention this week?

The WHO saw an increase worldwide in cases due to EG .5 and they have upgraded this strain from a “variant under monitoring” to a “variant of interest”, so it's just a little bit higher on their priority of surveillance. This does not mean that this variant is an increased public health threat over the other omicron variants.

So, what else should people do to protect themselves?

In terms of other fall protections, wearing a well-fitting N95/KN95 mask will help in crowds and indoor settings. We will also have a new flu shot for everyone to get (best time to get it is September/October, and can be combined with the other shots on the same day), and there is a newly-approved RSV vaccine for those over 60. For infants there is a monoclonal antibody shot for the prevention of RSV as well.

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