China is bracing for a spike in COVID-19 cases as Omicron’s variant, known as XBB, spreads rapidly across the country.
According to senior health adviser Zhong Nanshan, infections could reach 40 million per week by the end of this month and peak at around 65 million cases per week by the end of June. The wave of infections is expected to become the second largest in the country, although it will likely be smaller than the initial wave experienced last year.
Zhong Nanshan, China’s leading respiratory disease expert, recently discussed the projected COVID-19 wave at the 2023 Great Bay Science Forum. He revealed that two new vaccines targeting the XBB variant will soon be released to the market. Zhong emphasized the importance of developing effective vaccines against XBB, as it has become the dominant strain in China.
China has already approved two vaccines for the current variant of XBB, and more approvals are expected in the near future.
The China Center for Disease Control and Prevention (China CDC) reports a significant increase in XBB mutant infections, with its prevalence rising from 0.2% in mid-February to 83.6% in early May . Experts have expressed concern about limited testing and reporting in China, which could lead to an underestimation of the true number of cases.
Raj Rajnarayanan, a tracer of COVID variants, explains that low testing rates could make the wave largely invisible. China now faces the challenge of a substantial population at high risk of severe outcomes due to age, immune status, and comorbidities.
As the XBB variant continues to circulate, there is a chance that new variants will emerge. Rajnarayanan suggests that the increased circulation of XBB variants, not only in China but also elsewhere, could lead to the evolution of new strains. However, the latest World Health Organization report indicates that XBB variants have so far been relatively benign for those not at high risk.
The World Health Organization recently recommended in a statement that future vaccines against COVID-19 no longer include the original SARS-CoV-2 virus, but a different version that closely matches the circulating variants.
The WHO technical advisory group on the composition of the COVID-19 vaccine suggested on May 18 that the XBB.1.5 variant, which is responsible for the majority of new infections worldwide, be included. The WHO advised that the updated vaccine should focus on a single XBB variant rather than multiple versions.
Although not binding, this recommendation serves as a basis for national vaccine decisions. Some experts have advocated including multiple strains of the virus in the next vaccine, similar to the approach of the annual flu shot. The WHO panel emphasized that slight differences exist between existing XBB variants and alternative formulations or platforms that generate strong neutralizing antibody responses against XBB descendant lineages may be considered.
The latest US COVID-19 booster is bivalent, targeting the original version of SARS-CoV-2 and two Omicron variants (BA.4 and BA.5). Although these and earlier vaccines remain effective against serious illness, hospitalization, and death, they offer less protection against infection as antibody levels decline over time.
The WHO recommendation will be considered by the US Food and Drug Administration (FDA) when its vaccine experts meet in June to discuss which strains should be included in the next COVID vaccine -19. The FDA’s VRBAC committee is moving toward approving a single annual injection for most people, with additional doses for the elderly and immunocompromised.
The FDA announced in April that unvaccinated Americans can now receive a single dose of Moderna’s or Pfizer’s bivalent mRNA vaccines.
The Covid development comes amid a US presidential campaign that is gaining momentum. Florida Gov. Ron DeSantis on Wednesday announced his bid for the Republican nomination to run in 2024 against former President Donald Trump. The nation’s Covid response will remain a contentious issue as many states continue to point to the pandemic as a reason for no-excuse mail-in ballots in elections.
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