Hyper contagious subvariant gaining a foothold in Hawaii

Omicron subvariant BA.5 — perhaps the most transmissible coronavirus variant yet — is gaining a foothold in Hawaii as it dominates the COVID-19 landscape in the rest of the United States.

Omicron subvariants BA.4 and BA.5 together now account for 47%, or nearly half, of the COVID-19 variants circulating in Hawaii, according to the Department of Health’s latest variant report.

The report, released late Wednesday by the DOH State Laboratories Division, found through genome sequencing that subvariant BA.5 made up 39%, while BA.4 made up 8% of test samples collected in the two-week period ended July 2 .

The omicron subvariant BA.2.12.1, meanwhile, accounted for 42% of the variants circulating in the state, up from 58% two weeks earlier. BA.2 now accounts for only 11% of the variants circulating in the state.

Because there is a delay between processing the sequencing results and counting them for the report, the numbers are likely higher at the time of publication.

Sewage data can also provide clues to the extent of the virus that causes COVID-19 and variants present in a community.

The Centers for Disease Control and Prevention hired Biobot Analytics to help collect wastewater data to track virus concentrations at US sites, including 14 in Hawaii. Some preliminary wastewater data for several sites on the islands appear to be on an upward trend, although data collection has only recently begun.

Only Kauai County has allowed Biobot to post detailed results on its online platform. Sequencing of Kauai wastewater samples shows that approximately 61.3% of the samples are BA.5, while approximately 7.6% are BA.4 and 31% are BA.2 family.

DOH’s own wastewater program, which is slated to begin this summer, is not yet operational.

While all omicron subvariants are considered variants of concern, both BA.4 and BA.5 have an increased ability to evade antibodies elicited by vaccination or previous infection compared to BA.2.

However, BA.5 appears to have a significant growth advantage over BA.4 despite sharing identical mutations in the spike protein, the report said.

Epidemiologists are most concerned about BA.5, which has quickly become the dominant lineage nationwide and accounts for about 78% of new COVID-19 cases in the US, according to the CDC.

dr Eric Topol, a professor of molecular medicine at Scripps Research, has called BA.5 “the worst version of the virus we’ve ever seen” because of its immune evasion — or ability to evade antibodies produced by previous infections and vaccinations .

dr Dean Blumberg, chief of the division of pediatric infectious diseases at UC Davis Children’s Hospital, said BA.5 also leads to increased viral replication, meaning those infected tend to have the virus longer and shed it longer.

In general, most breakthrough infections were not severe enough to result in hospitalizations. But Blumberg said there is new evidence that with every COVID-19 infection, your risk of long-term effects, including stroke, heart and kidney disease and other health problems, increases, even if you’re vaccinated.

“COVID is not over, and people need to continue protecting themselves,” he said in a recent UC Davis Health video. “Even if people are vaccinated, even if people previously had some immunity to infection from other strains, you can still get a breakthrough infection.”

He encouraged people to keep up to date on COVID-19 vaccines and to continue to mask themselves indoors around others outside of their household.

BA.5 is thought to reignite cases in nearly every mainland state, from California to New York.

On Wednesday, DOH reported a reversal in the trend after consecutive weeks of falling COVID-19 cases — with Hawaii’s seven-day average new cases rising to 574 and the state’s average positivity rate rising to 15.1%.

The State Laboratories Division has so far detected 67 cases of BA.4 and its sublines and more than 250 cases of BA.5 and its sublines in Hawaii in COVID-19-confirmed PCR test samples collected between May and July.

All four of Hawaii’s major counties — Kauai, Honolulu, Maui, and Hawaii — have both BA.4 and BA.5 in their communities.