The Kraken is a giant sea monster of Scandinavian folklore that rises up from the ocean to devour its enemies. The line “Release the Kraken!” is the frightful stuff of Hollywood blockbusters.
Kraken is also the nickname given to XBB.1.5, the latest Omicron subvariant of the virus that causes COVID-19.
But there is really no evidence that the latest variation of the novel coronavirus is any more monstrous than its predecessors, and this sort of hyperbole serves no good purpose.
The virus is doing what viruses do: evolving.
In a nutshell, what we know about XBB.1.5 is that it’s a recombinant variant, a fusion of two Omicron lineages.
It appears to be more immune evasive, allowing it to spread more quickly and efficiently than previous iterations. The World Health Organization calls XBB.1.5 the “most transmissible” variant yet.
In the United States, during a six-week period, XBB.1.5 went from accounting for 0.3 per cent of COVID-19 cases to 40 per cent – and as high as 70 per cent in some northeastern states. The speed at which it has become dominant is unusual.
The way the coronavirus has evolved is fascinating, in a nerdy sort of way, especially since, with modern technology, we can see the changes almost in real time.
But we pay far too much attention to cell-binding properties and other minutiae of virology and not enough to the practical implications.
The risk of COVID-19 infections, or reinfections, increasing in the population just jumped another notch. But that doesn’t mean XBB.1.5 is more dangerous or that our individual risk is higher. No matter how theoretically transmissible a virus is, it’s ultimately our behaviour that matters.
We’ve essentially abandoned collective mitigation measures. We’ve just come through a busy holiday season, with lots of travel, and it’s now winter, when respiratory viruses spread more readily. We’ve created the perfect conditions for a new variant to spread.
That environment, combined with XBB.1.5′s higher transmissibility, means we will likely see a surge in cases.
This has happened previously, with the Delta variant and, most notably, a year ago, when Omicron came along and fundamentally changed the course of the pandemic.
Since January, 2022, virtually everyone has been infected with a least one strain of the coronavirus. It’s not uncommon to be reinfected.
While our interest in the pandemic has waned, its impact has not. In Canada, we recorded more COVID-19 deaths last year (19,035) than in the first two years (15,307 in 2020 and 14,606 in 2021).
Hospitalizations for pandemic-related illnesses were also significantly higher in 2022 than in previous years. The good news is that, proportionately, there are fewer people falling severely ill and ending up in intensive care.
The other bit of positive news is that the “tripledemic” is easing. The unprecedented surge of RSV (respiratory syncytial virus) seems to be over. Influenza cases also seem to have peaked. (However, we could see another jump in early spring.)
That means COVID-19 is back as the biggest infectious-disease threat. But the context is very different than a year ago.
Widespread infection means more people have at least some immunity. We know, too, that while COVID-19 vaccination does not prevent infection, it does make its impact less severe. U.S. data shows, for example, that those who have received the bivalent vaccine (a fourth, or in some cases fifth, dose) are 80 per cent less likely to be hospitalized.
Unfortunately, misinformation continues to spread even more quickly than the virus.
The latest anti-vax nonsense circulating is the claim that vaccination is fuelling mutations. Vaccines don’t create new variants – infections do. And our low rates of vaccination (boosters, in particular) make it easier for new variants to do harm.
The more people get infected – the more the virus is circulating – the more likely it is we will see mutations.
The best protection we have against new subvariants such as XBB.1.5 is still the boring basics: get vaccinated and boosted; test before attending gatherings; mask up in indoor public spaces; pay attention to ventilation; if you have symptoms, stay home; and if you have COVID-19, get the appropriate treatment.
We need to acknowledge, too, that three populations – frail elders, the immunocompromised and pregnant people – are at a disproportionately greater risk. We need to make concerted efforts to protect them. We can’t forget, either, that COVID-19 infections can have long-term consequences, in the form of long COVID.
The biggest advantage new variants have on us is our behaviour. The real Kraken is no longer the virus – it’s our monstrous level of indifference to the pandemic’s ongoing, and inequitable, carnage.
André Picard