There have been hundreds of variants since the original SARS-CoV-2 virus that caused COVID-19 made its debut in late 2019 and sparked a deadly global pandemic.
Most variants fizzle. But medical experts are keeping a close eye on BA.2.86 in case it has staying power or proves to be especially wily at beating people’s defenses and making them sick.
How concerned should you be about BA.2.86, and what is the origin of this new variant?
To sort out what’s happening with COVID-19 variants and infections this fall, we checked in with Dr. Michelle Barron, senior medical director of infection prevention and control for UCHealth and a professor of medicine and infectious diseases at the University of Colorado School of Medicine on the Anschutz Medical Campus.
Barron is one of the top infectious disease experts in the Rocky Mountain region.
There have been many variants of the original virus, SARS-CoV-2, that cause people to get sick with COVID-19. Why are infectious disease experts, like you, keeping an eye on BA.2.86?
“It’s the changes in the spike protein,” Barron said.
The BA.2.86 variant boasts more than 30 mutations or changes to the spike protein. That’s the mechanism the virus uses to send attackers into cells in our bodies. If a variant like BA.2.86 looks really different, it can evade detection by our immune systems, sneakily make copies of itself, and then launch an attack, which makes us sick.
New variants typically are slightly different than their predecessors. In this case, BA.2.86 has multiple genetic differences from its parents, grandparents and cousins, all of which are descended from the original omicron variant.
These genetic differences could be significant if they make it easier for the virus to re-infect people who have already had COVID-19 or cause infections in people who have been vaccinated.
Is BA.2.86 more infectious than other variants?
It’s not clear yet whether BA.2.86 is more infectious than other COVID-19 variants. Time will tell what happens with BA.2.86.
“There’s no evidence yet to suggest that this variant is more infectious or causes worse symptoms,” Barron said. “It’s like all the variants of interest and concern. We need to keep an eye on it. But we don’t know how it will impact us yet, if at all.”
Where did BA.2.86 come from? Why are we hearing about it now?
Researchers around the world detected BA.2.86 in recent weeks. A handful of confirmed cases popped up in Denmark, South Africa, Israel, the U.S. and the United Kingdom, according to experts at the U.S. Centers for Disease Control and Prevention (CDC).
Based on wastewater monitoring, CDC experts estimate that BA.2.86 is causing about 1% of COVID-19 cases in the U.S. now.
Even so, Barron said once a new variant is detected, it’s often spreading more widely than it first appears due to delays in reporting and lack of uniform testing across the U.S.
What is BA.2.86?
BA.2.86 is a descendant of the original omicron variant, which first sprang on the global scene and started causing millions of infections back in late 2021 and early 2022.
BA.2.86 is not different enough from the original omicron variant to earn its own new name from the Greek alphabet. But it looks different enough to demand attention from infectious disease experts
Barron compares this new variant to a sibling who looks really different.
“When you look at family photos, there’s always one person you’re related to that looks pretty different. And you wonder, ‘Where did you come from?’” Barron said.
The BA.2.86 variant is similar to that. It’s definitely part of the omicron family. But it looks pretty unique,” she said. “It may be different enough to where the immune system doesn’t recognize it as the virus.”
Time will tell if this particular variant is super-contagious or if other variants out-compete this one.
Is BA.2.86 causing more severe illness and triggering more hospitalizations?
No. Not yet. According to a recent CDC update, the current COVID-19 hospitalizations in the U.S. are driven primarily by the other dominant variants, which are known as XBB (another omicron descendant), not BA.2.86.
I’ve heard some people call BA.2.86 pirola. Is that a real name for this variant?
No. Pirola is not a real name for the variant. The CDC and World Health Organization have systems for naming variants. Pirola is not a sanctioned name. A person proposed the name on social media, but experts definitely are not using pirola as a name for the BA.2.86 COVID-19 variant.
Is there a chance that BA.2.86 will fizzle and won’t out-compete the other current XBB variants?
Barron said it’s typical for variants to appear strong, then sometimes disappear.
“Quite a few variants never made it to prime time,” she said. “Many never had their moment in the sun.”
We’ve all heard of the true villains in the world of variants. The delta and omicron variants wreaked havoc on the world.
But many others appeared to be worrisome at first, then disappeared.
What about the new COVID-19 vaccines that are coming out this fall? Will they protect me from BA.2.86?
The new COVID-19 vaccine that is expected to be released in mid-to-late September was formulated before BA.2.86 arrived on the scene. So, it won’t specifically fight this new variant. But the vaccine was created to fight omicron descendants, so it likely will provide some good protection, especially to prevent severe illness or hospitalization, Barron said.
She strongly encourages people to get their vaccines for COVID-19, flu and RSV (if they qualify) this fall. Learn more about the new COVID-19 vaccine along with flu and RSV.
With all annual vaccines, like the new shots for flu and COVID-19, vaccine makers have to guess in advance which strains of each virus will be spreading months later.
“It’s like a horse race,” Barron said, comparing virus variants to horses gathered at the starting gates.
“All the horses are lined up and ready to go. There are odds on which horse will finish first. The horses that are ranked at the top might end up placing. But every once in a while, a horse with really long odds ends up placing or winning the race,” Barron said.
That ends up happening in the world of infectious diseases, too. Sometimes, a longshot variant will come out of nowhere and will dominate all of the others.
Medical experts won’t know until later this fall and winter which flu and COVID-19 variants will dominate. They also don’t know yet how virulent new variants will be and if we’ll have a tough fall and winter for COVID-19, flu and RSV as we have in past years.
The good news is that nearly four years into the pandemic, researchers and infectious disease experts have a great deal of practice and are carefully monitoring what is happening in the world of infectious viruses.
Is it possible that vaccine makers might create a new version of the vaccine if BA.2.86 takes over and turns out to be highly contagious?
Barron said that it is possible but unlikely that the new fall COVID-19 vaccine will change.
CDC officials noted in an update on Aug. 30 that the new COVID-19 vaccine will be available in mid-to-late September. They say it’s a good match for the XBB variants, which remain dominant now.
There is a precedent for reformulating vaccines to contend with a new variant. Back when the H1N1 flu came on the scene in 2009, vaccine makers rushed to create a vaccine that would more effectively combat H1N1.
The new mRNA technology that Pfizer and Moderna used to create COVID-19 vaccines allows for faster production. But changing the formula now likely would be expensive.
Federal officials with the CDC and the U.S. Food and Drug Administration are closely monitoring variants as they also make decisions about vaccines.
Here in Colorado, Barron is also keeping a close eye on BA.2.86, along with all the other variants. She’s ready to fight back if any of them prove to be fierce opponents.
“I pay attention to all of them,” Barron said. “We have our playbook. It’s like a playbook for a football game. Once you know your competitors, you can adjust faster. You know what their basic moves will be, even if you’ve never played them before.”
What’s your overall advice to people?
“Get your vaccine. Think of it as your yearly shot,” Barron said.
What if I got a COVID-19 booster shot recently with the previous formulation?
Don’t worry if you got a COVID-19 booster before the new vaccine came out. But plan to get the new COVID-19 shot when you can. You’ll want to wait about three months or 90 days after your last vaccine dose before you get the new one.
Does it still make sense to test and isolate if you think you have COVID-19?
Yes. It’s very wise to test yourself. If you get a negative result from a home test, it might not be 100% accurate. But it can still be helpful. Check with your health insurance provider to see if they are still giving out free at-home COVID-19 tests.
Even if you don’t test positive for COVID-19, but you have the common symptoms, it’s wise and thoughtful to stay home so you don’t share the illness with others. Most people probably won’t have severe symptoms, but immunocompromised people and others who are vulnerable people still can become critically ill with COVID-19. Some will need to be hospitalized. And COVID-19 continues to cause deaths in the U.S. and around the world.
Will my COVID-19 vaccine be covered by insurance?
Most insurance plans should cover a COVID-19 vaccine.
The federal health insurance programs, Medicare and Medicaid, cover COVID-19 vaccines. Private health insurance plans typically follow in the footsteps of government insurance programs.