Publisher Health

A new Covid sub-variant is causing some concern in the US, where it is spreading rapidly.

Some cases have been recorded in the UK, so what do you need to know about XBB.1.5?

It is yet another offshoot of the globally dominant Omicron Covid variant, which itself followed the earlier alpha, beta, gamma and delta variants.

Omicron has outperformed all previous versions of coronavirus since it emerged in late 2021, and has given rise to many sub-variants which are even more contagious than the original.

Symptoms of XBB.1.5 are thought to be similar to those of previous Omicron strains, but it’s still too early to confirm this. Most people experience cold-like symptoms.

XBB.1.5 itself evolved from XBB, which began circulating in the UK in September 2022, but which has not been classified as a so-called “variant of concern” by health authorities.

XBB had a mutation that helped it beat the body’s immune defences, but this same quality also reduced its ability to infect human cells.

Prof Wendy Barclay from Imperial College London said XBB.1.5 had a mutation known as F486P, which restores this ability to bind to cells while continuing to evade immunity. That makes it spread more easily.

She said these evolutionary changes were like “stepping stones”, as the virus evolves to find new ways of bypassing the body’s self-defence mechanisms.

Scientists from the World Health Organization (WHO) confirmed on Wednesday that XBB.1.5 has a “growth advantage” above all other sub-variants seen so far.

But they said there was no indication it was more serious or harmful than previous Omicron variants.

The WHO said it would keep a close watch on lab studies, hospital data and infection rates to find out more about its impact on patients.

Over 40% of Covid cases in the United States are estimated to be caused by XBB.1.5, making it the dominant strain in the country.

At the beginning of December, it accounted for only 4% of cases so it has quickly overtaken other versions of Omicron.

Covid hospital admissions have been rising in recent weeks across the US.

The UK Health Security Agency is due to release a report on variants spreading in the UK next week, and may refer to XBB.1.5.

Nothing is certain, but it does look likely.

The UK had five Omicron waves in 2022, and further spikes in cases are inevitable.

Figures for the week to Saturday 17 December from the Sanger Institute in Cambridge suggested that one in 25 Covid cases in the UK were XBB.1.5.

But that was based on just nine samples, so we’ll need to wait for a week or two to get a better picture of how it is spreading.

Prof Barclay said she expected more hospitalisations in the UK if the variant takes off here, “as we expect it to do”.

Prof Paul Hunter from the University of East Anglia, said: “The balance of probabilities is that XBB.1.5 will trigger a wave here later this month, but we can’t be sure.”

NHS England has said the fears of a “twindemic” of Covid and flu have been realised, with both viruses putting strain on an already stretched NHS.

Prof Barclay said she was not especially concerned about the general UK population because there was “no indication” that XBB.1.5 would “breakthrough” the protection against severe illness provided by vaccines.

But she is worried about its effect on the vulnerable, including the immunocompromised, who get less benefit from Covid jabs.

Prof Hunter said he’d seen no evidence that XBB.1.5 was more virulent, meaning it was no more likely to “put you in hospital or kill you” than existing Omicron variants.

He added: “It’s ironic that everyone is focussing on possible variants emerging from China, but XBB.1.5 came out of the US.”

Prof David Heymann from the London School of Hygiene and Tropical Medicine acknowledged that there was still a fair amount to learn about this latest variant.

But he said it was unlikely to cause major problems in countries like the UK which have high levels of vaccination and previous infections.

His concern was for countries like China, where there was both low take-up of vaccines and little natural immunity because of prolonged lockdowns.

“China needs to share clinical information on people infected in order to see how the variant behaves in a non-immune population,” Prof Heymann said.