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5 Reasons to Beware the BA.5 Omicron Subvariant

It’s highly contagious and sweeping the U.S. Here’s how to stay safe during the summer surge

COVID omicron BA 5 strains are starting to spread.
Westend61 / Getty Images

More than 70 percent of adults age 50 and older haven’t received a second COVID-19 booster shot, and if you’re part of the pack, U.S. health officials say now is the time to roll up your sleeve.

Cases of COVID-19 are once again on the rise — hospitalizations are double what they were in early May — and a highly contagious version of the omicron variant, known as BA.5, is behind the uptick, accounting for about 65 percent of coronavirus infections in the U.S.

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Those numbers could continue to rise, experts warn, largely due to BA.5’s immune-evading abilities. Here’s what you need to know about BA.5, including steps you can take to help stay healthy this summer.

1. BA.5 is “maximized to evade immunity.”

When viruses replicate, they can mutate. Some of them shift into less menacing versions of themselves, while others pick up changes that make them more problematic. It’s a process that we’ve seen play out throughout the pandemic with the emergence of alpha, delta and then omicron.

BA.5 is what’s known as a subvariant of omicron — think of it like a branch on the omicron family tree. It has several mutations that set it apart from other variants of the virus, including its parent variant. And these mutations — many of which are on the part of the virus that binds to cells — make it easier for the virus to dodge frontline defenses put in place by either vaccination or a previous infection.

Even those who had COVID-19 this winter or spring are susceptible to another bout with this subvariant, experts say.

“So it’s sort of maximized to evade immunity,” says Andy Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health.

2. It’s very contagious.

On top of its immune-evading skills, BA.5 also transmits from person-to-person more easily than others in the omicron family, including the original omicron variant (BA.1), which burst on the scene in late 2021 and caused the largest spike in infections to date.

“And those viruses were transmitting much, much more efficiently than previous variants,” Pekosz points out. “So it’s sort of reaching a pinnacle in terms of not only being able to transmit but also to evade immune responses that are present in the population, and that’s why people are really looking at this carefully and following the surge of cases.”  

3. Symptoms still send some to the hospital.

“There’s no evidence to suggest” that BA.5 causes more severe disease than its predecessors, Centers for Disease Control and Prevention Director Rochelle Walensky, M.D., said in a July 12 briefing, though data is still being collected and reviewed. And the symptoms the subvariant causes seem to be similar to those brought on by its sibling strains. Fatigue, runny nose, sore throat, cough and fever are all common with BA.5.

“We’re not seeing loss of smell so much,” says Abinash Virk, M.D., a professor of medicine and infectious diseases at Mayo Clinic. For many, it’s mostly cold- and flu-like symptoms, she adds, though “some people are still getting sick enough to get into the hospital.”

In fact, each day about 5,775 people, on average, are being admitted to the hospital for COVID-19, CDC data shows. Adults 70 and older are being hospitalized at a rate much higher than younger people.

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4. Most Americans are undervaccinated.

Still, vaccine effectiveness against severe disease and death from COVID-19 remains high for omicron and its other subvariants, “and likely also for BA.4 and BA.5,” Walensky said. “So staying up to date on your COVID-19 vaccines provides the best protection against severe outcomes.”

Many Americans, however, are not up to date. Less than half (about 48 percent) of individuals eligible for a first booster dose have received one. And fewer than one-third (about 28 percent) of adults 50 and older, who are at increased risk for complications from COVID-19, have gone back for their second booster, federal data shows.

“We know immunity wanes with coronaviruses, whether that’s [immunity from] natural infection or vaccination,” top infectious disease expert Anthony Fauci, M.D., said in the July 12 briefing. “And so if you’ve been infected or vaccinated and your time comes for a boost, that’s when you should go and get the boost.”

Older adults, especially, have a less robust immune response than younger adults, making boosters all the more important. “It’s a matter of getting somebody who is at higher risk of severe disease a little edge to handle a potentially severe problem,” Virk says.

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Data shows that as of April, people age 50 and older who had one booster dose were four times more likely to die from COVID-19 than those with two boosters under their belt. And adults 50 and older who had been vaccinated and boosted twice were 42 times less likely to die from COVID-19 than unvaccinated individuals in the same age group.

“If you’re over 50, that extra booster dramatically lowers your risk of getting into the hospital, going to the ICU, and dying,” said Ashish Jha, M.D., White House COVID-19 response coordinator.

5. Reinfections come with risks.

Reinfections are becoming more common now that we’re two-plus years into the pandemic. And that will likely continue as immune-evading variants such as BA.5 tear through the country.

But reinfections come with risks, experts caution. Your symptoms may not be as bad if you get COVID-19 a second or third time, the thinking being that “you’ve got some immunity that’s going to prevent the disease from progressing quickly and to that severe disease state,” Pekosz says.

Emerging research, however, shows that with each infection, even an asymptomatic one, your risk of developing complications — heart attack, stroke, diabetes and long-term cognitive impairment — increases.

Another concern: “We don’t know how reinfection is going to affect things like long COVID,” Pekosz says — a term used to describe new or worsening symptoms that persist well after an initial coronavirus infection. “And certainly, if you’re reinfected you can spread the virus to others and continue the cycles of transmission,” he adds.

Staying safe from the summer wave

  • Don’t sleep on your booster.

BA.5 may sound like a lot of doom and gloom, but health experts say we have the tools we need to help protect us from some of the worst outcomes. Topping the list are the vaccines. Everyone 6 months and older is eligible for a primary series; people 5 and older can get a first booster; and adults 50 and older can get two — so can people with certain health conditions.

If you recently had COVID-19, you don’t need to wait months, or even weeks, before getting vaccinated or boosted. You just need to make sure you’re out of isolation before getting your next shot, the CDC says.

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What’s more, getting a booster this summer will not preclude you from getting one of the updated vaccines that are expected this fall or winter. Both Pfizer and Moderna are working on newer versions of their vaccines that target the original coronavirus strain, as well as the omicron variant, including BA.5.

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“For people who are 50 years of age or older, my message is simple: If you have not gotten a vaccine shot in the year 2022 … please go get another vaccine shot,” Jha said.

  • Plan for treatments. 

The prescription antiviral pill Paxlovid is still effective against an infection caused by BA.5, “and so it should be something that everyone is aware of,” Pekosz says. The treatment has been shown to reduce the risk of hospitalization or death from COVID-19 by nearly 90 percent in high-risk patients.

Starting the drug shortly after developing COVID-19 symptoms is key to its effectiveness, which is why Pekosz recommends knowing where your closest Test-to-Treat location is ahead of time. These sites test people for COVID-19 and prescribe and fill the medication for those who are positive and qualify for the drug. (Certain health conditions and drug interactions may not make you a good candidate.)

Your primary care doctor can also prescribe Paxlovid, as can some pharmacists. In addition to Paxlovid, the monoclonal antibody treatment bebtelovimab is predicted to work against a BA.5-caused infection, Fauci said.

  • Don’t forget about tests.

A rapid test that you can take at home can clue you in to your COVID-19 status in a matter of minutes, which can help cut down on the spread of the virus and help to keep others around you safe. Virk recommends taking one before traveling or attending indoor gatherings.

Curbing the spread of COVID-19 also helps to keep new variants at bay. “If a virus is not very robustly replicating and spreading, it gives it less of a chance of a mutation, which gives it less of a chance of the evolving of another variant,” Fauci said.

There are now 17 over-the-counter, at-home rapid tests federally authorized in the U.S., and many health plans, including Medicare, will cover the cost of up to eight each month. You can also order free at-home tests from the federal government.

  • Mask up.   

Wearing a mask indoors, even when others around you aren’t, can help prevent a coronavirus infection, experts say. Just be sure to choose one that is high quality, like an N95 or similar respirator. Also, be sure it fits properly. You want to make sure the mask completely covers your nose and mouth and that there are no gaps along the edges.

Walensky pointed out that roughly one-third of Americans live in communities where the CDC says they should be wearing masks indoors, based on local transmission levels and other factors.

  • Practice other pandemic precautions.

Don’t forget about all the tools we used before vaccines, treatments, tests and N95s were widely available. Give yourself some space when you’re around others, and if possible, opt for outdoor events over indoor. Also, avoid crowds in poorly ventilated areas.

“We’re moving our way back into normalcy, but we’re going to be fighting this virus for a while and we’ve got to use the arsenal that we have now with respect to the public health interventions, vaccines and the antivirals to really minimize the bad effects of this infection,” Pekosz says.

“If we do the things that we know, that we have learned over the last two years, we can get through whatever Mother Nature throws at us in the next four, six, eight weeks ahead. And also whatever Mother Nature throws at us this fall and winter,” Jha said.

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