Overview:
When the CDC reported BQ.1 and BQ.1.1 as rising variants, it sparked concern for a number of reasons: some medical, and some related to a longstanding mismanagement of COVID-19 data among professionals. Can we do better in this next wave?
On Friday, October 14, the US Centers for Disease Control and Prevention released weekly COVID-19 data with a new breakdown of dominant strains for infections. These included the “sudden” emergence of BQ.1 and BQ.1.1, which had been recorded under BA.5 in earlier data, and were now prominent and rising strains when recorded separately. Together with BF.7, they account for some 17 percent of new cases. The BQ variants were first identified in July, and in September a Chinese study noted that BQ.1.1 (along with four other strains) is antibody-evasive at a level between BA.5 and SARS-CoV-1 (i.e., high). The UK is also monitoring their striking growth rate, as Northern Hemisphere countries try to anticipate case load spikes this winter.
But a few checks-and-balances are required to navigate this data. For one, scientists are still trying to assess how much these variants will affect vaccine efficacy, and the jury is still out on how much increased infection rates will translate to worse symptoms, and higher levels of hospitalization and death. This is not to say that they won’t. This is to say that scientists are still working on this data.
While they do, though, public health officials have already expressed concern about the slow roll-out of bivalent boosters, vaccines that defend against the original strain and Omicron variants BA.4 and BA.5. Which leads to the broader issue behind this latest data: how it will impact two dominant “strains” of political tension that need to be weighed carefully, if we’re truly facing a winter of rising caseloads. The first strain involves people who believe the world is making “too much” of COVID-19, a disease that killed over 6.5 million in the last three years. The second involves those who believe the world is not taking COVID-19 seriously enough.
For the former group, a key consideration omitted from this latest data, as reported widely in mainstream media since Friday, is the fact that overall US case counts have been declining. On September 1, the seven-day moving average of US cases was 86,652. On October 13, when the striking breakdowns were released, the moving average was 37.808. This downward progression is not expected to continue as we approach a winter surge (and as more people submit to testing for it), but for now that number can easily mislead average readers. Reporters would therefore do well to include sample size in any discussion about shifting percentages of specific strains over time, to contextualize such data in advance.
Meanwhile, over 8,000 people in the US died of COVID-19 in September, the vast majority over 65: a demographic that saw a huge uptick in deaths this summer. For some, this added extra pain to US President Joe Biden’s declaration, in a September 18 60 Minutes interview, that “The pandemic is over.” And that leads to the second strain of political disillusionment:
When the CDC announced its latest data (on the back of a checkered pandemic history of politicizing important medical intel), it also came just one day after Dr. Eric Feigl-Ding, co-founder of the World Health Network, released the information as a “scoop” that he’d received from a “CDC-insider source”. This has fuelled belief among some reporters, like Benjamin Mateus of the World Socialist Web Site, that “the CDC deliberately concealed this vital information from the public for weeks, as part of the relentless propaganda campaign by the Biden administration and the corporate media to falsely claim that ‘the pandemic is over.'”
These two “strains” of politically disillusioned civic participants bode poorly for the management of shared intel around COVID-19. As we head into the next phase of this disease (which includes Singapore and Bangladesh’s current issues with XBB, a “recombinant” variant drawn from two highly antibody-evasive and transmittable strains), we’re left with a difficult truth:
Navigating a global outbreak requires more than pure virology. It requires understanding and accounting for human behavior every step of the way.
Confidence in many major Western institutions, and in each other, is currently fragmented around the trauma that COVID-19 brought to our shared lives. New data that offers the grim possibility of further infection, hospitalization, and death spikes should be managed with great care, because we can’t scare each other into better action forever. Nor should we be trying to. We have to cultivate systems of civic responsibility—individually, and within our institutions—that make it easier to face the inevitability of new societal crises with the intelligence they deserve.
And may there be a Nobel Prize waiting for whoever finally pulls that off.