XBB.1.16 ‘Arcturus’ Is New Covid-19 Variant Under Monitoring By The WHO: Symptoms and Treatment
Guess what? There’s yet another Covid-19 coronavirus variant spreading around the world and in the U.S. This one has the oh-so-easy-to-remember name XBB.1.16 because when has the name of another Omicron subvariant started with the letters XBB, right? On March 22, the World Health Organization (WHO) classified the XBB.1.16 as a new variant under monitoring (VUM), which isn’t as serious as a variant of interest (VOI) which isn’t as serious as a variant of concern (VOC). Nevertheless, a VUM could always eventually become a VOI or even a VOC. And the spread of the XBB.1.16 seems to have already fueled what’s been called by Business Today a “massive surge” of Covid-19 cases in India and sparked the return of face mask mandates there. These days the term “massive surge” isn’t great to hear unless you are talking about chocolate or sex. So the big question is how concerned should you be about this new subvariant that some have unofficially dubbed the “Arcturus” subvariant?
Well, “Acturus-lly,” the XBB.1.16 has gone from being about 0.21 percent of all Covid-19 cases worldwide in late February to an estimated 3.96% a month later. In the U.S,, the XBB.1.16 accounted for an estimated 7.2% of all Covid-19 samples from April 9 to April 15, according to the Centers for Disease Control and Prevention (CDC). That’s up from 3.9% the week before and 2.1% the week prior to that. XBB.1.5 is still the alpha-dog of variants in the U.S., accounting for an estimated 78.0% of all COvid-19 samples. But the XBB.1.16 has already overtaken all the other XBB’s to reach second place in the U.S. and seems to have XBB.1.5 in its sights, metaphorically, of course, since we don’t want to imply that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has eyes.
So it does look like the XBB.1.16 has a “growth advantage” over other existing SARS-CoV-2 variants and subvariant. A growth advantage may sound like a good thing when you are using the term to describe yourself or certain parts of yourself. But it’s a much more ominous term when being used to describe a still dangerous pathogen like the SARS-CoV-2. In this case, it’s when a given variant or subvariant has characteristics that makes it better able to spread than others.
During a March 29 press conference, Maria Van Kerkhove, PhD, the WHO’s Technical Lead on Covid-19, did indicate that the XBB.1.16 is “actually very similar in profile to XBB.1.5. It has one additional mutational mutation in the spike protein which in lab studies shows increase infectivity, as well as potential increased pathogenicity.” These aren’t positive terms. If a date describes you as having “increased pathogenicity,” you are unlikely to have a second date with him or her because it means increased disease-causing capabilities. Increased infectivity means that the XBB.1.16 may be more likely to infect you than other variants and subvariants. Potential increased pathogenicity suggests that the XBB.1.16 could potentially, maybe, perhaps, possibly cause more severe Covid-19 than other existing variants and subvariants. But the jury is still out on this latter issue. Van Kerkhove added, “This is one to watch. It has been in circulation for a few months.”
This is why the WHO has categorized the XBB.1.16 as a VUM three months after it was first detected on January 23. This is not an “everyone has VUM “situation as there are only six other variants and subvariants currently on the WHO VUM list. The WHO’s formal working definition of a VUM is one “with genetic changes that are suspected to affect virus characteristics and early signals of growth advantage relative to other circulating variants (e.g. growth advantage which can occur globally or in only one WHO region), but for which evidence of phenotypic or epidemiological impact remains unclear, requiring enhanced monitoring and reassessment pending new evidence.” It would become a VOI if it’s already demonstrated a clear “growth advantage over other circulating variants in more than one WHO region with increasing relative prevalence alongside increasing number of cases over time, or other apparent epidemiological impacts to suggest an emerging risk to global public health.” XBB.1.5 is the only WHO VOI right now. A subvariant would become a VOC if it either showed that it causes more severe disease, significantly affects the ability of health systems to provide care to patients, or is able to evade protection against severe Covid-19 from vaccination. The WHO VOC list is currently like the list of A-list celebrities wearing leg warmers, empty.
That doesn’t mean that the XBB.1.16 shouldn’t raise any concern. The XBB.1.16 has already appeared in at least 29 countries, according to the WHO. As mentioned earlier, it’s been making its mark on India. The April 14 Business Today article indicated that India had reported “11,109 cases in the last 24 hours, as per the health ministry data on Friday.” It also mentioned that India has 49,622 active Covid-19 cases and a fatality rate of 1.19%. This was the fifth consecutive day that India had reported a rise in Covid-19 cases.
Could the XBB.1.16 fuel surges in other countries like Singapore, the U.K., Australia, and the U.S. Well, Mike Honey, who is the Technical Lead for Manga Solutions based in Melbourne, Australia, provided on Twitter this animated map showing the spread of the “Acturus” variant around the world:
Now, Honey used the name “Arcturus.” But, remember, that name ain’t official, just like “Kraken” and “Orthus” names of earlier emerging subvariants weren’t official either. It’s just that the continued use of letter and number combos that sound more like Star Wars droids has made it more difficult for the general public to keep track of these different Omicron subvariants. That’s prompted folks on social media to create and use their own unofficial nicknames, to grin and bear it in a way. “Arcturus” is actually a Latinized version of the ancient Greek name Arktouros, which means “Guardian of the Bear,” because who wouldn’t want a bear to be guarded, right?
Speaking of bear, has this new subvariant brought to bear another Covid-19 surge in the U.S. yet? Well, it may be that one can “bearly” tell these days because so many folks seem to have abandoned getting officially tested for Covid-19. When people are home testing and not telling others their results or not getting tested at all, the reported Covid-19 cases probably don’t really reflect what’s really going on with the pandemic. The CDC numbers still show a downward trend in cases since mid-January with 101,437 reported Covid-19 cases for the week ending April 12. But as they say, who the bleep knows. Plus, reported cases always lag what’s happening right now since it takes time for people to get tested and public health officials to learn of these cases.
All of this is a reminder that although many political leaders seem to want to shove Covid-19 under the metaphorical rug and act as if it’s not a problem anymore, the virus certainly hasn’t agreed to simply go away. It is still important to keep track of what variants and subvariants continue to emerge and what problems they may bring.
There have been anecdotes of more people reporting conjunctivitis symptoms with XBB.1.16 infections. Conjunctivitis, which is popularly (or maybe unpopularly) known as pink eye, is when your conjunctiva gets inflamed and swollen. The conjunctiva is the thin layer of tissue that covers the white part of your eye and the inside of your eyelids. Tatiana Prowell, MD, an Associate Professor of Oncology at Johns Hopkins School of Medicine, warned on Twitter that the red, itchy, or sticky eye symptoms associated with such a viral conjunctivitis could be mistaken for allergies:
Keep in mind, though, that anecdotes are not the same as official data and well-constructed medical studies. So, it’s not clear yet how common conjunctivitis may be for those who get infected with the XBB.1.16 and what other symptoms and problems may emerge. In other words, it’s not clear yet what “Arcturus” may actually bring to bear, so to speak. What’s clear, though, is that this new subvariant does indeed bear close watching.
Over-the-Counter Help
Most people who get COVID will be just fine at home. “If you’re vaccinated and boosted and generally healthy, people do very well,” McBride says. Over-the-counter medications will not treat COVID directly but can help manage symptoms. Doctors recommend acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil or Motrin) to bring down fevers and relieve achiness. Early in the pandemic, there were reports that ibuprofen made COVID worse, but those have not been substantiated. NSAIDs are only intended to be taken for short periods, however, because they have more side effects than acetaminophen, and they are not safe for everyone. People who take other medications should consult with a doctor before taking NSAIDs. Antihistamines or cold medications such as DayQuil can be used to relieve congestion and cough.Using Prescription Drugs
One of the most significant recent changes in the COVID landscape is the wider availability of authorized outpatient treatments. The antiviral drug Paxlovid reduced risk of hospitalization and death by 89 percent in a clinical trial, and it is a pill, which makes it relatively easy to take. The drug cannot be taken with many common medications such as statins or blood thinners, however. Paxlovid is available by prescription or at Test to Treat sites nationwide for people who are eligible.Omicron variant XBB found to be resistant to monoclonal antibody treatments
XBB.1.5 is slightly different from its relatives, because it not only evades protective antibodies, it also is better at binding to cells. That means healthy adults are more likely to be infected with it even after vaccination or an infection with a different variant.
But other parts of the immune system can still come to our defense, Dr. Otto Yang, an infectious disease physician and immunology researcher at David Geffen School of Medicine at the University of California, Los Angeles, told The New York Times.
Even if mutations in some parts of the virus prevent antibodies from blocking an infection, T cells should be able to recognize the main part of the virus spike protein, Dr. Yang said. And because T cells remember how to respond to the coronavirus based on what they’ve learned from previous encounters or vaccines, they can mount an attack quickly if you do become infected. “They are what prevent severe illness,” Dr. Yang said. “People who are up to date on their vaccines and who get treatment early with Paxlovid or with remdesivir are going to do fine, for the most part.” (Paxlovid is an oral antiviral medication, and remdesivir is an injectable one.)
Immune evasion and infection are a bigger concern for people who are immunocompromised or who do not mount a strong immune response to vaccines. That includes people who have had stem cell or solid organ transplants, people receiving cancer treatments, people with autoimmune diseases and people who need immunosuppressive medication for various medical conditions, said Dr. Alpana Waghmare, an infectious disease expert at Fred Hutchinson Cancer Center.
The antibody treatments that many immunocompromised people have relied on, like the preventive shot Evusheld and the intravenous Covid treatment bebtelovimab, are not effective against XBB.1.5 and other new subvariants. As a result, immunocompromised people may have more severe disease, but other antiviral treatments will most likely keep deaths from increasing in this group.
Other At-Home Treatments
Emergency warning signs
Individuals are reminded to seek immediate medical attention (go to a hospital’s emergency department) if they develop emergency warning signs of COVID-19 such as:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- Bluish lips or face
- New confusion or inability to arouse
- Pulse oximeter reading below 95 percent (oxygen level)
Key Takeaway
- Always see or talk to your doctor before taking any drugs, supplements and over the counter products.
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