#17,130
The swap out of BA.5 for the tag-team of Omicron BQ.1/BQ.1.1 continues to gain momentum, with BA.5 slipping to 3rd place (24%), after several months of dominance. This week, the CDC has also added a new subvariant (BF.11) to their Nowcast list, giving us an even dozen active variants to monitor.
While there is some jostling for position in the list, only BQ.1 and BQ.1.1 are showing significant gains over last week's numbers (which have been revised).
While declining everywhere, BA.5 remains strongest in the Midwest and Pacific Northwest, while BQ.1 and BQ.1.1 are running strongest in the mid-Atlantic states (Region 2).
The CDC has also not reported detecting significant numbers of the XBB variant (see WHO: TAG-VE Statement on Omicron Sublineages BQ.1 and XBB) which has been making inroads mostly in Asia.
Given the limits of surveillance, testing, and genomic sequencing around the country, all of these numbers should be viewed as rough estimates which are subject to change and mostly useful for spotting trends.
So far, we've not seen any evidence that any of these new variants cause more severe illness than earlier Omicron strains, but many are not yet at a level that would send a strong signal.
We continue to see an erosion in our armamentarium of effective monoclonal antibody treatments, however, and the duration and degree of protection from current vaccines against these emerging variants remains to be seen.
Right now it appears that BQ.1 and BQ.1.1 are poised to be the dominant strains in the US this winter, but there are enough players in the wings to make it impossible to know what the COVID landscape will look like 90 days from now.
