The omicron variant of COVID-19 is still evolving, and new omicron subvariants have a better ability to evade coronavirus drugs or immunity acquired through past infection or vaccination.

The list of variants that may be a cause for concern is only growing. Subvariant BQ.1.1, an offspring of the BA.5, may be able to evade all defense tools we have against COVID-19, leading to more hospitalizations and more cases of long COVID and death.

What is BQ.1.1?

Subvariants BA.5 and BA.4.6 previously made up most of the reported cases in the U.S., but this is changing as BQ.1.1 and BQ.1 combined are behind nearly 35% of cases as of Friday.

“We’ve dealt with this before, with influenza, for example,” Dr. Albert Ko, a physician and epidemiologist at the Yale School of Public Health, told The New York Times. “Viruses and pathogens are constantly trying to adapt and escape the immune pressure that we pose to them.”

Experts are more concerned with how many deaths a variant causes rather than the number of new mild illnesses.

“If we see that deaths are reduced and if serious illness and hospitalizations are reduced, even if people do get infected, that’s still a big success,” said Michael Osterholm, an epidemiologist and the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, per the Times.

But this also means that the immunocompromised may have fewer tools at their disposal to fight the infection as current treatments may not work well against a highly mutated virus.

How do mutations work?

Many of the omicron lineages have similar mutations and this “pattern suggests that those mutations confer an evolutionary advantage, one that would allow the virus to continue to spread among people who have different layers of protection, from vaccination and infections from earlier omicron lineages,” as Andrew Joseph wrote for health news site Stat.

Andy Pekosz, a microbiology professor at Johns Hopkins Bloomberg School of Public Health, told Global News that the BQ.1.1, which was discovered a few weeks ago, has “the most ability to escape vaccine-induced immunity, as well as some antibody treatments,” at least on paper.

“So that’s one of the reasons why we’re focusing in on this one and trying to keep track of what it’s doing and where it is.”

How can you protect yourself?

Yes, the virus will constantly mutate, but overall, countries are better equipped to deal with COVID-19 after using various measures to prevent infections.

“I know there’s no mandates around these days, but you can lower your individual risk of getting COVID by putting on a mask in an indoor setting where we know the vast majority of COVID is transmitted,” said Dr. Isaac Bogoch, an infectious diseases specialist with the University Health Network in Toronto, per Global News.

Vaccines, testing and anti-viral treatments still work against the BA.5. As Hanna Seariac reported, the Commonwealth Fund estimates that “if 80% of eligible people get their COVID-19 booster by Dec. 31, then nearly 90,000 lives could be saved.”

What are the top omicron symptoms to look out for?

As I previously reported, omicron subvariants have a shorter incubation period, which is why the symptoms may appear earlier. The worst symptom is a “throat on fire,” said UCSF’s Dr. Peter Chin-Hong.

The most common omicron-related symptoms are:

  • Cough.
  • Fatigue.
  • Congestion.
  • Runny nose.