New COVID-19 Variant, "Pirola," Raises Concerns Amidst Ongoing Crises

Amidst a news cycle that now routinely features wildfires, former president indictments, and extreme weather events, the world is grappling with the resurgence of COVID-19 as a new and concerning variant, BA.2.86, emerges. This variant, informally dubbed "Pirola," has ignited alarm among public health experts due to its substantial spike protein mutations.

Dr. Scott Roberts, an infectious diseases specialist at Yale Medicine, warned that Pirola exhibits over 30 spike protein mutations compared to the previously dominant XBB.1.5 variant in the United States. The spike protein is critical for the virus's entry into human cells, and such a high number of mutations raises red flags. In an online Yale Medicine article, Dr. Roberts compared the mutation count to the shift from the Delta to the Omicron variant in 2021, which caused a significant surge in cases due to its immune evasion capabilities.

What's particularly concerning is that Pirola has been detected in at least six countries, and these cases appear unrelated. Experts said that suggests undetected community transmission and international spread, sparking concerns of a potential resurgence.

According to medical experts, BA.2.86 is a designated variant of Omicron, a variant of the SARS-CoV-2 virus responsible for COVID-19. BA.2.86 stems from BA.2, a previously circulating Omicron subvariant. The variant was first identified in Denmark in late July and made its way to the United States in August. Knowing that cases aren't linked indicates broader circulation, significantly as COVID-19 surveillance has waned, medical experts asserted.

The Centers for Disease Control and Prevention (CDC) reported that current COVID-19 tests and medications, such as Paxlovid, Veklury, and Lagevrio, seem effective against Pirola. However, Pirola may be more adept at infecting individuals who have had COVID-19 or have been vaccinated. There isn't any current evidence that it causes more severe illness.

The increase in COVID-19 hospitalizations in the U.S. is attributed to XBB lineage viruses rather than Pirola. The multitude of mutations in Pirola raises concerns about its potential to bypass immunity from natural infection or vaccination.

Dr. Roberts emphasized that ongoing studies would reveal the true nature of Pirola's threat. The unprecedented number of mutations in Pirola is reminiscent of significant shifts seen in other respiratory viruses, such as the 2009 swine flu. However, he noted that these variants sometimes fade away without causing a significant impact.

The critical question now is whether Pirola will follow the explosive growth pattern of Omicron or fade away, as everyone hopes. As of August 30, the CDC has identified Pirola in at least four U.S. states through samples from individuals or wastewater.

Some regions have reinstated mask mandates in response to the spike in COVID-19 cases. Upstate Medical University in Syracuse, New York, is among the institutions requiring masks in clinical areas to protect patients and staff. The CDC reports a nearly 19% increase in weekly new COVID-19 hospitalizations in the U.S., marking the sixth consecutive week of rising admissions.

The arrival of new COVID-19 vaccines from Pfizer, Moderna, and Novavax in mid-September is expected to offer robust protection against variants. Until then, experts stress that masking remains a crucial tool for safeguarding against COVID-19, even for individuals with normal risk levels, depending on their location and contacts.

Dr. Stephen Thomas of the Upstate Medical University in Syracuse told NPR that the facility has reverted to mandating masks.

"We wanted to, No. 1, protect our patients, and, No. 2, protect the men and women who work in our facility, and take care of them," Thomas told NPR. "So, we implemented universal masking for staff, visitors, and patients only in clinical areas. So, we're a university. We're large. We have a lot of non-clinical regions. Universal masking is not being mandated in non-clinical areas."