Sign up for TPR Today, Texas Public Radio's newsletter that brings our top stories to your inbox each morning.
The COVID-19 virus is still out there, moving through populations and evolving. One of the more recent evolutions is called NB.1.8.1 — nicknamed Nimbus — and it is a descendant of recombined Omicron variants.
The COVID landscape has been dominated by Omicron subvariants for years.
Nimbus is descended from Omicron subvariant XDV, which itself is a recombination of two previous Omicron subvariants. Recombination occurs when a cell is infected by two strains of a virus, and they exchange genetic material and become a distinct third strain.
According to the CDC, Nimbus is currently responsible for 37% of COVID infections in the U.S., though the federal health agency acknowledges that its numbers are no longer precise.
Sharply reduced funding for sequencing means they aren't getting many samples to analyze. UT Health San Antonio Infectious Diseases Specialist Dr. Jason Bowling says that means tracking is "less sensitive than it was in the past when we had more information."
Still, it's clear that Nimbus is rapidly becoming the most common of the COVID variants, and Bowling said it has a calling card.
"One of the nicknames that has been floated out there for this variant is 'razor blade sore throat,' because the sore throat is so prominent," Bowling said.
Other potential symptoms of a Nimbus infection are recognizable as typical COVID symptoms, Bowling said.
"It can go anywhere from just very mild symptoms like allergies, where they just have a stuffy nose, to people that have more of the flu-type symptoms," he explained.
Some people have a more gastrointestinal version of COVID, with nausea and diarrhea, and a handful will still get very sick with COVID, Bowling said. Respiratory failure from COVID can still occur. People can and do still die.
"That number is lower now than it was earlier in the pandemic," Bowling stressed, "But it's still a risk for some people, and just because someone had a mild infection before doesn't mean that they potentially couldn't get sicker with a reinfection."
Every COVID infection also comes with the risk of developing long COVID.
A summer COVID wave is possible, Bowling said, because it's been a while for most people since they've had a COVID booster or an infection. The current vaccine is not formulated for the Nimbus subvariant, but since Nimbus is also part of the Omicron lineage, it could still offer some protection against serious illness and death. However, vaccine guidance from the CDC is unclear.
"The COVID vaccine landscape has been confusing, and then more recently, there's been an overhaul on the Advisory Committee for Immunization Practices," Bowling said.
What does he, an infectious diseases specialist, advise about who should get a COVID vaccine right now?
"My advice is that it's very helpful to have a primary care doctor who knows your medical history, because there are some really important conversations that you can have there," Bowling said. Beyond that, "Everybody needs to do a self-calculation of their risk for severe disease."
"65 and older, if you have chronic medical conditions, I would say that would be worrisome. And then you need to look at when the last time was that you got a COVID vaccine," Bowling continued, adding that if you and your doctor agree that you should get a booster, you should get a booster.
Others can wait until a new vaccine formulation comes out in the fall.
Watching the ACIP meeting
Bowling expects the overhauled, eight-member Advisory Committee on Vaccination Practices (ACIP) to vote on the variants to be targeted in the vaccine this week. No vote on the COVID vaccine is on the agenda, but Bowling says it is time sensitive.
"My concern would be that if we make delays in decisions or discussions that need to happen, as far as picking a strain for the COVID vaccine, I don't want it to be suppressed by inactivity," he said.
He will also be watching for clear guidance on who the board thinks should get COVID-19 vaccines and when.
"That potentially can impact insurance reimbursement and access. So we need to know that," he added.
