COVID-19 variant FLiRT may be more contagious, but less likely to cause severe illnessExBulletin

Ailsa Chan, host:

We all want to ignore COVID, but the emergence of a new variant that scientists call FLiRT (lowercase I) is a reminder that COVID is still with us. The good news is that as of last Friday, the CDC said the number of respiratory illnesses in the U.S. is low. The not-so-good news is that COVID outbreaks often happen in the summer in the U.S. because of travel and gathering in air-conditioned places. So now I'm here with Dr. Ashish Jha. He's the dean of the Brown University School of Public Health and a former White House COVID-19 Response Coordinator. Welcome to the show.

Ashish Jha: Thank you for having me again.

CHANG: Well, thanks so much for joining us. So how concerned are scientists about whether these FLiRT variants might be more transmissible or increase the severity of the disease compared to previous variants?

JHA: Yes. That's exactly what we're seeing happening. The virus continues to evolve. It continues to evolve to try to escape the barrier of immunity that we've built up through vaccines and infection. This is just the latest incarnation of that. The key question is the one you asked: Is it more transmissible? Yes. That's why it's become more prevalent.

But the really important question is: does this variant make people more seriously ill than previous variants? All of the evidence we have right now suggests that it doesn't. So if you're one of the vast majority of Americans who's been vaccinated and/or been infected before, everything we know about this latest variant is that it's likely to cause a mild infection and not particularly severe disease. Of course, we have to continue to monitor any new variants, but this is pretty much expected.

CHANG: Okay. That's pretty reassuring, but do you foresee some kind of surge coming down the road and into the summer? And if so, what advice do you have for people who, even if they do get infected, don't want COVID-19 to ruin their summer plans?

JH: That's right.

CHANG: …A mild infection?

JHA: Right. So, I have a couple of thoughts. First, we've had a summer wave every summer since this pandemic started. So, I expect we'll probably have a summer wave. Some of the waves will be small, some will be bigger. And the reasons are exactly as you actually listed. You know, we get so hot in the summer, especially in the South, so we spend a lot more time indoors.

And when you think about who is at risk for complications from these infections, it's older Americans. It's Americans who are immunocompromised. For them, the two big things are, number one, keep your vaccines up to date. That way you stay out of the hospital. Number two, if you do get infected, there's a treatment that's widely available. That's really important. My elderly parents had COVID recently. I made sure they got treatment. They were fine. Of course, if you're worried about getting infected, avoid crowded indoor places. You can also wear a mask. Those are still effective. My sense is that most Americans aren't necessarily interested in those. Unless you're in a high-risk group, or even if you are, I think it's generally fine as long as you keep your vaccines up to date.

Chang: So, Dr. Jha, let me ask you a question. You've been on our show a number of times. Have you ever…

JH: That's right.

Chang: …What? It took us four and a half years to observe this virus…

JH: That's right.

CHANG: …The spreads continue to change. I'm just wondering, at this point, what are the key patterns that you've seen over this time?

JHA: So, I have a couple of questions. First, we typically experience two waves a year, one in the summer and one in the winter. The winter waves tend to be worse. All of this is due to the virus continuing to evolve. We still have a lot of people ending up in the hospital, getting very sick from this virus. They are very frail people, elderly people, immunocompromised people. It's these people that I'm worried about. How do we keep them safe?

Another thing to think about is that there is always the possibility that this virus could evolve significantly in some way and cause more chaos and disease. We have to continue to monitor and be vigilant. I don't think that will happen, but we need to be prepared if it does.

CHANG: But in the long term, do you think we're going to end up treating COVID the same way we treat other seasonal respiratory diseases? Like, we're going to have new vaccines every fall in preparation for the expected seasonal surge, and we're going to be accepting of this all the time.

JHA: Yeah. The way I've thought about this is, I go get a flu shot every year. There's a new prescription. I'll probably continue to do that for COVID as well. So I'm going to get the flu shot and the COVID shot. And then at some point, as I get older, I'll probably have to get an RSV shot every year as well. It's inconvenient. It might be a little bit of a pain. But at the end of the day, these are life-saving things, and people should do it. For most people, this is once a year. I think this is how we're going to manage COVID in the long run.

Again, of course, there is a chance that something untoward will happen, but assuming that doesn't happen, this will be one of many respiratory pathogens that can be managed with a vaccine or treatment, and if we do that well, we can keep people healthy and live their lives out of the hospital.

Chang: Dr. Ashish Jha from Brown University. Thank you as always.

JHA: Thank you for being here.

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