Global COVID markers show few hot spots as XBB.1.16 overtakes XBB.1.5

Woman taking rapid test

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Some countries continue to report high COVID-19 burdens, reflected mainly in hospitalization and death data, the World Health Organization (WHO) said in its latest weekly update.

As countries decrease testing and timely reporting, however, cases don't accurately show infection rates, and like other health groups, the WHO said it is leaning more on hospitalization and deaths to track global trends.

Hospitalizations rise in a few countries

Of 24 countries that consistently report hospitalization data, three reported a rises of more than 20% over the last 28 days. They include Afghanistan, Bangladesh, and Malta. Looking at hospitalizations by WHO region, the Eastern Mediterranean is the only one to report a rise in hospitalizations over the last month. The WHO included a caveat that hospitalization data likely reflects both incidental COVID-19 cases and admissions specifically for the virus.

Of 18 countries that regularly report new intensive care unit (ICU) admissions, two countries reported rises of 20% or more: Lithuania and Mexico. By WHO region, the Americas is the only one that reported a rise in ICU admissions over the past 4 weeks.

At the global level, all world regions except Africa reported a decrease in deaths. Over the past month, Africa reported a 20% rise in deaths, with the highest number reported from Zambia. Over the same period, a few other countries in other regions reported fatality rises, including Lebanon and Thailand.

XBB.1.16 overtakes XBB.1.5 globally

In its update on variant activity, the WHO said the proportion of the Omicron XBB.1.5 subvariant continues to decline steadily, dropping from 32.1% to 19.8% over the past month. In a risk assessment update last week for XBB.1.5, the WHO said the virus doesn't pose an additional public health risk compared to other subvariants.

Meanwhile, the XBB.1.16 subvariant for the first time topped the XBB.1.5 proportion, now accounting for 20.5% of sequences globally. The WHO notes that countries that have low prevalence of XBB.1.5 are now seeing significant rises in XBB.1.16 prevalence, while countries that had high XBB.1.5 activity are experiencing low circulation of XBB.1.16.

The only other subvariants showing rising prevalence are XBB, XBB.1.9.2, and XBB.2.3.

Rising cases in Japan, high long-COVID rates in Europe

In other global developments, Japan's former top COVID adviser Shigeru Omi, MD, said this week that the country may have entered its ninth wave, with cases up slightly and differences among prefectures, the Tokyo-based newspaper Asahi Shimbun reported.

Elsewhere, the head of the WHO's European regional office in comments this week said though COVID isn't the looming threat it once was, it continues to have big impacts on the most vulnerable, and long COVID remains a complex condition that has affected as many as 36 million people in the region over the past 3 years.

Long COVID remains a glaring blind spot in our knowledge.

Hans Henri Kluge, MD, MPH, said nearly 1,000 deaths are reported across the region every week, which he said is probably an underestimate due to reduced reporting.

He said the long-COVID estimate comes from Seattle's Institute for Health Metrics and Evaluation.

"We are listening to the calls from long COVID patients and support groups, and raising awareness of their plight, but clearly much more needs to be done to understand it," Kluge said. "Long COVID remains a glaring blind spot in our knowledge, that urgently needs to be filled."

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