Overall COVID-19 cases declined again last week, down 6% compared to the week before, but some Western Asian nations such as Singapore are experiencing a steady surge in cases, the World Health Organization (WHO) said today in its latest update on the pandemic.
Though cases as a whole are slowly declining, European health officials have been tracking rises in a number of European countries, and now some nations in Asia, including Singapore, are reporting spikes in cases. Health officials have said they expect cases to rise as people in the Northern Hemisphere gather indoors during the cooler months, but the emergence of several more Omicron subvariants adds uncertainty about how the patterns will take shape in the months ahead.
WHO closely watching XBB Omicron subvariant
Of about 2.9 million new cases reported to the WHO last week, the five countries that reported the most were Germany, France, China, Italy, and the United States.
At a WHO media briefing today, Director-General Tedros Adhanom Ghebreyesus, PhD, said the WHO's COVID-19 emergency committee met last week to discuss the latest developments. He said they recommend keeping the public health emergency of international concern (PEHIC) in place, urging countries to strengthen surveillance, testing, treatment, and vaccination, especially for high-risk groups.
"While the global situation has obviously improved since the pandemic began, the virus continues to change, and there remain many risks and uncertainties," Tedros said. "This pandemic has surprised us before and very well could again."
Five of the WHO's six regions reported declining cases last week, but cases rose 11% in the Western Pacific region, with Singapore, Vietnam, and Brunei Darussalam reporting the largest proportional increases.
Deaths dropped 17% last week compared to the week before, with about 8,300 fatalities reported to the WHO. Deaths decreased or remained stable in five WHO regions, but were up sharply in the African region, with the highest numbers reported from South Africa, Reunion, and Zimbabwe.
Omicron viruses that descend from the BA.5 lineage are still dominant, making up 78.9% of sequences, followed by BA.4 (6.7%) and BA.2 (3.9%) lineages.
The WHO said its monitoring of emerging subvariants suggests that XBB—a recombinant of BA.2.10.1 and BA.2.75 with 14 more mutations in the BA.2 spike protein—has the most immune escape properties of any SARS-CoV-2 variant. So far, XBB has been reported by 26 countries. Though the subvariant seems to have a higher growth rate, there's no evidence of any change in disease severity.
Last week, Singapore's health ministry said its rise in cases over the past month is mainly due to the Omicron XBB subvariant. It noted that XBB was first detected in August in India and that there is evidence that XBB may be driving an increase in reinfections, which currently make up 17% of the country's new cases. Officials said severe case numbers remain low and that they expect the XBB wave to peak by around the middle of November.
In other global developments, the European Medicines Agency (EMA) recommended approval of mRNA vaccines targeting the original SARS-CoV-2 strain for the youngest children. The Pfizer-BioNTech vaccine is recommended for ages 6 months to 4 years and the Moderna vaccine is recommended for those ages 6 months to 5 years.
The EMA also recommended approval of a second bivalent booster from Moderna, the one that targets the Omicron BA.5 and BA.4 subvariants. The group had earlier recommended approval of a bivalent booster geared toward the BA.1 Omicron subvariant. It added that the European Union's strategy is to have a broad range of adapted vaccines that target different SARS-CoV-2 variants so that countries have different options to meet their vaccine campaign needs.
Moderna releases booster data, Novavax poised for booster use
In US developments, Moderna today released new clinical data suggesting that its bivalent booster that targets the original virus plus the Omicron BA.1 subvariant prompts a durable immune response, as compared to its original vaccine, after 3 months of follow up.
In another vaccine development, Novavax today announced that the Food and Drug Administration (FDA) has granted emergency use authorization (EUA) for its protein-based adjuvanted COVID-19 vaccine. The EUA is for the vaccine to be used as a booster dose for adults at least 6 months after completing a primary vaccine series with any other authorized or approved COVID-19 vaccine when an FDA-authorized mRNA bivalent booster isn't available or clinically appropriate.
Use of the Novavax vaccine as a booster awaits a policy recommendation from the Centers for Disease Control and Prevention (CDC).
Also, the CDC's Advisory Committee on Immunization Practices (ACIP) is meeting today and is expected to vote on whether to add COVID-19 vaccines to the child and adolescent immunization schedule, which would make them available to the Vaccines for Children (VFC) program. Implemented in 1994, the VFC program provides free vaccines to children who don't have health insurance or can't afford the cost.