Here’s what to know about XBB, the new top COVID variant in the Northeast

COVID-19 will continue until 2023, as a new strain of KSBB was recently discovered to be the dominant strain across New England, according to the Centers for Disease Control and Prevention.

The Omicron subvariant of KSBB accounted for about 52.6% of all cases in New England between Dec. 18 and Dec. 24, according to the CDC. KSBB accounts for 18.3% of cases nationwide.

Here’s a cross-section of what is currently known and what remains to be explored about KSBB.

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How portable is KSBB?

Health experts have cited the spread of KSBB as a sign of increased transmission rates.

Colorado School of Medicine immunologist and vaccine specialist Ross Kedle told UCHealth that KSBB and other new variants are “hot on the heels of measles, and that’s a pretty remarkable level of transmission.”

Dr. Jeremy Luban, a professor of molecular medicine, biochemistry and molecular biotechnology at the UMass Chan School of Medicine, echoed this point to The Boston Globe. KSBB “looks like it’s just going to blow up the other (variants) in a very short period of time,” he said.

How hard is it to get the KSBB variant of COVID?

The World Health Organization’s Technical Advisory Group on the Evolution of the SARS-CoV-2 Virus released its initial findings with current variants of concern, including KSBB, in October. Early evidence indicated a higher risk of reinfection compared with other circulating Omicron subvariants.

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“Although further studies are needed, current data do not suggest that there are significant differences in disease severity for KSBB infections,” the advisory group said in a statement.

However, infection with COVID-19 remains most severe among those who are unvaccinated, immunocompromised, or both. Cassandra Pierre, director of Boston Medical Center’s public health program, told GBH that there is no data to suggest that KSBB can avoid paclovid and remdemsivir, among other antiviral drugs.

This is in contrast to monoclonal antibodies, according to the New England Journal of Medicine. KSBB carries “additional substitutions in the spike protein receptor binding domain, which is a major target for vaccines and therapeutic monoclonal antibodies for 2019 coronavirus disease,” the journal said, adding that the new variants reinforce “the need for novel therapeutic monoclonal antibodies for COVID-19.”

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How to stay protected

As with previous strains of COVID-19, protection begins with vaccination. Because KSBB is a subvariant of the Omicron strain, the New England Journal of Medicine suggested receiving a bivalent injection of Omicron to remain protected against KSBB and other Omicron subvariants such as BA.2.75.2 and BK.1.1

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But vaccines do not offer complete immunity from disease. White House Chief Medical Advisor Dr. Anthony Fauci told reporters in November that the booster, while the best security against KSBB, would take a hit from the new variant.

“Protection is reduced many times over with KSBB…,” Fauci told reporters. “It goes down even more with KSBB. It doesn’t fall off the map, but it goes down. So you might expect some protection, but not optimal protection.”

Fauci also reiterated that people should limit their indoor capacity during the holiday, get tested before attending any gathering and wear a mask.

Do I need to wear a mask?

Wearing a KN95 or N95 mask is still the best external protection against airborne viruses like COVID-19, according to the CDC.

How “new” is KSBB?

Scientists first identified KSBB in the United States on Sept. 15, Rajendram Rajnarayanan, associate dean for research at the New York Institute of Technology, told Fortune in October.

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Where was KSBB discovered?

KSBB has been found in 35 countries, including India, England, Australia, Bangladesh, Denmark, Singapore and Canada, according to Time on November 7. An updated number of countries has yet to be reported.

In the United States, KSBB accounts for more than half of the COVID-19 cases in New York, New Jersey, Connecticut, Rhode Island, Massachusetts, Vermont, New Hampshire and Maine, according to the CDC. In the states between Pennsylvania and Virginia, KSBB accounts for approximately 20% of cases.

Cases in the southeastern United States are close to 13%. Around the Great Lakes and east of the Mississippi River, including Alaska and Hawaii, KSBB accounts for between four and 9% of cases.

What does “KSBB” mean?

KSBB is a recombinant of two BA.2 strains derived from the Omicron variant, the CDC said. If the KSBB variant was completely unrelated to Omicron, it would have been given the appropriate Greek letter designation like the previous variants, such as Delta.

T. Rian Gregory, a professor of integrative biology at Canada’s University of Guelph, told Time that names with letters and numbers are crucial for scientists to know because they convey information about how COVID-19 evolved.


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