Will the JN.1 variant trigger a new wave of COVID-19 infections in China?

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Will the JN.1 variant trigger a new wave of COVID-19 infections in China?

Will the JN.1 variant trigger a new wave of COVID-19 infections in China?

China Health Commission Advises Vaccination and Mask-Wearing due to JN.1 of COVID-19 Emerges.

Individuals who have not received a COVID-19 booster shot face a higher risk of severe illness?

In recent weeks, a resurgence of COVID-19 infections has been observed globally, with monitoring data from various countries indicating a correlation between the current wave of infections and the prevalence of the Omicron variant, specifically the JN.1 subvariant.

Since November, the proportion of JN.1 variant among global circulating strains has rapidly increased from 4% in early November to around 30% by early December. As of December 10, at least 40 countries or regions have reported the presence of the JN.1 variant.

The National Health Commission of China released a statement on the evening of December 15, revealing that since the first identification of the local JN.1 variant in November, a total of seven cases have been detected in China by December 10. Considering the impact of international variants and imported cases, the possibility of JN.1 becoming the predominant strain domestically is not ruled out.

Will the JN.1 variant trigger a new wave of COVID-19 infections in China?

Fastest-growing variant in recent weeks

From a global distribution perspective, Europe has the highest proportion of the JN.1 variant. By mid-November, exponential growth of JN.1 variant infections was reported in several countries, including Ireland, Iceland, Portugal, Spain, and France. In Denmark, this variant had already covered 50% of the population.

In the United States, JN.1 has become the fastest-growing variant of the virus. According to the Centers for Disease Control and Prevention (CDC), as of December 9, JN.1 accounted for approximately 15.1%-29.4% of all new COVID-19 cases in the U.S., a significant increase from 8.8% at the end of November and less than 0.1% at the end of October.

JN.1 is the second-generation subvariant of the Omicron variant BA.2.86 and is a branch with strong transmission advantages within the BA.2.86 lineage. Due to its rapid increase in global prevalence, the World Health Organization (WHO) upgraded BA.2.86 from a “variant under monitoring” (VUM) to a “variant of interest” (VOI) on November 21.

Why is JN.1 spreading so rapidly? According to the UK Health Security Agency, BA.2.86 has over 20 mutations that could alter antigenic properties and enhance immune escape capabilities. Additionally, JN.1 has a crucial spike protein mutation, theoretically making it more adept at binding to human cells. Coupled with its increased immune evasion, the public is more susceptible to infection.

While it spreads rapidly, there is no evidence to suggest that JN.1 leads to more severe cases. The CDC in the U.S. stated that there is currently no indication of increased severity of illness following infection with the JN.1 variant. Chinese monitoring data also show that individuals infected with the JN.1 variant exhibit mild or asymptomatic symptoms. According to WHO assessments, the clinical severity risk of BA.2.86 variants, including JN.1, is low.

Will infection with JN.1 result in different symptoms compared to other COVID-19 variants? Dr. Jill Foster, Director of Pediatric Infectious Diseases at the University of Minnesota Medical School, suggests that JN.1 and other new variants may cause more gastrointestinal symptoms such as abdominal pain or diarrhea. However, this information has not been confirmed by the CDC.

The CDC emphasizes that, in general, symptoms of infection with different variants are often similar. “The type and severity of symptoms usually depend more on a person’s immune response and overall health than on the variant causing the infection.”

Hospitalization peaks may resurface

Based on current evidence, the public health risk of the JN.1 variant is relatively low. However, data indicate a recent surge in respiratory diseases, including COVID-19 and influenza, placing strain on healthcare systems worldwide.

According to reports from The Straits Times, Singapore recorded 56,043 new COVID-19 cases last week, a nearly 75% increase from the previous week. Hospitalizations rose from an average of 225 per day to 350 per day, with the number of patients in intensive care units increasing from an average of 4 to 9. The Singapore Ministry of Health and public hospitals are collaborating to implement measures, including deploying additional personnel and postponing non-urgent treatments, to free up beds for critically ill patients.

In the United States, hospitalizations due to COVID-19 are also rapidly increasing. The CDC issued a warning on Thursday that the growth of the JN.1 variant will once again strain the U.S. healthcare system.

Although the rapid spread of JN.1 has not yet led to an increase in the severity of COVID-19 cases in the U.S., experts remain concerned about the future.

Dr. Jill Foster, the aforementioned Director of Pediatric Infectious Diseases, told Health magazine that the difference between this year and last is that people have not taken any risk mitigation measures. A Yahoo News poll shows that only 12% of Americans claim to wear masks in public places most of the time.

Dr. Foster predicts that with the rapid spread of JN.1 and the upcoming holiday season, this winter could witness a “perfect storm” in crowded places. “Wearing masks in crowded places or where there are a lot of strangers is the most important thing people can do right now,” she advises, also suggesting that during the holidays, all sick individuals should stay at home.

Poor vaccination coverage

Similar to preventing infection with other Omicron variants, vaccination remains one of the preventive measures against the JN.1 variant. WHO reports indicate that COVID-19 vaccines containing the XBB.1.5 component remain effective against the JN.1 variant.

The Singapore Ministry of Health, in a statement on the 15th, strongly recommends vaccination and timely booster shots based on data from July 1 to November 30.

In the past year, the number of hospitalized and critically ill patients in the group that did not receive booster shots was 1.6 times higher than those who did. Individuals who have not received booster shots face a higher risk of severe illness.

Will the JN.1 variant trigger a new wave of COVID-19 infections in China?

In light of this, Singapore health authorities strongly urge individuals aged 60 and above who have not received booster shots in the past year, residents of nursing homes, and high-risk groups with chronic illnesses to get the latest vaccines. They also advocate for additional doses for all individuals aged six months and above, especially for healthcare workers and the family members and caregivers of high-risk individuals, and strongly recommend wearing masks indoors or in crowded places.

According to a report by CBS News, the CDC continues to urge U.S. residents to get vaccinated as soon as possible, especially vulnerable populations such as the elderly, to prepare for the upcoming peak of mixed infections involving three respiratory viruses—flu, COVID-19, and RSV.

The report mentioned that vaccination rates in the U.S. have seen an unprecedented decline this quarter. In nursing homes, only one-third of residents and less than one-tenth of staff have received the updated COVID-19 vaccine.

China’s National Health Commission, in its statement last night, also advised the public to wear masks scientifically and get vaccinated in a timely manner. When the population attains broad immunity to Omicron variants (through vaccination and natural infection), the transmission capability of the JN.1 variant may be relatively limited.

As of now, China has approved six COVID-19 vaccines related to the XBB antigen, including three recombinant subunit vaccines (injections), two mRNA vaccines (injections), and one adenovirus type 5 recombinant vaccine (inhalation).