The COVID-19 subvariant, dubbed XBB.1.16 by the World Health Organization, was first detected in the Indian subcontinent in late January. It has since been detected in 29 countries, though experts say it is likely circulating undetected in many others. So far, XBB.1.16 does not appear to have been detected in Canada.
“We don’t know yet how this variant is going to pan out,” said Dr. Don Vinh, a professor in the departments of medicine, medical microbiology and human genetics at McGill University, in a phone interview with CTVNews.ca on Wednesday.
“There have certainly been variants that have emerged and then fizzled out, like the Gamma variant in South America, and there are clearly more often variants that have emerged and caused problems, like Omicron. I think what we have to do is be vigilant.”
The WHO hasn’t yet classified XBB.1.16 – informally nicknamed ‘Arcturus’ – a variant of concern or interest, referring to it instead as a “variant under observation.”
Here is what we know about the Omicron subvariant so far.
WHAT IS THE ‘ARCTURUS’ COVID VARIANT?
According to the World Health Organization’s April 13 epidemiological update, detections of the subvariant had been reported 2,222 times in 29 countries as of April 11.
XBB.1.16 is the recombinant – or a product of the mixing together – of the BA.2.10.1 and BA.2.75 subvariants. It is similar in profile to another variant, XBB.1.5, except that it has one additional spike protein mutation, which lab studies have shown could increase infectivity and disease severity.
However, the WHO said it has no evidence the subvariant has actually caused more severe illness than previous variants. XBB.1.16 does appear to have a high growth rate, and it has driven a surge in cases and hospitalizations in India. So far, the WHO reports XBB.1.16 does not seem to have driven a rise in ICU admissions or deaths even in countries where it has driven up case counts.
“Most of the sequences are from India, and in India XBB.1.16 has replaced the other variants that are in circulation. So, this is one to watch. It has been in circulation for a few months,” said Maria Van Kerkhove, technical lead for COVID-19 response at the WHO, during a virtual media briefing on March 29.
WHAT ARE THE SYMPTOMS?
Although XBB.1.16’s genetic makeup suggests it could lead to more severe COVID-19 symptoms, the data scientists have on the variant so far suggests it hasn’t done so. People sick with SARS-CoV-2 and its variants – and subvariants – can experience a wide range of mild-to-severe symptoms.
These can include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, a new loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting and diarrhea.
“It’s likely that it’s going to be more of the same in the sense that we might see a rise in cases and we might see a corresponding rise in hospitalizations associated with it,” said Dr. Isaac Bogoch, clinical investigator at Toronto General Hospital Research Institute and associate professor at the University of Toronto, in a phone interview with CTVNews.ca on Wednesday.
“It’s extremely unlikely that it’s going to cause the same degree of pressure on our health-care system as we once saw earlier on in the pandemic.”
IS THIS SOMETHING CANADIANS SHOULD BE CONCERNED ABOUT?
Neither Vinh nor Bogoch is aware of evidence that XBB.1.16 is circulating in Canada, however, both said that doesn’t mean it isn’t here or won’t be detected here eventually.
And although it hasn’t been shown to lead to severe symptoms in most people, Bogoch said even a variant that leads to mild illness can seriously impact provincial health-care systems, as Canada saw during the Omicron – or BA.1 – wave in late 2021 and early 2022.
“That initial wave was extremely challenging. It put considerable pressure on our health-care system because so many people were sick in such a short period of time,” Bogoch told CTVNews.ca in a phone interview on Wednesday.
“And even though hospitalizations weren’t all that common, there were so many people who were infected that a small percentage requiring hospitalization out of a large number of people who were infected ended up being a lot of people in hospital.”
Additionally, while many people infected with the subvariant might experience mild-to-moderate illness, seniors and people with immunocompromising conditions would face significant risk in the event of another variant-driven COVID-19 surge. Canada has reported 52,121 COVID-19 deaths since the pandemic began, many of which were in vulnerable, high-risk populations.
And Vinh pointed out that even mild COVID-19 cases in otherwise healthy people can have lasting consequences.
“There are people who get infected, recover from it, but then develop the long-term complications of long COVID,” he said. “People think long COVID is that you can’t smell or your brain is foggy. But we also have…things like an increased risk of heart attacks or an increased risk of strokes in the months subsequent to that infection, even if they are mild in the acute phase.”
In short, Canadians shouldn’t dismiss XBB.1.16 as a non-threat.
Fortunately, Bogoch said it’s highly likely the existing bivalent COVID-19 vaccine boosters provide some protection against XBB.1.16, just as they have with other Omicron subvariants. Other tried and tested precautions shown to reduce the risk of COVID-19 infection should also help protect against XBB.1.16, should it begin circulating widely in Canada.
“No one wants to be infected with COVID or any other infection, so in the absence of large public health initiatives, people can take their own initiative to reduce the risk of infection,” he said. “So that means putting on a mask in indoor settings, being up to date on vaccinations, which lowers the risk of more severe manifestations of the virus, things like that.”
TALLAHASSEE, Fla. (AP) — A judge has blocked the head of Florida‘s state health department from taking any more action to threaten TV stations over an abortion-rights commercial they’ve been airing.
U.S. District Judge Mark Walker’s ruling Thursday sided with Floridians Protecting Freedom, the group that produced the commercial promoting a ballot measure that would add abortion rights to the state constitution if it passes in the Nov. 5 election. The group filed a lawsuit earlier this week over the state’s communications with stations.
“The government cannot excuse its indirect censorship of political speech simply by declaring the disfavored speech is ‘false,’” the judge said in a written opinion.
He added, “To keep it simple for the State of Florida: it’s the First Amendment, stupid.”
State Surgeon General Joseph Ladapo and John Wilson, who was then the top lawyer at the health department before resigning unexpectedly, sent a letter to TV stations on Oct. 3 telling them to stop running an FPF ad, asserting that it was false and dangerous. The letter also says it could be subject to criminal proceedings.
FPF said about 50 stations were running the ad and that most or all of them received the letter — and at least one stopped running the commercial.
The group said the state was wrong when it claimed that assertions in the commercial were false. The state’s objection was to a woman’s assertion that the abortion she received in 2022 after she was diagnosed with a terminal brain tumor would not be allowed under current state law.
The state hasn’t changed its position. In a statement Thursday, a spokesperson for the health department again said that the ads are “unequivocally false.”
The judge’s order bars further action from the state until Oct. 29, when he’s planning a hearing on the question.
The ballot measure is one of nine similar ones across the country, but the campaign over it is the most expensive so far, with ads costing about $160 million, according to the media tracking firm AdImpact. It would require the approval of 60% of voters to be adopted and would override the state law that bans abortion in most cases after the first six weeks of pregnancy, which is before women often realize they’re pregnant.
WASHINGTON (AP) — The blast shook the ground and its red flash of fire covered the doorway as U.S. special operations forces blew open a door during a recent training exercise.
Moments later, in their next attempt, the boom was noticeably suppressed and the blaze a bit smaller, testament to just one of the new technologies that U.S. Special Operations Command is using to limit the brain injuries that have become a growing problem for the military.
From new required testing and blast monitors to reshaping an explosive charge that reduces its blowback on troops, the command is developing new ways to better protect warfighters from such blast overpressure and to evaluate their health risks, particularly during training.
“We have guys lining up to volunteer for these studies,” said retired Sgt. Maj. F. Bowling, a former special operations medic who now works as a contractor at the command. “This is extremely important to the community. They’re very concerned about it.”
The Defense Department does not have good data on the number of troops with blast overpressure problems, which are much harder to detect than a traumatic brain injury.
Traumatic brain injuries are better known and have been a persistent problem among combat forces, including those subjected to missile strikes and explosions that hit nearby.
According to the department’s Traumatic Brain Injury Center of Excellence, more than 20,000 service members were diagnosed with traumatic brain injuries last year. More than 500,000 have been diagnosed since 2000.
Josh Wick, a Pentagon spokesperson, said emerging information from evaluations of both acute blasts and repetitive low-level exposures shows links to adverse effects, such as the inability to sleep, degraded cognitive performance, headaches and dizziness.
“Our top priority remains our forces’ long-term cognitive well-being and operational effectiveness as warfighters,” said Gen. Bryan Fenton, head of U.S. Special Operations Command. “We are committed to understanding and identifying the impacts of blast overpressure on our personnel’s brain health.”
Fenton said research with academics and medical and industry experts is helping find ways to mitigate and treat overpressure. He said cutting-edge technologies are key to reducing the effects of repeated exposures, such as those many of his troops experience.
Out in a remote training area for Army special forces at Fort Liberty in North Carolina, commandos used what they call a Muchete breaching charge, specifically formed into a shape that more precisely directs the blasts and limits the harmful waves coming from an explosion. A small number of journalists were allowed to watch the training.
“The reduction on the blast overpressure coming back on the operator on average is generally between 40 and 60%,” said Chris Wilson, who leads the team at the command that oversees clinical research and other performance-related initiatives. “It really also depends on where somebody is standing. But it’s certainly a pretty dramatic reduction in the exposure. So I think that’s a win.”
Wilson said development and testing of the refined charge is ongoing but that units are using this one now in training until one gets final approval and can be more widely distributed.
Because of the extensive amount of training for special operations forces — both to hone their skills and to prepare for specific operations — troops may practice breaching a door dozens or hundreds of times. As a result, training is where they are most likely to have such repeated exposures. The command wants a better sense of how each person is affected.
During the demonstration, a number of the Army special forces soldiers were wearing small monitors or sensors to help leaders better understand the level of blast pressure that troops are absorbing. The sensors allow officials to compare readings based on where troops were standing and how close they were to the blast.
The command is evaluating a number of blast sensors on the market, and some higher risk troops are already using them. Testing and other studies are continuing with the goal of getting them out across the force in the next couple of years.
According to Wilson and Col. Amanda Robbins, the command’s psychologist, there are distinct differences between acute traumatic brain injuries and what is called long-term blast exposure or blast overpressure.
Traumatic brain injuries, they said, are acute injuries that are relatively well documented and diagnosed. They said repetitive blast exposure needs more attention because there are lots of questions about the impact on the human brain. The damage is far more complex to diagnose and requires more study to establish links between the repetitive blasts and any damage or symptoms.
To aid the research, Special Operations Command is looking at doing more routine testing throughout service members’ careers. One test is a neurocognitive assessment that the command does every three years. Officials also want warfighters to be assessed if they have had a concussion or similar event.
The Defense Department more broadly will require cognitive assessments for all new recruits as part of an effort to protect troops from brain injuries resulting from blast exposures. New guidance released in August requires greater use of protective equipment, minimum “stand-off distances” during certain types of training, and a reduction in the number of people in proximity to blasts.
The other test being done by Special Operations Command is a more subjective comprehensive assessment that catalogs each person’s history of injuries or falls, even as a child. It’s done early to get a baseline.
Robbins said what they have seen is that new, younger operators and those with 20 or more years of experience are more amenable to doing the testing.
“The challenge is going to be in the midcareer operators who may be more concerned about self-reporting potentially having a perceived negative impact,” she said.
She added that the assessment is a way to take into account incidents that may not be in their medical records, so that problems can be identified early on and people can get treatment.
SAN FRANCISCO (AP) — A federal judge on Friday delayed an order requiring Google to open up its Android app store to more competition until an appeals court decides whether to block the shake-up because of legal questions surrounding a jury’s verdict that branded Google as an illegal monopolist.
The delay granted during a court hearing in San Francisco comes less than two weeks after U.S. District Judge James Donato issued a decision that would have forced Google to make sweeping changes to its Play Store for Android smartphones starting Nov. 1.
The mandated changes included a provision that would have required Google to make its library of more than 2 million Android apps available to any rivals that wanted access to the inventory and also distribute the alternative options in its own Play Store.
Google requested Donato’s order be stayed until the Ninth Circuit Court of Appeals could examine the handling of a monthlong trial that led to the December 2023 verdict, which framed the Play Store as an illegal monopoly that stifles innovation and drives up consumer prices.
In Friday’s hearing, Donato scoffed at the notion that Google could succeed in overturning the trial verdict. “The verdict in this case was amply supported by a mountain of evidence about Google’s anti-competitive conduct,” the judge said.
But he decided the Ninth Circuit should be given a chance to consider a postponement until a panel of judges can decide can consider Google’s appeal of the 2023 trial focused on antitrust claims lodged by video game maker Epic Games.
Donato said he wouldn’t be surprised if the Ninth Circuit imposes an even longer delay on his ruling, “but that is for someone else to decide.”
In a statement, Google said it was pleased Donato hit the pause button while it tries to extend the delay even further.
“These remedies threaten Google Play’s ability to provide a safe and secure experience and we look forward to continuing to make our case to protect 100 million U.S. Android users, over 500,000 U.S. developers and thousands of partners who have benefited from our platforms,” Google said.
Epic pointed to Donato’s critical comments about the merits of Google’s appeal in a statement that described the stay as a “procedural step.”
It’s unclear how long the Ninth Circuit will take to decide on Google’s request for a permanent stay of Donato’s ruling while its appeals unfolds — a process that could take more than a year.
In 2021, the Ninth Circuit delayed a provision of another federal judge’s order mandating that Apple allow links to alternative payment systems with apps made for the iPhone as part of another antitrust case brought by Epic.
Although Apple avoided being labeled an illegal monopolist in a trial involving the iPhone app store, it unsuccessfully fought the provision requiring the company to allow alternative payment links within apps. But delaying that requirement preserved Apple’s exclusive control of a payment system that has generated commissions ranging from 15% to 30% on some e-commerce occurring within apps. Apple exhausted its avenue of appeals in the U.S. Supreme Court earlier this year.
Google also pockets billions of dollars annually from a similar commission system within its Play Store for Android phones — a setup that is allowed to continue as long as Google can prevent Donato’s ruling from taking effect.
In its arguments for delaying Donato’s order, Google said it wasn’t being given enough time to make the drastic changes it framed as “a Herculean task creating an unacceptable risk of safety and security failures within the Android ecosystem.” In its Friday statement, Epic blasted Google’s tactics as “fearmongering.”
Google also argued the shake-up would saddle it with unreasonable costs, a contention Donato also brushed aside during Friday’s hearing.
“I don’t want to be glib about it, but the expense that Google might incur appears to be a drop in the bucket compared to the profits it reaps annually from the Play Store,” Donato said.
