The question is: What does this all mean for parents? Should we be worried about our kids getting infected or reinfected? Will masks come back? Will there be outbreaks in classrooms? What else should parents know about these new variants?
What Are the Symptoms of the BQ.1 Variant?
BQ.1 and BQ.1.1 are sublineages of Omicron. The two variants are quickly multiplying in the U.S., rising from 1% of cases just a few weeks ago to almost 12% in mid-October. There is a lot we don’t know about these variants so far, says Coleen Cunningham, MD, a pediatric infectious disease specialist and chair of pediatrics at UCI Health. However, these variants do have some troubling characteristics. “The problem is they are rapidly increasing (suggesting they’re quite transmissible) and can evade the monoclonal antibody treatments available. They also partially evade the immune response from previous infection or vaccine,” Dr. Cunningham says. “It is still likely that the vaccine protects from severe disease but it may not protect from any infection.” As for how symptoms of these variants might differ from other COVID variants or Omicron sublineages, there’s not a lot of data about that right now, says Zachary Hoy, MD, a pediatric infectious disease specialist at Pediatrix Nashville Pediatric Infectious Disease. “With the BQ.1 variant increasing, healthcare settings have not reported a spike in different types of symptoms,” he says. “There are similar symptoms as with other COVID variants, including cough, fever, and body aches.” However, anecdotally, Dr. Hoy says some of his colleagues have reported somewhat lower degrees of fever with BQ.1 and BQ.1.1. J. Wes Ulm, MD, PhD, a physician, medical researcher, and bioinformatics expert, says there have been more reports of sore throats associated with these new variants. “BQ.1 seems to distinguish itself symptomatically in having a much higher [tendency] to cause a noticeable sore throat (sensation of one’s ‘throat being on fire’ as many patients have described it), as well as rhinorrhea (runny nose),” he describes.
Should Parents Be Worried About BQ.1?
After the past few years of COVID concerns and disruption to our kids’ lives, it’s natural parents might be worried about what these new variants might mean for their families. As for how the new variants might affect our kids’ health, Dr. Ulm says there is some cause for hope. “On the one hand, there is a reason for optimism in the sense that this is hardly our first rodeo with Omicron subvariants. There is some level of population immunity, even if waxing and waning when it comes to COVID, along with better and more readily available treatments,” he describes. At the same time, Dr. Ulm says, these BQ.1 and BQ.1.1 variants are brand new, immune-evasive, and very contagious, so it’s unclear how well prior infection from other versions of Omicron might impact new waves of the virus. “BQ.1 is a new animal in the COVID zoo and it poses novel threats that must be taken seriously,” he says. How might the variants affect our kids’ schools or activities? The truth is, the impact these variants might have on things like outbreaks at school or extracurricular activities, masks, or cancellations is tough to predict at this point, says Michael Chang, MD, a pediatric infectious disease specialist at UTHealth Houston and Memorial Hermann Hospital. “Parents can look at the historical response (infection prevention measures, physical distancing guidelines, closures, masking) to the initial Omicron waves to predict how their community, school, and government leadership will respond to possible upcoming SARS-CoV-2 surges driven by future variants,” Dr. Chang advises. He also says the way schools and other institutions handle outbreak and infection prevention will likely be different regionally and even on a case-by-case basis.
Other New COVID Variants
There is another COVID variant making headlines: XBB, which is currently spreading overseas, especially in Singapore. Should parents be worried about this one, too? “It’s too early to know if XBB will become dominant in the U.S.,” says Dr. Chang. “As all the variants ‘converge’ on similar mutations, we don’t know yet how these variants will interact when circulating in the same population and which variant will ‘win.’” What we do know from Singapore, says Dr. Chang, is that patients are reporting similar symptoms as other COVID infections. “The Singapore Ministry of Health is reporting increased re-infections, since XBB became the dominant variant,” Dr. Chang adds. Still, he says XBB has not changed the trajectory of their COVID situation, with respect to severe disease.
Does the New Bivalent Booster Protect Kids From COVID Variants?
As of October 12, 2022, the bivalent COVID booster targeting BA.4 and BA.5 is now available to all children 5 and up. There is limited data at this time regarding the extent to which the booster will prevent infection. But experts agree that getting your child boosted will help prevent severe cases of infection. The bivalent vaccine is expected to boost immunity for a period of time, says Dr. Cunnigham, though it’s unclear how long. “It is likely that they will prevent any infection for several months and protect from hospitalization or severe disease for an extended period of time,” she says.
What Else Can I Do to Protect My Kids From Variants?
As the CDC notes, children can sometimes get serious cases of COVID with some experiencing long-term symptoms. Not only that, but they can pass the infection to others in their home, community, and school who may be more vulnerable to serious infections. That’s why it’s still a good idea to protect your child, especially during outbreaks. Being up to date on your vaccines is the most vital step to take when it comes to these new variants, says Dr. Chang. This includes children who were previously infected with COVID. “Children who were more recently infected with an Omicron variant (particularly BA.5) are likely to have some protection against severe illness, but again we don’t have any details yet,” he says. “Parents and children who had prior infection should also be up to date on SARS-CoV-2 vaccinations to maximize protection against severe illness and potential complications.” In addition to vaccines, Dr. Chang advises anyone who is at high risk for severe illness to keep watch on their local COVID infection rate and take the common sense measures known to reduce chances of infection when cases are high. These include physical distancing, avoiding crowded spaces, and wearing high-quality, well-fitted masks.
