New COVID-19 subvariant EG.5 confirmed in New Brunswick

The new rapidly rising COVID-19 Omicron subvariant, EG.5, now dominant in the United States and declared a variant of interest by the World Health Organization, has hit New Brunswick.

"We acknowledge that the EG.5 strain has been detected in the province in very low numbers," Department of Health spokesperson Clarissa Andersen confirmed in an email. 

She did not say when the virus was detected and declined to say how many cases have been confirmed.

"The Department of Health does not regularly report on numbers in relation to strains in circulation and will not be providing further breakdown at this time."

EG.5, a descendent of Omicron XBB.1.9.2, which has the same spike amino acid profile as Omicron XBB.1.5, has been circulating in Canada since at least May, according to the Public Health Agency of Canada (PHAC), and has spread to several provinces.

"EG.5 has been steadily increasing in national samples since early July, following sporadic detections in the months prior," PHAC said in a weekly COVID-19 update Tuesday.

While EG.5 has shown increased prevalence, growth advantage, and immune escape properties, there have been no reported changes in disease severity to date.— World Health Organization

"There are signs of continued fluctuations in some COVID-19 activity indicators after a long period of gradual decline. This may be an early sign of increases in activity," the agency noted.

In the most recent reporting week, national per cent positivity increased, while longer-term trends had shown gradual decreases since March 2023. The number of COVID-19 patients in hospital across Canada also increased "slightly" between Aug. 2 and Aug. 8.

Cases of EG.5 have also been reported in at least 50 other countries.

"Globally, there has been a steady increase in the proportion of EG.5 reported," the World Health Organization (WHO) said in a recent risk evaluation.

"While EG.5 has shown increased prevalence, growth advantage, and immune escape properties, there have been no reported changes in disease severity to date."

Still, WHO said EG.5 may contribute to a surge in cases and become dominant in some countries or even globally.

WHO increased the status of EG.5 from a variant under monitoring to a variant of interest, meaning it has genetic changes that give it a growth advantage and its prevalence is growing. This is the second-highest ranking after variant of concern.

Assess and manage your own risk, N.B. says

Asked how closely New Brunswick is monitoring the new subvariant and what advice the Department of Health has to offer with school about to resume soon and as people begin to gather indoors more as the weather cools, the spokesperson said New Brunswickers, "as always … are advised to assess and manage their personal risk and to continue using public health precautions that can decrease their risk of contracting or spreading COVID-19."

This includes "basic healthy behaviours, such as washing their hands often, covering their coughs and sneezes, limiting contact with those at risk of more severe illness, and staying home if sick," Andersen said.

"If there is reason to alert the public about new ways to protect themselves from a particular strain it will be communicated at that time," she added.

No word on fall COVID-19 boosters

Public Health is still finalizing its plans for COVID-19 vaccine boosters this fall, along with flu and pneumococcal shots for those eligible, said Andersen. "We will have more details to share as they are available," she said.

A month ago the National Advisory Committee on Immunization (NACI) strongly recommended Canadians get another shot this fall if it's been at least six months since their last dose or infection.

The next round of vaccines are expected to be designed to target the more recent, immune-evasive Omicron family of sub-lineages that are still circulating globally, such as XBB.1.5 and XBB.1.16, NACI said.

Asked what plans or recommendations Public Health has for those who received a late spring booster and, under current guidance, would have to wait as late as December — well into the fall respiratory season —- to get their next shot, especially if they're high-risk, Andersen did not respond.

COVID-19 vaccination rates in the province have remained largely unchanged for months, according to figures provided by the department. As of July 25, only 30.7 per cent of eligible New Brunswickers have received a second booster. Data on subsequent boosters is not provided.

CBC asked what Public Health plans to do differently for the fall boosters to help increase uptake, but Andersen did not respond.

Vaccines alone not enough

It's unclear what protection current vaccines offer against the new variant, said Iris Gorfinkel, a family doctor and vaccine researcher in Toronto.

But a recent review of 40 studies from the Journal of the American Medical Association found bivalent vaccines, whether by Pfizer or Moderna, were 40 per cent effective at preventing symptomatic Omicron, she said.

"The problem? It doesn't last. You turn the clock six months forward, it's only 13 per cent effective."

The bivalents are even better at preventing hospitalizations, at 62 per cent among those with a normal immune system, said Gorfinkel. Two months after getting the shot, however, the effectiveness drops to 50 per cent.

"That means 50 per cent of people could still become hospitalized even after having had the bivalent vaccine," she said, noting only one in four Canadians have had a bivalent. "And if somebody's immune-compromised, it's even less effective."

So people should not rely on vaccination or protection from a previous infection alone, said Gorfinkel. "Masking in health-care facilities, air filtration, hand washing, staying at home when sick — all of that remains critical in our armamentarium to prevent sicknesses, especially come the fall."

Viruses, such as the coronavirus, common cold and flu, transmit more rapidly in cooler and drier conditions, she said.

In addition, a recent study at Harvard found the immune response in our noses is inhibited in cooler temperatures.

"Add to that the immunity … tends to drop over time, and all of this conspires to make us more susceptible."

New advice for rapid test use

Symptoms to watch for, so far, are the same as with previous Omicron strains, said Gorfinkel. These include runny or stuffy nose, changes in ability to smell, headache, fatigue, sneezing, sore throat and a cough, she said, remarking they're impossible to distinguish from a common cold without being tested for COVID-19.

Rapid tests, which were designed to detect the original strain of the novel coronavirus, pick up only about three out of five symptomatic cases of Omicron, according to Gorfinkel.

For people with no symptoms, rapid tests are "actually not not very good at all at detection."

To increase their effectiveness, Gorfinkel contends the instructions should be updated to advise people to swab five areas for at least five seconds each — the five by five rule.

People should first swab the right and left bottom gums, between the cheek and teeth, rotating the swab the whole time, she said. They should swab the back of their throat next. Then they should swab deep inside each nostril.

"It's really critical to do multiple areas," said Gorfinkel. "Even then, you're not going to necessarily be able to detect it, but that gives us the best chance."

The next COVIDWatch report for New Brunswick is scheduled to be released on Aug. 29.