There is concern in the scientific community about the large increase in covid-19 cases in the community, the change in all hard indicators (hospitalizations, intubations, deaths), but also the detection of the new JN.1 variant.

SARS-CoV2 is here and continues to mutate and – although we are no longer in a pandemic – there are newer data that are troubling scientists.

The World Health Organization (WHO) designated the JN.1 mutation as a “variant of interest” because of “its of its rapidly increasing spread” worldwide. The JN.1 subvariant has been identified in European countries, the USA, India and China. In Greece, 110 cases were detected and in countries where it has been recorded, there is an exponential increase in cases and an increase in hospitalizations. The subversion appeared just before the holidays, where there are festive tables, gatherings and mingling. And it’s not just covid-19 that is spreading widely. It’s both the flu virus and RSV.

Theodora Psaltopoulou, professor of epidemiology and preventive medicine EKPA, speaking to APE-MPE emphasizes the observance of personal protection measures with special care for the elderly and the vulnerable. We are careful not to have fever the symptoms from the respiratory. In case of illness, early diagnosis is important in order to receive the appropriate treatment.

What we know about JN.1

JN.1 has sent covid-19 sewage levels to all-time highs in some countries, Theodora Psaltopoulou reports to APE-MPE.

JN.1 is a sub-variant of the BA.2.86 ‘Omicron’ strain known as ‘Pirola’, which experts flagged this summer for its unusually high number of mutations — a ‘variant of interest’. It is second in alert level to the “concern variant”, a designation previously held by “Omicron”, “Delta” and “Alpha”.

What we don’t know about the new sub-variant

According to Ms Psaltopoulou it is too early to know if the symptoms of the JN.1 subvariant differ from the typical symptoms of ‘Omicron’. So far, there isn’t much evidence that this is the case.

It’s also too early to know if it causes more serious disease than other subvariants of ‘Omicron’, although hospital admissions are increasing in some areas such as New York City, which is considered a state where what’s to come for much of the rest of the country.

“But the increase in hospitalizations could be a result of the population’s waning immunity, at least in part. In addition, the remaining variants also undoubtedly contribute to more hospitalizations in the US, while deaths remain stable. Additionally, it is premature to answer whether JN.1 causes immune escape.”

The vaccine protects

It is considered that the updated vaccine available to us and in our country since October will remain protective against severe disease, hospitalization and death, but studies and enough time are needed to find out to what percentage, Theodora notes to APE-MPE Psaltopoulou. Also, available antiviral drugs are thought to be effective.

“The rapid doubling time of the JN.1 subvariant in some regions sets it apart, but other factors such as weather conditions, social distance and population ‘immunity’ play an important role,” he points out.

What about the triad of respiratory viruses?

Influenza, respiratory syncytial virus (RSV) and covid-19 are part of a series of seasonal respiratory viruses. “As is the case every year it is difficult to predict exactly what will happen during the 2023-2024 winter season. According to the Centers for Disease Control and Prevention (CDC), it is expected to have a similar number of hospitalizations for respiratory diseases as last year,” says the Professor.

covid-19 continues to pose a threat as new variants continue to emerge.

Influenza is a seasonal contagious respiratory disease caused by the influenza virus that changes every year.

RSV is also increasingly recognized as an important cause of respiratory disease in older adults in the US and is estimated to cause 60,000–160,000 hospitalizations and 6,000–10,000 deaths in adults aged 65 years and older annually.

“The true burden among all age groups is likely even higher, as many cases of RSV infections go unreported. Data from the CDC last year showed that influenza, Covid-19 and RSV did not peak at the same time, leading to better management of both patients and health systems,” it says.

The symptoms of the three respiratory infections

He explains that similar to other respiratory viruses such as influenza or covid-19, symptoms of RSV infection include runny nose, cough, sneezing, fever, decreased appetite and wheezing.

In very young infants, the only symptoms may be irritability, decreased activity, and difficulty breathing. Those infected with RSV usually develop symptoms within 4 to 6 days after infection. Healthy adults infected with RSV may have few symptoms, but they can still spread the virus to others. Population groups at greatest risk are people over 60 years of age, infants less than 6 months of age, as well as population groups with chronic heart disease, lung disease and weakened immunity.

He adds that gastrointestinal symptoms are an important indicator of the SARS-COV-2 virus. Vomiting and diarrhea are more common with Covid-19, and to some extent influenza, compared to RSV. This is partly because SARS-CoV-2 attaches to ACE2 receptors found in both the lungs and gut, so it can affect both parts of the body. Furthermore, it is widely accepted that loss of taste and smell is an (almost) unique sign of illness from Covid-19.

Another clue is the time of onset of symptoms. Patients infected with the influenza virus tend to develop symptoms more quickly than other viruses and to a greater degree than when they started. On the other hand, runny nose and wheezing are some characteristic symptoms of RSV and lead to bronchiolitis.

That is why, for 3 months WHO/Europe has been following the campaign: “Protecting ourselves from covid-19, influenza and RSV this winter by protecting our lives and strengthening health systems”