The US is on edge as an Omicron subvariant fuels an alarming wave of infections in China: XBB 1.5. A case was detected in India on Friday.

The XBB is a hybrid of two Omicron BA.2 subvariants. Scientists are still studying the XBB subvariant, but a newer version, known as XBB.1.5, has emerged.

Yunlong Cao, a biochemist at Peking University, says XBB.1.5 isn’t immune-evasive like XBB but is more transmissible. Scientist JP Weiland says XBB.1.5 is faster and more sustained than any variant since Omicron’s first wave [BA.1] last January.

JP Weiland first noted XBB.1.5 a couple weeks ago. This coincided with a steep rise in hospitalizations there, but it’s not clear how much of that is because of XBB.1.5.

Yunlong Cao and his colleagues reported in October that XBB and three other subvariants have become immune to antibodies in blood samples from people who are vaccinated or have Covid infections.

In November, top US infectious diseases expert Anthony Fauci said that updated Covid booster shots might provide some protection against the XBB subvariant, but they wouldn’t be “optimal.”

The virus seemed exceptionally adept at evading antibodies created by prior infection or vaccination, which form the body’s first line of defense against it. Despite that, Dr. Fauci said he and others were encouraged by data showing that countries like Singapore where XBB spiked infections didn’t see a corresponding rise in hospitalizations.

“Whenever a new variant moves, it runs the risk of spawning a mini-outbreak,” Andrew Pekosz, a virologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore told Reuters. Pekosz says he doesn’t see the XBB subvariant driving the kind of massive surges seen last winter with Omicron.

According to the WHO, the XBB subvariant has a global prevalence of 1.3% and has been detected in 35 countries. As compared to other circulating Omicron sublineages, WHO’s Technical Advisory Group on SARS-CoV-2 Virus Evolution found early evidence of a higher risk of reinfection. Reinfections were mostly limited to people who got sick before Omicron.

Based on the size and timing of previous Omicron waves, as well as the coverage of COVID-19 vaccine, the increased immune escape of XBB may be enough to drive new infection waves.

CDC estimated last week that the XBB subvariant now accounts for nearly a fifth of cases in the country, up from only 3 percent a month ago. The CDC estimates that XBB accounted for 18.3% of COVID-19 cases in the United States last week, up from 11.2% the week before.

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