Chapter 1: The Ongoing Battle Against COVID-19

As we near December 2024, marking five years since the onset of the COVID-19 pandemic, it is essential to reflect on the tremendous sacrifices made by countless individuals involved in this struggle. From healthcare workers to everyday citizens, the unwavering commitment of many has been vital in combating the virus. Although the disease persists, the efforts of individuals and communities are appreciated, often at a significant personal toll.

By the end of August 2024, the United States was still dealing with over a million new cases daily, with some regions reporting that a quarter of the population was infected. This highlights the important role every person plays in curbing the virus's spread. Your actions matter; individual vigilance and adherence to safety protocols can create a substantial impact. This is a collective responsibility, and through personal actions, we can empower ourselves to effect change.

Vaccination remains crucial.

During this pandemic, an interesting development has emerged: the extensive rollout of new vaccines, combined with the hundreds of millions who have been infected and reinfected, has led to a complex form of herd immunity—natural, artificial, and hybrid. This interplay of immunity types has significantly reduced hospitalization and mortality rates.

While vaccines may not completely prevent infection, they are effective in protecting against severe outcomes. The next step involves developing nasal mucosal vaccines that promise a broader spectrum of protection.

The Omicron variant appears to be a new threat.

The future trajectory of the pandemic is closely tied to the Omicron variant, which remains an evolving story. The uncertainty of what lies ahead emphasizes the need for continual vigilance and adaptability in navigating this shifting landscape. By staying informed, we can confidently face the future.

Introduced in November 2021, Omicron transformed the epidemiological and clinical landscape. This new variant spawned a complex array of lineages and sub-lineages that have continued to dominate the scene. Its rapid spread led to the coined term “soup of variants,” reflecting the intricate mix of acronyms that represent various mutations, insertions, deletions, and genetic recombinations—mechanisms viruses employ for survival (even if some evolutionary paths lead to dead ends).

It’s crucial to remain aware of the serious risks associated with Long Covid, as these potential outcomes warrant our caution and attention.

Is Omicron a novel coronavirus? Likely not, but it certainly resembles one.

Chapter 2: Understanding the Variants

What is JN.1 and its lineage?

The JN.1 variant emerged during the winter of 2023–2024, descending from BA.2.86.1, which itself is derived from BA.2, a prominent player in the Omicron saga.

In summary, here’s a chronological breakdown of the evolution: the original Wuhan COVID-19, followed by the D614G mutation, and variants of concern including Alpha, Beta, Gamma, Delta, and the Omicron series (BA.1, BA.2, BA.3). The current Omicron saga includes variants like BA.2.86, BA.2.86.1, and JN.1, among others.

The newcomers after JN.1.

If you’ve kept up with the intricate details, we can dive deeper into JN.1, the great-granddaughter of BA.2. Recent mutations (F456L and R346T) introduced subvariants colloquially termed FLiRT, with KP.2 being one of them. Yet, the virus continues to adapt: it has shed the R346T mutation and introduced Q493E instead.

This new subvariant is informally known as FLuQE, while its official designation is KP.3. Following a deletion (S31del), it has been renamed DeFLuQE (with "De" signifying deletion). This variant, KP.3.1.1, is now the dominant strain in certain regions, accounting for 50% or more of infections. It poses a high risk of evading both natural and vaccine-induced immunity. If it exhibits the same lethality as the Delta variant, we could face another global crisis.

In summary, the last notable Omicron descendants are JN.1, KP.2, KP.3, and KP.3.1.1.

What’s the status of vaccinations?

The last booster shot millions received (including myself) was in November 2023, targeting the then-dominant lineage, XBB.1.5. As we enter the fall, a new mRNA vaccine adaptation (from Pfizer and Moderna) will be available, specifically designed to protect against KP.2. Importantly, this KP.2 vaccine also offers protection against KP.3.1.1.

In essence, we are still navigating the Omicron saga three years after its emergence. The FDA has also authorized the Novavax COVID-19 vaccine for those aged twelve and older, featuring a monovalent component targeting the JN.1 strain. Remember: mRNA vaccines cover the KP.2 variant; Novavax is for JN.1.

Should we get vaccinated, and when?

In my personal view (not an official recommendation), yes—particularly for individuals over 65, pregnant women, those with obesity, or individuals with compromised immunity (like cancer, autoimmune disorders, or diabetes).

The timing of vaccination is crucial: SARS-CoV-2 isn’t strictly a fall-winter virus; it tends to spike twice a year. Depending on age, health status, previous infections, vaccination history, and risk factors (such as being in a nursing home or healthcare setting), it may be wise to get vaccinated in September or October—ideally 6–8 weeks before holiday gatherings.

Consultation with a family physician, who understands individual patient histories, is essential. It’s also critical to adhere to public health guidelines.

The coronavirus threat remains.

The virus is unperturbed by human events; it remains indifferent to sports outcomes or cultural milestones. The most predictable aspect of the virus is its unpredictability.

A new variant, XEC, is emerging from Germany. As it’s difficult to ascertain the implications of XEC, we can focus on the upcoming KP.2 vaccine, which is expected to provide protection for several months.

Dr. Eric Topol emphasizes that vaccination can reduce the risk of developing Long Covid (prolonged or post-viral symptoms) by 50% after even mild infections.

Despite the current decrease in hospitalizations and deaths, we must not overlook Long Covid, which can have devastating effects (cardiovascular, neuropsychological, and respiratory) on even the healthiest individuals, regardless of prior hospitalizations. Excellent resources on this topic can be found in various articles.

Additionally, we must not ignore the virus's procoagulant and neuropathogenic effects, as fibrin contributes to thromboinflammation and neuropathology in COVID-19—another complex and troubling issue deserving exploration.

An exploration of the socio-economic impacts of the pandemic and the reactions to global agendas.

A comprehensive cinematic walkthrough of the SOMA game, highlighting themes relevant to the ongoing human experience amid crises.