JN.1 Now Accounts for Over One-Third of New U.S. COVID Cases
A new Omicron subvariant of COVID-19 called JN.1 is rapidly spreading and causing an increase in cases in parts of the U.S. going into the holiday season, according to health officials. The subvariant accounted for nearly 40% of new COVID cases nationwide last week, up from about 21% the week prior according to the CDC.
JN.1 descended from the BA.2 Omicron variant and contains additional mutations that may enable it to spread more easily. So far, it does not appear that JN.1 causes more severe illness, but its rapid growth is concerning experts.
“This new variant is concerning due to how transmissible it appears to be and how quickly it is overtaking other variants,” said Dr. Eric Topol, head of Scripps Research Translational Institute. Experts say JN.1’s prevalence is likely underestimated as well since many at-home tests go unreported.
JN.1 Driving Upticks in Parts of U.S., Symptoms Remain Largely Same
Several regions are reporting noticeable upticks in COVID-19 levels thought to be driven by JN.1. Wastewater data shows elevated COVID levels in parts of the Northeast U.S. including near Boston. Health officials say JN.1 now makes up 75% of cases in the region, calling it a “worrisome situation” ahead of the holidays.
California is also reporting a rise in cases that state health officials believe is linked to JN.1. The subvariant accounted for 43% of the state’s cases in early December versus 16% the month before. Hospitalizations have started trending upwards as well.
So far, symptoms linked to JN.1 appear to be similar to previous Omicron variants – including sore throat, runny nose, fatigue, and cough. Loss of taste and smell seems to be less common compared to early COVID variants. Most experts say vaccines still provide protection against severe disease and death from emerging subvariants.
“I would describe [JN.1] as a first cousin of BA.5,” said Dr. Andrew Pekosz of Johns Hopkins’ Bloomberg School of Public Health. “Maybe more efficient at infecting people, but it doesn’t cause more severe disease as far as we can tell.”
Concerns Over JN.1 Growth With Holiday Travel, Gatherings
The rise of JN.1 is sparking renewed concerns of increased transmission, hospitalizations, and deaths associated with end-of-year holiday gatherings and travel. Air travel has returned to 97% of 2019 pre-pandemic levels, and AAA predicts 109 million Americans will travel for the holidays this year.
“I’m worried that the U.S. is going to have another bad three months or so” said Dr. Eric Topol regarding JN.1. CDC Director Dr. Rochelle Walensky issued a warning earlier this month for Americans to mask-up indoors and get booster shots ahead of planned holiday gatherings.
Other experts urge situational awareness and responsible decision-making. “Assess your risk, assess the risk of who you’re going to be with and where you’re going to be spending time,” advised Dr. Devika Dixit of Memorial Healthcare System in Florida.
| Holiday Travel Volumes | 2019 Actual | 2022 Estimate |
|---|---|---|
| People Traveling | 112 million | 109 million |
| Automobile Travelers | 102 million | 100 million |
| Air Travelers | 7 million | 6.9 million |
*Source: AAA
JN.1 Designated a “Variant Under Monitoring” by WHO
Earlier this week, the World Health Organization (WHO) designated JN.1 as a “variant under monitoring.” This means JN.1 meets criteria for a variant that could pose a future public health risk based on genetic changes that suggest increased transmissibility or immune evasion. It also means more aggressive tracking and analysis by governments and health organizations.
The WHO stopped short of labeling JN.1 a “variant of concern,” like the earlier Delta and Omicron variants. But they warned countries to remain vigilant and bolster testing, treatments, and vaccinations – particularly for vulnerable populations. Some experts believe we could see additional JN.1 “offshoot” variants emerge as well.
“The likelihood that there are going to be new variants emerging is still substantial,” said Dr. Dan Barouch director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston. “And there may be future variants that are more pathogenic than current variants. So we have to actively maintain surveillance.”
Next Steps – Vaccines, Boosters, Testing, Treatments
Health officials continue to stress the importance layered protections including vaccines, boosters, masking, improved ventilation, testing, and COVID antiviral treatments to address current and future outbreaks.
Most experts believe our existing mRNA vaccines from Pfizer-BioNTech and Moderna still provide protection against emerging subvariants. Studies on updated Omicron booster shots also show they neutralize JN.1 infections. However, their durability against the subvariant is still unknown.
“[JN.1] is not so antigenically distant from existing vaccine strains that existing vaccines do not provide protection against severe disease,” said Dr. Rajeev Venkayya, president of global vaccine company Takeda. But he and others note additional boosters may eventually be required if protection from current shots wanes too far.
Widespread testing also remains critical for early outbreak detection and rapid response. Improved COVID treatments like Pfizer’s Paxlovid antiviral pill and monoclonal antibody infusions have proven effective as well for those at highest risk for hospitalization and death. And tactics like voluntary isolation when sick can help reduce transmission rates.
Sustained funding and innovation for next-generation vaccines, treatments, and diagnostics are also called for by public health leaders to prepare for future variants. “We have to get out of crisis mode and start thinking about the long game here,” noted Dr. Topol. Proper preparation and vigilance remain our best defenses against COVID-19 moving forward.
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