• The BQ.1 and BQ.1.1 subvariants of Omicron (descendents of BA.5) are now the dominant strains of COVID pushing a new wave of infections this winter.
  • The new COVID sublineages are not different enough from the original Omicron strain to be considered separate variants of concern.
  • These subvariants are likely more resistant to the currently-used monoclonal antibody treatments.
  • The updated bivalent COVID vaccine does show strong neutralizing antibody response to BQ.1.1.
  • The variant XBB is also circulating at low levels currently – we are watching its progress as it’s been touted as more immune-evasive than prior variants. The BF.7 strain is also picking up globally with more transmission potential than prior variants. The severity of illness with each new variant is being reviewed.


  • RSV is a common virus that infects the respiratory tract. It’s transmissible via respiratory droplets and is one of the three most threatening respiratory viruses this season as non-pharmacologic measures have by-and-large been dropped. It can be particularly severe for infants younger than 6 months or those who are compromised or elderly.
  • The virus typically spikes in January, but RSV surged early this year with the overall shifting viral landscape during the pandemic. As of mid-November, RSV activity was high in all regions of the US, with a particularly burdensome number of hospitalizations.
  • According to the American Academy of Pediatrics, palivizumab, a monoclonal antibody to prevent severe lung infection, may be given to eligible infants throughout the 2022-23 RSV season.


  • The CDC has reported that hospitalization rates for influenza are at their highest in over a decade. The flu season also got off to an early and more severe start as predicted, based on what we knew of the season in the southern hemisphere this year.
  • As of the week of November 19, a large number of states are experiencing high levels of flu, stressing many urgent cares and emergency rooms.
  • Flu vaccines are recommended to prevent severe infection and transmission – it’s not too late to get the influenza vaccine for this season.
  • Though preliminary, CDC data indicates that the 2022-2023 influenza season flu vaccine formulations are a good match to protect against the currently circulating flu viruses.
  • For those at high risk of severe disease with influenza, therapeutics exist and can be reviewed with your Private Medical physician.