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JN.1 is now the dominant Covid variant in the United States

The emergence of a new COVID-19 strain, JN.1, is significantly impacting the United States, swiftly becoming the most dominant variant in the country. 

The rapid rise in the prevalence of JN.1 highlights the ever-evolving nature of the SARS-CoV-2 virus and poses new challenges for public health authorities and the medical community.

Understanding JN.1

JN.1, identified as a “variant of interest” by the World Health Organization (WHO), is a recent addition to the list of COVID-19 subvariants. 

According to the Centers for Disease Control and Prevention (CDC), JN.1 has seen a swift rise in cases, with projections indicating further increases through the winter months. 

Notably, JN.1 has surpassed other subvariants, including HV.1 and EG.5, in prevalence. By December, JN.1 accounted for over 44% of COVID-19 cases in the United States.

SARS-CoV-2 is still evolving 

Dr. Heidi Zapata, an infectious diseases specialist at Yale Medicine, said that there is still much to learn about JN.1. “We don’t know much about this new subvariant just yet,” she said, emphasizing the ongoing efforts to understand its characteristics.

“I would say the most important thing for people to know is that the virus is out there, as are respiratory syncytial virus [RSV] and the flu,” said Dr. Zapata. “Any new subvariant is a sign that the SARS-CoV-2 virus is still evolving; it’s still here with us, and we can’t ignore it.”

Characteristics and concerns

One of the distinguishing features of JN.1 is its relation to BA.2.86 (Pirola), a lineage of the Omicron variant. While it shares similarities with its predecessors, JN.1 possesses a unique mutation in its spike protein, which could potentially affect its behavior, such as immune evasion capabilities.

Despite its rapid spread, there is no evidence yet that JN.1 causes more severe COVID cases or poses a greater risk to public health than other circulating variants. 

Symptoms and severity seem consistent with previous strains, largely dependent on individual immunity rather than the variant itself. However, its quick evolution and increased prevalence are points of concern, suggesting a possible higher transmissibility or better immune system evasion.

Protection measures

The CDC’s current recommendations remain unchanged in the face of JN.1’s emergence. These include getting updated vaccines, testing for COVID if respiratory symptoms arise, and following general protective measures like strategic masking and hand-washing.

New vaccines and antiviral treatments are expected to maintain efficacy against JN.1. The availability of updated COVID vaccines this fall is a significant step in enhancing protection against this and other variants. 

“I would advise getting your updated vaccine, consider masking in certain situations, and if you get sick, please test for COVID because you can get medicine to treat it,” said Dr. Zapata.

Implications and the global picture

The rapid spread of JN.1 has implications both domestically and internationally. As of late December, it was most prevalent in the Northeast U.S., particularly in the Department of Health and Human Services’ Region 2, which includes New York and New Jersey.

Despite JN.1’s prominence, the WHO assesses the additional public health risks posed by this variant as low. However, the potential burden on health systems, especially when combined with other respiratory viruses like influenza and RSV, remains a significant concern.

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