The World Health Organisation (WHO) is closely monitoring a new COVID-19 sub-variant, XBB.1.16, also known as “Arcturus,” which is currently responsible for a surge of cases in India and has been identified in at least 22 countries, including the United States.

According to Maria Van Kerkhove, COVID-19 technical lead at WHO, XBB.1.16 has the potential to produce disease, and its increased infectivity and pathogenicity make it “one to watch.” Although XBB.1.16 is a global issue, it has been reported in at least 18 US states, and case counts have nearly doubled over the last week. XBB.1.5, another sub-variant, is currently responsible for almost 80% of COVID-19 cases in the US, according to the Centers for Disease Control and Prevention (CDC).

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One of the big uncertainties around COVID-19 is that the virus continues to evolve, and there is a potential for it to become not only more transmissible but even more severe. Van Kerkhove stated that there would continue to be waves of COVID infection, but the peaks of those infections may not be as large as before, thanks to population-level immunity that has increased around the world from vaccination and past infection.

People over 60 years old and those with underlying health conditions continue to be at the highest risk for severe COVID-19.

Healthcare systems need to focus on vaccinating those who are most at risk and providing good antivirals to prevent severe disease, according to Van Kerkhove. COVID-19 testing still detects the XBB.1.16 sub-variant, so people who think they may have been infected should be tested.

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The severity of illness that XBB.1.16 causes is not yet fully described, but it is hoped that it will be a mild course for most patients. However, people with chronic medical issues, especially those who have lung issues or are immuno-compromised, may still be at risk of more severe illness. Paxlovid remains effective in reducing the duration of viral shedding for this variant, and thus it is likely beneficial for patients in those high-risk categories.