As Australia heads into winter, a new wave of COVID-causing sub-variants, dubbed FLiRT, has emerged. These variants, known as KP.1 and KP.2, are proving to be more transmissible than their predecessors, despite their playful nickname. Derived from the JN.1 variant, FLiRT is less severe in terms of illness but poses a significant challenge due to its increased spreadability.
JN.1, a recent descendant of the Omicron family, evolved from the BA.2.86 Pirola variant identified in August 2023. In the United States, FLiRT has quickly overtaken JN.1 as the dominant strain, and a similar trend is expected in Australia, with cases already on the rise.
The World Health Organisation (WHO) is closely monitoring these JN.1 descendants and may soon classify some of them as Variants Under Monitoring (VUM). This classification indicates that a variant could significantly impact global health, warranting increased attention and surveillance.
Symptoms of FLiRT are similar to those of recent COVID-19 variants, ranging from severe illness to mild symptoms. The most common symptoms include fever or chills, cough, fatigue, muscle or body aches, headache, congestion, nausea, and diarrhoea. FLiRT’s ability to evade the immune system could lead to more people falling ill, putting additional pressure on the healthcare system.
Accurate case numbers are difficult to determine due to decreased testing and reporting. However, NSW Health has noted a rise in COVID-19 cases, with 2,820 positive cases recorded in the week ending May 11. A significant portion of these cases were among individuals aged 90 and older. In Queensland, nearly half of the COVID-19 hospitalisations last week were among people aged 75 and older. Victoria has also seen an increase in cases, with hospitalisations averaging 284 in the week ending May 17, up from 208 the previous week.
The ongoing emergence of new variants is a natural part of the virus’s evolution. While most changes are minor, some can significantly affect the virus’s transmissibility, severity, or response to treatments and vaccines. Scientists are still trying to understand the driving factors behind these changes.
The WHO has acknowledged that the virus does not yet show clear seasonal or evolutionary patterns. This uncertainty complicates efforts to predict future variants and their potential impact.
Regarding COVID-19 vaccines, no immediate changes are necessary. However, the WHO recommends that future vaccines be based on the JN.1 variant to provide protection against its descendants. It will take several months to develop and approve updated vaccines. Meanwhile, the Australian Technical Advisory Group on Immunisation (ATAGI) advises adults aged 18 to 64 to consider annual COVID-19 vaccinations. Those who are severely immunocompromised may need vaccinations more frequently. As always, consulting with a GP is the best course of action to determine individual vaccination needs.
For the period from April 28 to May 11, nearly 30% of new cases were caused by KP.2, up from less than 16% in the two-week period before that. This rapid increase highlights the need for awareness and preparedness.
Existing vaccines should still offer protection against KP.2. The CDC has issued guidance recommending a second shot of the vaccine that was first released in autumn 2023 for those 65 and older. Federal health officials are expected to recommend a newly formulated version of the COVID-19 vaccine in the autumn. These new vaccines will target the variants predicted to be in circulation over the autumn and winter. If KP.2 is among these variants, the new vaccines will likely be more effective against it.
People at high risk for developing severe illness from COVID-19 should consider antiviral treatments. This high-risk category includes older individuals, people who are immunocompromised, and those with serious underlying medical conditions. There are two oral medications available, and there is also an injection of a third antiviral. Everyone is advised to consult their healthcare provider to determine if they should take an antiviral treatment if they contract the coronavirus, and if so, which one and how to access it.
Whenever a new variant emerges, key questions include whether it is more contagious, causes more severe disease, and if existing vaccines and treatments remain effective. KP.2 is highly contagious but does not appear to cause more severe disease. Hospitalisations associated with COVID-19 are at record lows, and there is no indication that existing vaccines and treatments will stop working against it.
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