The ‘Kraken’ is powering New York COVID hospitalizations to their highest level in nearly a year. Is it a sign of what’s coming for the rest of the country?

New York COVID outbreaks are at their highest level in nearly a year, just after a new, ultra-transmissible variant of COVID XBB.1.5, known as the “Kraken,” gained dominance in the northeastern US.

According to the New York State Department of Health, current hospitalizations for COVID are nearing 4,000 — the highest level since February.

It is unlikely that the XBB.1.5 subvariant is solely responsible for the increase in hospitalizations, given recent holiday gatherings and other seasonal factors known to increase cases each winter. But the increase worries experts given that the new variant was recently declared the most transmitted so far by the World Health Organization and also because of New York’s history as a better state than the rest of the country when it comes to word about covid.

It’s “certainly possible” that the regional increase in hospitalizations is a sign of things to come for the rest of the nation, Dr. Michael Merson, visiting professor at New York University’s School of Global Public Health. XBB.1.5 is expected to spread westward in increasing volume in the coming days before eventually becoming the dominant strain of COVID in the country.

Because the variant is so new, it’s unclear how well vaccines and previous infections protect against it. That adds to the uncertainty about any increase XBB.1.5 may be causing in hospitalizations — or whether the new strain is generally more the same, albeit more transmissible.

“Their immune defenses may not be as effective against this variant. This is the biggest concern,” said Dr. Fortune. Bruce Y. Lee, professor of health policy and management at the School of Public Health of the City University of New York.

“We don’t have nearly enough people vaccinated”

The increase in New York’s COVID hospitalizations is due to several factors, including people spending more time indoors due to cold weather, holiday gatherings, lack of masks and high levels of XBB. 1.5 moving northeast, experts told Fortune.

But it’s still too early to tell how big a role each factor is playing, said Dr. Jay Varma, chief medical advisor at the Kroll Institute and the lead architect for New York City’s response to the COVID-19 pandemic before joining the institute in March. Wealth.

“Even if we didn’t have a new variant, I think we can pretty confidently say that there would still have been an increase in COVID infections, hospitalizations and deaths this winter,” Varma said.

But XBB.1.5 and holidays aside, New York COVID hospitalizations have been trending upward since last spring. That’s likely due to declining herd immunity in the U.S. — due to low boost levels of the Omicron vaccine, Merson said.

“We still don’t have enough people vaccinated,” he said, referring to CDC data that says only 15% of Americans age 5 or older have received an updated Omicron booster.

While the booster “probably doesn’t work as well against [preventing] infection” as well as against previous variants of Omicron, “it is still protective against serious diseases and that is the most important thing,” he added.

Kraken cases increase in New York

Early data indicate that XBB.1.5 may spread faster than other variants currently circulating, the New York State Department of Health said in a statement late Monday.

“While at this stage there is not yet clear evidence of significant changes in the virulence or severity of the disease, the department reminds all New Yorkers to take precautions to protect themselves and loved ones against a rapid strain,” Monica Pomeroy, a spokeswoman for the department. , he wrote, among other things, referring to reinforcement shots.

With testing widely considered to be at an all-time low, it is impossible to say for sure whether infections are on the rise. But national levels of COVID-19 are approaching the second-highest ever of the pandemic. And nearly 40% of individuals tested for COVID at New York Walgreens tested positive for COVID, according to a company dashboard, the highest positivity rate ever recorded by the company in the state.

Dr. Jessica Justman, associate professor of epidemiology at Columbia University Medical Center in New York, told Fortune that she is angry that the increase in hospitalizations in the state is not reflecting the high hospitalization rate of the first Omicron wave two years ago.

At that time, hospitalizations reached 12,000 – triggering a resurgence of the first wave of the pandemic, when hospitalizations rose above 18,000 and patients died while waiting for care.

“I’m encouraged that we don’t see those vertical increases happening now,” Justman said.

She is also encouraged by the lack of increase in hospitalizations among vaccinated New Yorkers since a relatively small increase a year ago, when Omicron first came on the scene. Currently, an average of 2.3 vaccinated New Yorkers are hospitalized per 100,000 per week.

Among unvaccinated New Yorkers, however, it’s a different story, with rates generally on the rise since last fall. Currently, about 17 unvaccinated New Yorkers are hospitalized per 100,000 per week.

“Most of what we’re seeing is hospitalization among the unvaccinated,” she said. “The vaccinated seem to have very good protection.”

The country, however, will inevitably see more vaccinated individuals hospitalized if individuals who received only one or two doses or the vaccine at the beginning of the pandemic are still considered among the vaccinated, Dr. Georges Benjamin, executive director of the American Public Health Association. , Fortune said. The partially vaccinated — those who failed to receive boosters — will increasingly need to be hospitalized, he said.

It’s possible that the recent spike in national levels of COVID-19 — one that preceded the dominance of XBB.1.5 in the Northeast U.S. — is simply a precursor to an uptick in cases involving the Kraken, experts say. Some expect the number of cases to soon surpass last summer’s high, but not the all-time high of Omicron’s first wave.

Cases of COVID—mostly Delta—were already increasing in November 2021, before Omicron.

“The suspicion was that Omicron, when it arrived, drove that growth,” Lee said. “This may be the case with XBB as well.”