Could the COVID-19 surge in China unleash a new coronavirus mutant on the world?

Scientists don’t know but worry that might happen. It could be similar to omicron variants circulating there now. It could be a combination of strains. Or something entirely different, they say.

“China has a population that is very large and there’s limited immunity. And that seems to be the setting in which we may see an explosion of a new variant,” said Dr. Stuart Campbell Ray, an infectious disease expert at Johns Hopkins University.

Every new infection offers a chance for the coronavirus to mutate, and the virus is spreading rapidly in China. The country of 1.4 billion has largely abandoned its “zero COVID” policy. Though overall reported vaccination rates are high, booster levels are lower, especially among older people. Domestic vaccines have proven less effective against serious infection than Western-made messenger RNA versions. Many were given more than a year ago, meaning immunity has waned.

The result? Fertile ground for the virus to change.

“When we’ve seen big waves of infection, it’s often followed by new variants being generated,” Ray said.

About three years ago, the original version of the coronavirus spread from China to the rest of the world and was eventually replaced by the delta variant, then omicron and its descendants, which continue plaguing the world today.

Dr. Shan-Lu Liu, who studies viruses at Ohio State University, said many existing omicron variants have been detected in China, including BF.7, which is extremely adept at evading immunity and is believed to be driving the current surge.

Experts said a partially immune population like China’s puts particular pressure on the virus to change. Ray compared the virus to a boxer that “learns to evade the skills that you have and adapt to get around those.”

One big unknown is whether a new variant will cause more severe disease. Experts say there’s no inherent biological reason the virus has to become milder over time.

“Much of the mildness we’ve experienced over the past six to 12 months in many parts of the world has been due to accumulated immunity either through vaccination or infection, not because the virus has changed” in severity, Ray said.

In China, most people have never been exposed to the coronavirus. China’s vaccines rely on an older technology producing fewer antibodies than messenger RNA vaccines.

Given those realities, Dr. Gagandeep Kang, who studies viruses at the Christian Medical College in Vellore, India, said it remains to be seen if the virus will follow the same pattern of evolution in China as it has in the rest of the world after vaccines came out. “Or,” she asked, “will the pattern of evolution be completely different?”

Recently, the World Health Organization expressed concern about reports of severe disease in China. Around the cities of Baoding and Langfang outside Beijing, hospitals have run out of intensive care beds and staff as severe cases surge.

China’s plan to track the virus centers around three city hospitals in each province, where samples will be collected from walk-in patients who are very sick and all those who die every week, Xu Wenbo of the Chinese Center for Disease Control and Prevention said at a briefing Tuesday.

He said 50 of the 130 omicron versions detected in China had resulted in outbreaks. The country is creating a national genetic database “to monitor in real time” how different strains were evolving and the potential implications for public health, he said.

At this point, however, there’s limited information about genetic viral sequencing coming out of China, said Jeremy Luban, a virologist at the University of Massachusetts Medical School.

“We don’t know all of what’s going on,” Luban said. But clearly, “the pandemic is not over.”

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AP video producer Olivia Zhang and reporter Dake Kang in Beijing contributed to this report.

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The quickly changing coronavirus has spawned yet another super contagious omicron mutant that’s worrying scientists as it gains ground in India and pops up in numerous other countries, including the United States.

Scientists say the variant – called BA.2.75 – may be able to spread rapidly and get around immunity from vaccines and previous infection. It’s unclear whether it could cause more serious disease than other omicron variants, including the globally prominent BA.5.

“It’s still really early on for us to draw too many conclusions,” said Matthew Binnicker, director of clinical virology at the Mayo Clinic in Rochester, Minnesota. “But it does look like, especially in India, the rates of transmission are showing kind of that exponential increase.” Whether it will outcompete BA.5, he said, is yet to be determined.

Still, the fact that it has already been detected in many parts of the world even with lower levels of viral surveillance “is an early indication it is spreading,” said Shishi Luo, head of infectious diseases for Helix, a company that supplies viral sequencing information to the U.S. Centers for Disease Control and Prevention.

The latest mutant has been spotted in several distant states in India, and appears to be spreading faster than other variants there, said Lipi Thukral, a scientist at the Council of Scientific and Industrial Research-Institute of Genomics and Integrative Biology in New Delhi. It’s also been detected in about 10 other countries, including Australia, Germany, the United Kingdom and Canada. Two cases were recently identified on the West Coast of the U.S., and Helix identified a third U.S. case last week.

Fueling experts’ concerns are a large number of mutations separating this new variant from omicron predecessors. Some of those mutations are in areas that relate to the spike protein and could allow the virus to bind onto cells more efficiently, Binnicker said.

Another concern is that the genetic tweaks may make it easier for the virus to skirt past antibodies — protective proteins made by the body in response to a vaccine or infection from an earlier variant.

But experts say vaccines and boosters are still the best defense against severe COVID-19. In the fall it’s likely the U.S. will see updated formulations of the vaccine being developed that target more recent omicron strains.

“Some may say, ‘Well, vaccination and boosting hasn’t prevented people from getting infected.’ And, yes, that is true,” he said. “But what we have seen is that the rates of people ending up in the hospital and dying have significantly decreased. As more people have been vaccinated, boosted or naturally infected, we are starting to see the background levels of immunity worldwide creep up.”

It may take several weeks to get a sense of whether the latest omicron mutant may affect the trajectory of the pandemic. Meanwhile Dr. Gagandeep Kang, who studies viruses at India’s Christian Medical College in Vellore, said the growing concern over the variant underlines the need for more sustained efforts to track and trace viruses that combine genetic efforts with real world information about who is getting sick and how badly. “It is important that surveillance isn’t a start-stop strategy,” she said.

Luo said BA.2.75 is another reminder that the coronavirus is continually evolving – and spreading.

“We would like to return to pre-pandemic life, but we still need to be careful,” she said. “ We need to accept that we’re now living with a higher level of risk than we used to.”

Ghosal reported from New Delhi. Ungar reported from Louisville, Kentucky.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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