Experts call for COVID-19 variant monitoring after S. Korea reports cases of XE, XM recombinants

Posted on : 2022-04-20 17:54 KST Modified on : 2022-04-20 17:54 KST
Medical experts say that more measures need to be put in place for economically vulnerable populations as well
A staff member at a senior welfare center in Seoul’s Seongdong District disinfects equipment on April 19. (Yonhap News)
A staff member at a senior welfare center in Seoul’s Seongdong District disinfects equipment on April 19. (Yonhap News)

The XE and XM recombinants of the COVID-19 virus’s Omicron variant have been detected in South Korea for the first time.

Experts are stressing the need for a close monitoring system, while calling for stronger assurances for high-risk and economically vulnerable population segments within the country’s post-Omicron measures in order to prepare for a possible wave of new mutations.

The Central Disease Control Headquarters (CDCH) stated Tuesday that of the two cases of infection with the XE recombinant detected in South Korea to date, one of them was found in a traveler who tested positive on March 27 after arriving from the UK, while the other was found in a domestic patient who tested positive on March 30. The two patients were respectively in their 20s and 50s.

Another domestic case of infection with the XM recombinant was also found.

Multiple recombinants prompt experts to call for “stronger monitoring”

XE and XM are subvariants resulting from the recombination of genes from the existing Omicron BA.1 subvariant and the so-called “stealth” BA.2 subvariant. They are among 17 recombinants with confirmed lineages to date, which range from XA to XS (not including XI or XO).

Another patient who tested positive on March 23 was confirmed to have the XL recombinant, marking its first detection in South Korea. The recently discovered XE recombinant was found in early analyses to spread 12.6% faster than BA.2, according to the British Health and Safety Executive (HSE).

Lee Sang-won, director of the CDCH epidemiological investigation and analysis group, said, “In one case each of XE and XM, there is a possibility that the subvariant was introduced from overseas, and with the current circumstances suggesting a sufficiently high possibility of [recombinants] occurring domestically as well, we’re currently conducting an investigation on that basis.”

According to the World Health Organization, 489 examples of infection with XE have been detected in four countries since January, including the UK, the US, and Ireland. The HSE announced on April 8 that 1,179 cases of infection with XE had been confirmed in the UK.

Lee Sang-won explained, “Because the mutations are recombinants of Omicron, the WHO simply classifies them as ‘Omicron,’ and we are not anticipating any changes in characteristics.”

“In the absence of any analysis data on transmissibility or severity, we plan to continue stepping up monitoring,” he added.

Experts stressed the need to prepare for the possibility of the new mutations once again impacting the infection situation.

“The number of whole-genome analyses that the government is currently doing is too low,” commented Paik Soon-young, an emeritus professor of microbiology at the Catholic University of Korea.

“They’ve done 1 million in the UK and a complete population study in Denmark, whereas in South Korea there have only been around 12,000 [analyses],” Paik said.

“With so many confirmed cases, there’s a strong possibility of recombinants, but we’re not doing nearly enough monitoring,” he added.

“We need to be predicting mutations and more actively monitoring their characteristics.”

Need for stronger measures to protect vulnerable in “post-Omicron” era

With the emergence of new mutations and other growing uncertainties, observers are calling for swift action to develop measures to support high-risk and economically vulnerable populations when implementing “post-Omicron” policies.

With mandatory isolation set to end late next month, the elimination of support of healthcare costs is leading to predictions that individuals will face a higher financial burden for testing and treatment. Under those circumstances, members of economically vulnerable population segments could end up forgoing treatment entirely.

“Older populations without money could be faced with the threat of dying at home alone,” warned Jacob Lee, a professor of infectious disease at Hallym University Kangnam Sacred Heart Hospital.

“There need to be measures such as treatment cost subsidies for members of the near-poverty class, and guarantees for the economically vulnerable population will be key if we hope to normalize healthcare,” he urged.

Jacob Lee also called for measures such as cost of living assistance to economically vulnerable populations.

“There are platform workers and others who lose their income entirely when they go into isolation,” he explained. “Those people may opt not to enter voluntary isolation, and while the threat of workplace transmission is an issue, we could also see growing polarization where people who are sick don’t have the option of taking time off.”

Some also called for the expansion of oral treatments to other high-risk groups in addition to older populations. The transition committee for President-elect Yoon Suk-yeol has mentioned the possible expansion of oral COVID-19 medication prescriptions to all individuals aged 12 and up who have underlying conditions.

“I can say that it’s a plan that warrants consideration from a scientific standpoint, although it’s difficult to say right now how it is being considered,” Lee Sang-won said.

Paik Soon-young said, “The medication has been approved for those aged 12 and over who weigh at least 40 kilograms, so it should be prescribed to [all] members of high-risk groups who fall within the approved age range.”

The CDCH announced that 118,504 new confirmed cases had been counted as of the end of the day Monday. The number was 70,761 higher than the 47,743 recorded by the end of the day on Sunday, a day of the week when confirmed cases are typically at their lowest. But the Monday figure was also down by 92,228 from the 210,732 new confirmed cases tallied a week prior.

Total domestic confirmed cases for the week from April 10 to 16 were down by 31.8% from the week before. At 0.78, the reproduction number was below 1 for a third straight week.

By Park June-yong, staff reporter

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