(NEW YORK) — Even as COVID-19 cases and hospitalizations driven by the omicron subvariant BA.5 continue to fall in the United States, the proportion of infections attributed to other omicron offshoots is rising.

According to data from the Centers for Disease Control and Prevention, BA.5 currently makes up 67.9% of new virus cases as of last Friday.

The remaining cases are made up of BA.4.6 — which has been circulating in the U.S. for weeks — as well as newly identified subvariants like BQ.1, B.Q.1.1 and BF.7, which have been spreading mainly in Europe.

The subvariants have been attributed to an increase in infections in Europe. According to the latest weekly report from the World Health Organization, published Oct. 12, there were more than 1.66 million COVID-19 cases recorded across the continent, up from more than 1.53 million cases recorded in the previous report published on Oct. 5

Throughout the course of the pandemic, Europe has been considered a bellwether of what’s to come in the U.S.

Should we be concerned about the new subvariants? Experts told ABC News that the U.S. may see a new wave as we enter the colder weather months and move indoors and it’s important to remain vigilant.

“In the next few months, I think there’s reasonable expectation that we’ll probably see a fall wave,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News contributor. “But the magnitude of that wave, I think, is still very much in question.”

What are the new subvariants?

The subvariant that makes up the most cases after BA.5 is BA.4.6. An offshoot of the omicron subvariant BA.4, it’s estimated to account for 12% of new cases, according to the CDC.

Then there are newer subvariants, which have recently begun steadily spreading in the U.S: BQ.1 and BQ.1.1, Both are offshoots of BA.5 and make up 12% of new cases together. This is a rapid rate of increase considering they made up just 3% of new cases for the week ending Oct. 1.

“It seems to have come out of nowhere,” Dr. Peter Chin-Hong, an infectious diseases specialist at the University of California, San Francisco, told ABC News. “But it didn’t really come of nowhere. It was first seen in Nigeria in summer and then spread to other countries in Europe and Asia, and now in the United States.”

Another offshoot of BA.5 that is picking up speed is BF.7. It makes up 5.3% of new cases in the U.S., up from 3.2% just two weeks prior.

Meanwhile, there have been reports of another subvariant called XBB, which combines multiple strains of the omicron variant and other COVID-19 variants and has been detected mostly in Asia. So far, it has not been detected in the U.S.

Not much is known about any of these newer subvariants. Preliminary data suggests they have mutations that are better at evading immunity, whether from vaccination or prior infection, and may be more transmissible.

Another reason these offshoots could be spreading more rapidly is because human behavior has changed. Travel is reaching pre-pandemic levels, children are back in school and most restrictions — including masking, social distancing and vaccinations requirements — have ended.

There is some good news. Since September, bivalent boosters that target BA.4 and BA.5 have been approved in the U.S. for those aged 12 and older and for those aged 5 and older since last week. Early data suggests the booster increases antibody response.

Because these subvariants are related to BA.4 and BA.5, it’s likely that the booster will provide at least some protection against them as well.

“I think there’s a very reasonable expectation that the vaccines, especially with the new boosters, will provide good protection,” said Brownstein. “But we’re still missing a lot of real-world data, especially given that these new sort of omicron variants of BA.5 and BA.4 are starting to take hold in various parts of the world.”

“We’ll hopefully have reasonable insight from other countries that will help inform some of the forecast for the coming months, but that data is still being compiled,” he continued.

Chin-Hong said it’s also reasonable to expect, as with previous variants, that those most at risk are Americans with the least amount of protection.

“For people who are unvaccinated, those over age 65 who’ve never gotten a booster, or people who are immunocompromised, they may become more seriously ill and die if they don’t protect themselves,” Chin-Hong said.

Should we be concerned?

Brownstein said he thinks public health officials should remain vigilant and keep tracking the spread of these subvariants but the public should not yet worry.

“I think it’s too early to tell the level of concern,” Brownstein said. “Of course, everyone should be concerned about how new variants emerge, especially when there’s uneven vaccination across the U.S and then across the globe.”

He added, “The brunt of that concern should be on public health and scientists right now, as we try to work out [what’s happening].”

Brownstein said Americans should be willing to modify their behavior — like masking indoors again — if cases spike or a new variant emerges.

According to CDC data, the daily average of COVID-19 cases sits at 35,000 as of Oct.16 and the average estimate of new hospital admissions is 2,990 as of Oct. 15.

Brownstein said if the health care system becomes overwhelmed by a surge, city- or state-level officials might consider masking to reduce the number of patients entering hospitals.

“I think that clearly targeted masking, especially in high-risk places like health care settings and long-term care facilities, will be critical, because those places are charged with protecting the most vulnerable,” Brownstein said. “Beyond that, I think it’s going to be really driven by local level cases.”

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(NEW YORK) — Nearly 30% of Americans living with diabetes who are uninsured may ration their insulin to save money, according to a new study.

Researchers at Harvard Medical School, the City University of New York’s Hunter College and consumer advocacy organization Public Citizen determined the prevalence of insulin rationing by analyzing the Centers for Disease Control and Prevention’s 2021 National Health Interview Survey in the study, published in the Annals of Internal Medicine on Monday.

Overall, researchers found that 16.5% of adults with diabetes who use insulin — some 1.3 million Americans — rationed insulin by either skipping doses, taking less or delaying buying it to save money in the past year.

Rates of insulin rationing were highest among those with no insurance, at 29.2%, the study found. Among those with private insurance, it was nearly 19%.

Rationing was lower among those with public coverage, such as Medicare (13.5%), and those ages 65 and older (11.2%), who would be largely eligible for Medicare.

Insulin rationing was also found to be more common among Black Americans (23.2%) than white and Hispanic (16%), as well as among middle-income insulin users (19.8%) than higher-income (10.8%) and low-income (14.6%), researchers found.

There was no data provided on the health consequences of insulin rationing, though prior research has shown cost-associated non-adherence to insulin can have serious negative consequences.

The study “provides the first national estimate of how many Americans with diabetes are rationing their insulin now due to cost,” Public Citizen said in a news release, noting that soaring insulin costs can average at least $1,000 each month.

Rationing insulin can put people at risk for serious and even deadly complications, experts say.

“In the ICU, I have cared for patients who have life-threatening complications of diabetes because they couldn’t afford this life-saving drug,” Dr. Adam Gaffney, a pulmonary and critical care physician at Harvard Medical School and the Cambridge Health Alliance and the lead author of the study, said in a statement. “Universal access to insulin, without cost barriers, is urgently needed.”

The findings of the study come amid policy debates around the price of insulin.

The Biden administration’s Inflation Reduction Act, which goes into effect next year, includes a provision to cap the monthly cost of insulin for people on Medicare at $35, though the bill excludes those on private insurance or the uninsured.

The initial draft of the bill would have also capped insulin costs for those with private insurance, though Republicans stripped that provision from the bill due to a technicality in the reconciliation process.

More than 37 million Americans have diabetes, according to the American Diabetes Association. Among them, 8.4 million use insulin, which costs 10 times more in the U.S. than anywhere else in the world, according to the association.

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(NEW YORK) — Racial and ethnic minorities are more likely to be hospitalized with the flu in the United States, new federal data shows.

A new report published by the Centers for Disease Control and Prevention Tuesday looked at data from the 2009-10 through the 2021-22 flu seasons — excluding the 2020-21 season — and flu vaccination coverage from the 2010-11 season through the 2021-22 season.

They found that compared to white adults, influenza-related hospitalizations were 80% higher among Black adults.

Although there was some variation by season, during most seasons, hospitalization rates for Black adults were between 1.5 and 2.4 times the rates among white adults.

Additionally, American Indian and Alaska Natives (Ai/AN) flu-related hospitalizations were 30% higher and hospitalizations among Hispanics were 20% higher.

For AI/AN adults, rates were highest during the 2011-12 season and the 2021-22 seasons with rates 2.7 times those of white adults.

Meanwhile for Hispanics, the highest rates were seen during the 2009-10 and 2021-22 seasons and were 2.1 times those of their white counterparts.

The report also found that Asian/Pacific Islander adults had the lowest rates of hospitalization of all the racial and ethnic groups, ranging from 60% to 90% of hospitalization rates of white adults.

Although experts say flu vaccination is the best protection against the flu, rates are lower among racial and ethnic minorities.

“Every year, the flu continues to cause severe illness hospitalization and death,” said CDC Acting Principal Deputy Director Dr. Debra Houry in a press briefing to reporters Tuesday.

“Unfortunately, flu vaccination rates have been consistently lower among black, Hispanic, and American Indian, Alaska Native adults in the United States since 2010,” Houry said.

During the 2021-22 season, 49.4% of white adults were vaccinated against flu. By comparison, just 42% of Black adults, 37.9% of Hispanic minorities and 40.9% of AI/AN adults were vaccinated.

Asian and Pacific Islander adults had the highest rate of vaccination at 54.2%.

According to the CDC, there are several reasons for racial and ethnic disparities, including lack of access to health care and insurance, which in turn leads to less vaccine access.

Another reason for the disparities is missed opportunities to vaccinate.

“For adults who reported a recent medical checkup, vaccination coverage was still lower for Black, Hispanic, American Indian and Alaska Native and adults of other races than for white adults,” Dr. Carla Black, an epidemiologist from the CDC’s Immunization Services Division, said during the press conference. “This suggests that health care providers are missing opportunities during routine medical appointments to vaccinate people from certain groups.”

She added there may be misinformation about how serious flu is and vaccine safety as well as distrust due to past racist health policies that have negatively affected America’s communities of color.

CDC officials recommend that doctors encourage their patients, including those of color, to get the flu shot and that public health officials host outreach events including town halls and pop-up clinics to increase access to flu vaccines.

Black also encouraged flu vaccination due to the risk of a potentially severe flu season this year after the U.S. had two years of little to no flu activity:

“Well, what we can so far is that we’ve had mild flu season, and this means we might be ripe for a severe season, because people are not, you know taking all the measures they took for COVID which also had an impact on flu like masking and social distancing,” she said. “People haven’t had natural disease in two years. So, you know, there’s less natural immunity out there. People are going back to work. People are traveling again; all of these factors could contribute to us having a more severe flu season.”

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