Health officials keep eye on ‘FLiRT’ COVID variants that could lead to fall surge

A Centers for Disease Control and Prevention screen from May 2023 shows Maryland infection levels at the time. File photo by Danielle E. Gaines.

With Maryland nearing 1.5 million reported cases of COVID-19 since the start of the pandemic, experts are monitoring new variants of the virus that could create a surge in cases in the coming months.

Despite its cutesy nickname, health officials say the so-called “FLiRT” variants of COVID-19 seem to be more successful at evading immunity despite previous infections or vaccinations.

“While ‘FLiRT’ is an interesting name, it’s actually based in science. Because, scientists have single letter initials for certain mutations that occur. And these FLiRT variants, they have two mutations, ‘F’ to an ‘L’ and ‘R’ to a ‘T.’ And so, someone just threw a little ‘i’ in between, and you get ‘FLiRT,'” said Andrew Pekosz, a professor of molecular microbiology and immunology at Johns Hopkins University Bloomberg School of Public Health.

The FLiRT strains are a result of convergent evolution, Pekosz said.

“A bunch of viruses in different places that are all developing the same mutations,” he said. “So in essence … they all have the same mutations that are probably driving the increase in cases that we are seeing right now and evading preexisting immunity.

“But because they’re all genetically different, we don’t have a way of lumping them all together,” he said. “Outside of some of these nicknames.”

The current set of FLiRT strains do not appear to be a cause for additional caution or increased public safety policies.

Maryland COVID-19 data

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“We’re not seeing any major changes in disease symptoms or severity that these variants are causing,” Pekosz said.

The Maryland Department of Health plans to maintain its current messaging for COVID-19 precautions, and the FLiRT variants have not prompted any changes to prevention methods.

“Vaccination is still recommended as the best protection against severe illness, hospitalization or death from COVID-19,” said Chase Cook, the department’s communications director, in a written statement.

Standard procedures to reduce the spread of germs are also encouraged, such as washing hands, covering sneezes and coughs, and staying home when sick.

The Centers for Disease Control and Prevetion estimates that as of May 11 , only 28.3% of adult Marylanders had received an updated COVID-19 vaccine, which is defined as anyone receiving at “least one vaccination since September 14, 2023.”

That is higher than the national average of 22.5% of adults with an updated COVID-19 shot, but lower than the rate of those who received a flu shot this year in Maryland. As of May 11, CDC estimates that 55.5% of Marylanders had received their flu shot.

“We haven’t really found a good way to communicate effectively to that population to get across the idea that COVID really is a concern,” Pekosz said. “It’s not as serious as it was at the beginning of the pandemic. But that’s great — the reason that it’s not as much as concern is because we have things like vaccines that reduce the severity and the case numbers.”

The FLiRT strains may have complicated the process of developing an updated COVID-19 vaccine this year.

An advisory committee for the U.S. Food and Drug Administration was scheduled to recommend on May 16 which strains of virus should be used to develop the 2024-25 COVID-19 vaccine. But the meeting was postponed to June 5, to “allow for additional time to obtain surveillance data and other information so the … committee will have more up-to-date information when discussing and making recommendations.”

Maryland Matters has been tracking weekly COVID updates from the Maryland Department of Health.

As of Wednesday, it said there had been at least 1,454,614 cases of COVID-19 reported since the start of the pandemic in 2020. Of those cases, 17,727 people died from the virus. The data shows that 86% of those deaths were of people aged 60 and older.

Pekosz says that vulnerable populations such as older people and those who are immunocompromised are still most at risk for severe cases of COVID-19, especially if they are not up-to-date with COVID-19 vaccinations.

There tend to be fewer COVID-19 cases during the summer months, as fall and winter tend to be the seasons when the illness spikes.

The state health department said there had been 1,788 reported COVID-19 cases in Maryland since the start of May. That’s down from 2,124 cases in April and 4,690 cases in March. There were 7,242 cases reported in February and 11,864 cases reported in January.

KP.2 is one of the main strains that fall under the new “FLiRT” moniker, and is responsible for almost 30% of new COVID-19 cases in the United States, according to CDC estimates.

Pekosz explained that researchers differentiate specific strains of a disease by a “clade,” which is a string of numbers and letters that indicate the ancestry of a virus. The clades are useful to researchers but are often hard for the general public to follow, he said.

Pekosz recommends that people stay up-to-date with available vaccines to best protect themselves from COVID-19 if the FLiRT strain leads to a surge in the fall.

“[KP.2] is becoming the dominant virus. It will probably be the virus that is responsible for the fall surge of cases that we’re going to see, that’s almost guaranteed,” he said. “I think the vaccine will be matched fairly well with it, come fall.”

He said that despite the potential challenges the FLiRT strains may pose, antivirals can still combat symptoms, and COVID-19 tests will still detect the virus.

“We have the tools to minimize the severe disease caused by COVID, we just have to be aware and utilize them when needed,” he said.

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