An Infectious Disease Doctor Reveals the Only Covid-19 Factor Everyone Should Track In 2024

We’re riding another Covid wave this summer, this time on the FLiRT variants. These variants comprise a family, including all variants that start with KP or JN, such as KP.2 and JN.1.7. They all descend from the JN.1 variant. They’re named for mutations called “FLiRT”s or “FLip”s, which refer to specific positions in the spike protein. As usual, people are asking what’s different about these variants, and what we need to do differently. However, at this point in the pandemic, the key might not be knowing the ins and outs of every single variant. But according to an infectious disease expert, there is another key marker we should be watching for — and it's far easier to track.

“There's new variants every second being made,” Amesh Adalja, an infectious disease doctor at the Johns Hopkins Center for Health Security, tells Inverse. But this parade of variants isn’t necessarily crucial for laypeople to know in meticulous detail. More often than not, Adalja says, the practical details for avoiding each variant tend to stay the same.

New variants are also a natural part of viral evolution. “Basically, the question is, why is evolution occurring?” Adalja says. Every other respiratory virus — from influenza to rhinovirus — evolves new variants, but they’re not written about (with the exception of avian flu right now).

“I think that there's a lot of focus on the ups and downs of Covid, rather than focusing on the full context of what a new endemic respiratory virus means,” Adalja says. “It's almost like it's a celebrity.”

Tracking Covid-19’s every change as if we’re the paparazzi doesn’t necessarily equip the public with new, useful information. In fact, it runs the risk of breaking trust between the public and health officials. Adalja recalls how in 2021 the public began referring to variants as “scariants,” especially in the face of types with ominous nicknames like Cerberus and Kraken. “That breeds mistrust,” he says.

“There's times when there's needs for updates,” Adalja says. “There's a new medication that's been approved, or a new finding about long Covid, or there is a new treatment, or there's going to be an updated vaccine, or the guidance changes.” But those updates don’t necessarily come with every single new variant.

What Covid-19 stat should everyone be following?

What’s more important is following transformations that we saw in 2021 and 2022, with the emergence of different genetic clusters like Alpha, Omicron, and Delta. These clusters contained characteristic mutations that didn’t resemble each other. “Omicron basically came from left field,” Adalja says. “It wasn’t a different variant” because it didn’t descend from Delta. This was a new genetic cluster of SARS-CoV-2 altogether, one that required the vaccine formulation to be changed.

“Since the omicron has appeared, every other variant that's become dominant has been an Omicron variant,” Adalja says. And yes, even the FLiRT variants are part of the omicron family.

New variants are a part of endemic viruses. As long as Covid is around, it will breed new variants — and Covid isn’t going anywhere.

“I think that people have a difficulty understanding that Covid-19 is never going away,” Adalja says. “It's not magically going back into bats. It's going to be one of the viruses that are part of the human condition.”