Comment on this story
Comment
Unlock This article is free to access.
Why?
America decided the pandemic was over. The coronavirus has other ideas.
The latest omicron offshoot, BA.5, quickly became dominant in the United States and, thanks to its elusiveness when encountering the human immune system, caused a wave of cases across the country.
The size of this wave is unclear, as most people are tested at home or not tested at all. The Centers for Disease Control and Prevention reported an average of just over 100,000 new cases a day this past week. But infectious disease experts know that greatly underestimates the true number, which could be in the millions, said Eric Topol, a professor at Scripps Research who closely follows pandemic trends.
Antibodies from vaccines and previous covid infections offer limited protection against BA.5, leading Topol to call it “the worst version of the virus we’ve seen”.
Other experts point out that despite being hit by multiple rounds of increasingly contagious sub-variants of omicron, the country has yet to see a dramatic spike in hospitalizations. About 38,000 people had been hospitalized nationally with covid as of Friday, according to data compiled by The Washington Post. This figure has steadily increased since early March, but remains well below the record 162,000 patients hospitalized with covid in mid-January. The average daily death toll on Friday was 329, unchanged over the past two months.
Tracking US COVID-19 cases, deaths and other indicators by country
There is widespread agreement among infectious disease experts that it remains a dangerous virus that causes disease of unpredictable severity — and they say the country is not doing enough to limit transmission.
Restrictions and mandates are long gone. Air travel has almost returned to pre-pandemic levels. Political leaders we’re not talking about the virus — that’s practically a non-issue in the campaign. Most people are done with masking, social distancing and the pandemic in general. They risk the virus.
“It’s the wild west,” said Ziyad Al-Ali, an epidemiologist at Washington University in St. Louis. “There are no public health measures at all. We are in a very strange place where the risk is glaring and there is, but we have let our guard down and have chosen to deliberately expose ourselves and make ourselves more vulnerable.
Angela Rasmussen, a virologist at the University of Saskatchewan, would like to see more money for vaccine testing and development, as well as stronger messaging from the Biden administration and top health officials. She was horrified recently on a trip to Southern California where she saw few people wearing masks at the airport. “That’s what happens when you don’t have politicians and leaders taking a strong stand on the issue,” she said.
The CDC said it urged people to watch for community transmission, “keep up with vaccines and take appropriate precautions to protect themselves and others.”
Covid deaths are no longer prevalent among the unvaccinated as the number of elderly people increases
Almost a third of the US population lives in counties rated as having “high” rates of transmission by the CDC. Cases are increasing especially in the south and west.
Many people now see the pandemic as part of the fabric of modern life rather than an urgent medical emergency. Part of this is simply a widespread recalibration of risk. This is no longer the spring of 2020. Few people remain immunologically naïve to the virus. They can still get infected, but the immune system — primed by vaccines or previous bouts with the virus — usually has deeper layers of protection that prevent severe illness.
But the death rate from covid-19 is still much higher than the death rate from the flu or other infectious diseases. Officials have warned of a possible fall or winter wave — perhaps as many as 100 million infections in the United States — that could flood hospitals with Covid patients. Besides the direct suffering of such a massive epidemic, there could be economic disruption as tens of millions of people become too sick to work.
“I feel like everyone has given up,” said Mercedes Carnetton, an epidemiologist at Northwestern University Feinberg School of Medicine.
Carnetton said she’s also not as cautious as she used to be. She wears a high-quality mask on planes, but doesn’t wear a mask at the gym. He’s worried he’ll catch covid again — he caught it during the omicron wave last winter. But she doesn’t think the “zero covid” strategy is plausible.
“I feel like there’s a very limited amount I can do individually other than end my life,” Carnetton said. “It’s risky. I’ll get covid at an inconvenient time. I hope it’s softer than the first time I caught it.
a lot experts concerned about continued transmission have, too opposed to online fear-mongering and apocalyptic warnings about the virus; people don’t routinely get infected every two or three weeks, Rasmussen said.
Immunity at the population level is one of the reasons why the virus remains in mutational mode. The risk of reinfections has increased because newly emerging subvariants are better able to evade the immune system’s front line of defense and there are essentially no community-level efforts to limit transmission.
They got sick with covid. Then they got it again.
Al-Ali, who is also chief of research and development at Veterans Affairs St. Louis Health Care System, searched the vast VA database to see what happened to nearly 39,000 patients infected with the coronavirus for a second or third time. What he found was sobering. In a paper published online last month but not yet peer-reviewed or published in a journal, Al-Ali and his co-authors report that people with multiple infections have a higher cumulative risk of severe illness or death.
Not that the later illnesses are worse than or even as bad as the earlier cases. But every coronavirus infection carries a risk, and the risk of a really bad outcome — a heart attack, for example — builds up cumulatively, like plaque, as infections multiply.
“Reinfection adds risk,” he said. “You roll the dice again. You’re playing Russian roulette.
Vaccination remains an important, if still underused, weapon against the virus – even if it is not as effective at stopping new infections.
Omicron blasted the basically vaccinated population last winter with stunning ease and ever since sub-variants arrived in quick succession, starting with the BA.2 and BA.2.12.1 in the spring, and now the BA.5 and its near-identical cousin the BA.4.
The vaccines are based on the original strain of the virus that emerged in Wuhan, China in late 2019. The Food and Drug Administration has asked vaccine manufacturers to come up with new formulations targeting BA.5 and BA.4. These boosters may be ready this fall.
But there’s no guarantee that these latest sub-variants will still be dominant four or five months from now. The virus is not only evolving, it is doing so at a remarkable rate. The virus can continually outrun vaccines.
“My concern is that by the time we have a vaccine for BA.5, we will have BA.6 or BA.7. This virus continues to outsmart us,” Al-Ali said.
The lucky few who have never contracted the coronavirus can teach us more about it
“We’re in a very difficult position in terms of choosing a vaccine for the fall because we’re dealing with a bit of a moving target,” Anthony S. Fauci, President Biden’s top adviser on the pandemic, told The Post in June, a few days before he also announced that he was sick with the virus.
There is now another omicron subvariant that has caught the attention of virologists: BA.2.75. First seen last month in India, it has been identified in several other countries, including the United States. But it’s too early to know if it will overtake the BA.5 as the dominant option.
There is no evidence that new forms of the virus lead to different symptoms or severity of illness. Omicron and its many offshoots – including BA.5 – typically replicate higher in the respiratory tract than earlier forms of the virus. This is one theory why the omicron seems less likely to cause severe disease.
It is also unclear whether these new variants will change a person’s risk of contracting the long-lasting symptoms known as “long covid”. The percentage of people with severely disabling symptoms is probably between 1 and 5 percent — which equates to millions of people in this country, according to Harlan Krumholz, a professor of medicine at Yale University.
His colleague Akiko Iwasaki, a professor of immunology and an expert on long-term Covid, said in an email that she thinks the world is no longer vigilant enough about the disease. She is often the only person wearing a mask in a crowd, she said.
“I understand the pandemic fatigue, but the virus is not done with us,” she said. “I’m afraid that the current human behavior is leading to more people getting infected and getting a long covid.” I fear that this situation may lead to a large number of people with disabilities and chronic health problems in the future.
The premature nature of the virus has made infectious disease experts nervous about predicting the next phase of the pandemic. Topol warns that a new batch of variants could emerge unexpectedly, in the same way that omicron emerged unexpectedly last November with a staggering collection of mutations already clustered together. The exact origin of Omicron is unknown, but a leading theory is that it developed in an immunocompromised patient with a persistent infection.
“Inevitably, we may see a new family of Greek letters like the omicron,” Topol said. “There is still room for this virus to evolve. It has been developing rapidly for months. So we have to rely on that.”
Add Comment