The country’s daily case rate – about 55,000 a day – is still less than a third of Omicron’s peak, but cases are rising as quickly as they were falling just two weeks ago, when the country removed epidemic-related restrictions.
The situation in Europe is of interest to public health officials for two reasons: first, the UK offers a preview of what might happen in the US, and second, something unusual appears to be happening. In previous waves, increases in Covid hospital admissions have reversed jumps in cases by about 10 days to two weeks. Now, in the UK, cases and hospitalizations appear to be rising side by side, something that has baffled experts.
“Obviously we’re very interested in what’s going on with that,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN.
Fauci said he and his UK counterparts have spoken, and they have linked the rise to a combination of three factors. Fauci said, in order of contribution, these are:
- Variant BA.2, which is more portable than the original Omicron
- Opening up of society, as people mingle more indoors without masks
- Weakened immunity from a previous vaccination or infection
Given that BA.2 does not appear to cause more serious disease – at least not in the highly vaccinated British population – it is not clear why hospitalization rates are so high.
“The issue of hospitalization is a bit puzzling, because despite the increase in hospitalizations, it is very clear that their use of intensive care beds has not increased,” Fauci said. “So is the number of hospital admissions a true reflection of Covid cases, or is there a difficulty deciphering between people who are hospitalized with or because of Covid?”
“Without a doubt, the openness of the community and the mingling of people inside is clearly a contributing factor, as well as poor immunity in general, which means we really have to stay informed and watch the pattern here,” Fauci said. “So that’s why we’re monitoring this very carefully.”
Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, told CNN, “It’s like a weather alert. Right now, it’s sunny and bright, and we hope it stays that way. But we can have bad weather by evening, and we just don’t know.” .
What will BA.2 do in the US?
BA.2 is growing steadily in the United States. Last week, the CDC estimated that it causes about 12% of new Covid-19 cases here.
Meanwhile, BA.2 now accounts for more than 50% of cases in the UK and several other European countries.
“The tipping point appears to be correct at about 50%,” said Keri Altoff, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “That’s when we really started to see this variant flexing its strength in the population” as much as it shows its severity.
Althoff said that while the UK may offer a glimpse into the future, there are key differences that will affect how BA.2 operates in the US.
In the UK, 86% of eligible people are fully vaccinated, and 67% are boosted, compared to 69% of those vaccinated and 50% boosted in the US.
“What we’re seeing happening in the UK is probably a better story than we should expect here,” Altov said.
She noted that in the Netherlands, it took BA.2 about a month to beat BA.1. If the same timeline occurs in the United States, this means that the variant takes off just as immunity from winter Omicron infection will be waned.
“I’m worried about that,” Altoff said. “But we were in a similar situation last spring, where we were really hoping things would settle down, we get a little bit of summer, and then Delta blows us away.”
Altov said it will be important for people to understand that they may be able to take their masks off for a few weeks, but they may also need to wear them regularly if cases spike.
“We could see another wave of disease in our hospitals,” she said.
“Wastewater monitoring is an amazing advance in how we monitor SARS-CoV-2 and what it does in the population without really needing any input from people,” she said. “Wastewater monitoring is an important tool for understanding where the virus is going and whether it is increasing in terms of infection.”
Preparing for the next wave
Protection against the next variant must begin with vaccination.
“We definitely have to keep looking for and vaccinating unvaccinated people,” Altov said.
Fauci agreed that vaccination rates could be better in all age groups, but the current figures are particularly bad for children: only about a third of children aged 5 to 11 and about half of children aged 12 to 17 have been vaccinated.
Although younger children, under the age of 5, cannot yet be vaccinated, recent studies have shown that young children are less likely to contract Covid-19 when they are surrounded by vaccinated adults.
“The way you protect them is to surround the children, as much as possible, with people who have been vaccinated and boosted so that you have to some degree of protection around them,” Fauci said.
It will also be important to continue to be flexible.
“The important thing about this huge experiment as we get rid of all the masking and the limitations is that we have to remain diligent in terms of monitoring and testing them and be prepared to reverse a lot of the loosening of those restrictions,” Deborah Fuller said. , a microbiologist at the University of Washington.
“We can’t let our guard down, because the message people get when they say ‘we are lifting restrictions’ is that the pandemic is over. It is not,” she said.