‘People aren’t taking this seriously’: experts say US Covid surge is big risk | Coronavirus
In the fourth year of the pandemic, Covid-19 is once again spreading across America and is being fueled by recent holidays, fewer precautions and the continued evolution of Omicron sub-variants of the virus.
The new sub-variants are causing concern about their increased transmissibility and ability to evade certain antibodies, but the same tools continue to limit the spread of Covid, particularly bivalent boosters, masks, ventilation, antivirals and other precautions, experts said. .
However, uptake of boosters has been “painful,” said Neil Sehgal, an assistant professor of health policy and management at the University of Maryland School of Public Health. Antiviral uptake has been low and few mandates for masking, vaccination and testing have resumed in the face of the winter wave, which is again putting pressure on health systems.
New Covid hospital admissions are now at the fourth highest rate of the pandemic, according to the US Centers for Disease Control and Prevention (CDC). Hospital discharges for Covid fell somewhat after the summer surge, but never fell to the lows seen after earlier hits, which continued through the fall and rose again over the winter holidays.
“Hospitals are at capacity,” Brendan Williams, president and CEO of the New Hampshire Healthcare Association, said of his region’s current rates. “I’m not sure what the trajectory of this thing is going to be, but I’m concerned.”
Most hospitalizations with Covid are among those aged 65 and over, although the proportion for children under four is expected to roughly double in 2022.
In the past week, deaths from Covid increased by 44%, from 2,705 in the week ending January 4 to 3,907 in the week ending January 11.
This is one of the largest increases in Covid cases in the entire pandemic, according to analysis of the sewage virus. It is well below the peak in January 2022, but similar to the increase in summer 2022, which was the second largest.
And it’s not done yet. “It certainly doesn’t look like we’re at the peak yet,” Sehgal said.
Omicron subvariants BQ.1.1 and BQ.1 as well as the rapidly expanding XBB.1.5 account for the majority of cases, according to CDC estimates. The northeastern country, where more than 80% of cases are estimated to be from the XBB.1.5 subvariant, has the highest proportion of cases, according to wastewater data.
“With XBB, there’s such a significant broadcast advantage that exposure is really dangerous — it’s more dangerous now than it’s ever been” in terms of broadcastability, Sehgal said.
The number of official cases has been slower to rise, due to the spread of home testing and a general reluctance to test at all, experts say. Of the tests being reported, however, positivity rates have been very high, with about one in six tests (16%) testing positive.
Despite the high rates of spread of Covid, hospitalizations have not yet reached previous peaks seen earlier in the pandemic, possibly due to immunity from vaccinations and previous cases, said Stuart Ray, a professor of medicine and infectious diseases at Johns Hopkins University School of Medicine. .
But this protection should not be taken for granted, he said, especially as immunity decreases.
Nurses administer Covid-19 tests to members of the public at a testing site in Washington DC. Photo: Michael Reynolds/EPA
“The boosters really do make a difference,” he said. “The severe cases we’re seeing are probably at least somewhat avoidable if people make sure they stay up to date on vaccination, because that’s still the safest way to gain immunity.”
Boosters, especially updated bivalent boosters, are very effective in reducing the risk of severe disease and death. However, only 15.4% of Americans over the age of five have received the new boosters.
“You’re just fighting a lot of misinformation and also some political fallacies when it comes to vaccines,” Williams said. When Joe Biden declared that the pandemic was “over” in September, he said, it probably stunted public enthusiasm for the new stimulus and prompted further inaction by Congress on more funding to address the pandemic.
“It’s challenging to hit that parallel narrative that you don’t have to worry about Covid but also go get a shot,” Sehgal said, calling the statement “another unforced error.”
While vaccines are very important, other precautions also help prevent infection, disease and death, Sehgal said — especially important during a surge like this. However, because of weak messaging from officials, many people may not realize that the US is experiencing an increase and precautions are still needed, he added.
“I think most people who don’t mask today just don’t know they should.”
Even if the U.S. reaches the point where the increases don’t cause a corresponding increase in hospitalizations and deaths, they will still increase the number of people sickened and disabled by Covid for a long time, experts said.
“There is accumulating evidence that repeated Covid accumulates risk for short-term and long-term complications, including cardiovascular problems, mental health and other problems,” Ray said. “We will only know in retrospect exactly how big that cost is. But emerging data suggests there is a cost that is increasing as we accumulate infections.”
Williams is concerned that hospitals are reaching maximum capacity even as long-term care facilities see explosions among residents and staff after years of staffing shortages.
“In New Hampshire, nursing homes won’t admit those they think they can’t staff to care for, which I think is admirable, but the consequence of that is that hospitals are bogged down,” he said. . Hospitals that can discharge patients to transitional or long-term care facilities will see beds filled for longer, putting even more pressure on hospitals, patients and healthcare workers.
“It’s a continuum, but right now the continuum is broken,” Williams said.
Health workers have experienced three years of burnout, disability and death, and some have had to leave the workforce. Others have been alarmed by unsafe working conditions and ongoing crises caused by the pandemic. Nurses in New York reached a tentative agreement this week after striking for safer working conditions.
Joe Biden took his vaccine booster public, but perhaps undermined the message by declaring that the pandemic was ‘over’. Photo: Jonathan Ernst/Reuters
Nursing homes and residential care facilities have roughly 300,000 fewer workers today than in March 2020, Williams said. “It’s hard to see how it’s going to get better,” he said.
Meanwhile, Covid continues to circulate, with nursing home residents and staff seeing one of the biggest increases in cases of the pandemic.
“The first key to keeping people healthy in a nursing home is to keep people in the community healthy,” Williams said. But “it just doesn’t seem like people are wearing masks and bracing themselves – people aren’t taking any of that seriously. It just seemed like we stated that when it comes to Covid mortality, we’re number one and that’s a headline that we will not give it up to any other country.”
Sehgal calls it a “collective forgetfulness” of how and why we need to protect ourselves and each other. “There are people for whom a mild infection is actually not that mild, either because of their underlying health or because of social factors in their lives,” he said. “It’s just an incredible self-inflicted wound.”
And the more the virus spreads, the more opportunity it has to evolve, potentially acquiring mutations that make it easier to overcome immunity.
However, the same measures that helped curb previous growth continue to work today. And they don’t just prevent disease and death – they also minimize social disruptions, such as hours lost at work and school. “Those steps that we can take to protect ourselves and to protect other people – they don’t seem heavy in the face of a Covid infection,” Sehgal said.
As Ray said, “When we could wear a mask, why aren’t we?”