The country’s daily infection rate – about 55,000 a day – is still less than a third of Omicron’s peak, but cases are rising just as fast as they fell just two weeks earlier when the country lifted pandemic-related restrictions.
The situation in Europe is attracting the attention of health officials for two reasons: first, the UK is offering a preview of what could happen in the United States, and second, it looks like something out of the ordinary is going on. In previous waves, the rise in Covid hospitalizations has lagged the spike in cases by about 10 days to two weeks. Now in the UK, cases and hospitalizations appear to be rising at the same time, which has left experts baffled.
“So we’re obviously very interested in what’s going on with this,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN.
Fauci said he spoke to his British counterparts and they attributed the growth to a combination of three factors. According to Fauci, in order of contribution, these are:
- Variant BA.2, more transmissive than the original Omicron.
- Opening up society where people socialize more indoors without masks.
- Weakened immunity from vaccination or previous infection
At a technical briefing on Friday, the UK Health Security Agency said BA.2 had an 80% higher relative growth rate than the parent Omicron strain, although the likelihood of hospitalization was no higher.
Given that BA.2 does not appear to cause more serious illness – at least in a well-vaccinated British population – it is not clear why the number of hospitalizations is on the rise.
“The issue with hospitalizations is a little more puzzling because while hospitalizations are on the rise, it is clear that ICU bed usage has not increased,” Fauci said. “So is the number of hospitalizations a real reflection of Covid cases, or is there a difficulty in deciphering between people entering the hospital with Covid or because of Covid?”
The US, like the UK, has lifted most mitigation measures as cases of Covid-19 infections have dropped. Two weeks ago, the US Centers for Disease Control and Prevention changed the way they measure the impact of Covid-19 on communities. The new metric, which depends on hospital admissions and hospital capacity in addition to cases, does away with masking recommendations for most parts of the country. States and schools have followed suit by removing mask requirements indoors. READ: Answers to your top questions about Covid
“Without a doubt, the openness of the society and the communication of people indoors is clearly something that is contributing, as well as a general weakening of the immune system, which means that we really need to stay alert and follow the pattern here.” Fauci said. “So that’s why we’re watching it very closely.”
Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota, told CNN: “It’s like a weather alert. The sky is sunny and bright right now, and we hope it stays that way. But we could have bad weather in the evening, but we just don’t know.”
What will BA.2 do in the USA?
BA.2 is growing steadily in the US. Last week, the CDC estimated that it was responsible for about 12% of new Covid-19 cases here.
Meanwhile, BA.2 currently accounts for over 50% of cases in the UK and several other European countries.
“The tipping point seems to be around 50%,” said Keri Althoff, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “That’s when we really start to see how this variant shows its strength in the population,” demonstrating its seriousness.
Althoff said that while the UK could provide a glimpse into the future, there are key differences that will affect how BA.2 works in the United States.
In the UK, 86% of eligible people are fully vaccinated and 67% are boostered, compared to 69% of eligible vaccinated and 50% revaccinated in the US.
“What we’re seeing happening in the UK might be better than what we should expect here,” Altoff said.
She noted that in the Netherlands it took BA.2 about a month to overtake BA.1. If the same timeline happens in the US, it would mean that the variant is starting to spread just as the immunity created by Omicron’s winter infections is waning.
“It worries me,” Althoff said. “But we were in a similar situation last spring where we were really hoping things would settle down and we had a bit of a summer and then we got smashed by Delta.”
Althoff said it will be important for people to understand that they can take masks off for a few weeks, but they may also need to return to wearing them regularly if the number of cases spikes.
“We may see another wave of illnesses in our hospitals,” she said.
Althoff will also be closely monitoring wastewater data over the next few weeks.
“Surveying wastewater is an incredible advancement in how we can monitor SARS-CoV-2 and what it does to the population without really needing any input from the people,” she said. “Sewage monitoring is an important tool for understanding where the virus is moving and whether it is increasing in terms of contagion.”
Preparing for the next wave
Protection against the next option should start with vaccination.
“We absolutely need to continue to find unvaccinated people and vaccinate them,” Althoff said.
Fauci agreed that vaccination rates could be better across all age groups, but current numbers are particularly bad for children: only about a third of children aged 5 to 11 have been vaccinated, and only about half of children aged 12 to 17 .
Even though the youngest children, under 5 years of age, 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.
“So you protect them by surrounding the kids as much as possible with people who are vaccinated and boosted so that you have some kind of protective veil around them,” Fauci said.
It will also be important to remain flexible.
“The big thing about this massive experiment, where we are dropping all masks and restrictions, is that we need to stay diligent in terms of monitoring and testing, and be prepared to possibly reverse most of the relaxation of these restrictions,” said Deborah Fuller. , a microbiologist at the University of Washington.
“We cannot let our guard down because the message people get when they say ‘we are lifting restrictions’ is that the pandemic is over. And it’s not like that,” she said.