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It’s the third year of our pandemic. We’ve seen cases decrease dramatically in the past few weeks and national numbers drop to historic lows. Some areas are recording small increases even as cases continue to fall in other places.
So, where do we stand in our fight against COVID-19? Is there an end in sight?
The BA.2 Variant
CDC has been tracking the BA.2 sublineage of the Omicron variant carefully. The variant has been in the United States for the past 2 months, and has been slowly increasing in proportion to BA.1. “This week, we estimate that BA.2 represents 35% of circulating variants nationally”, says Dr. John T. Brooks, a Senior Science Advisor at the CDC Emergency COVID-19 Response.
At a March 25 EMS briefing co-hosted with the CDC, experts on the state of the pandemic US-wide and globally agreed that while BA.2 is more transmissable than the BA.1, it seems unlikely to evade immune protection or result in more severe disease.
Despite small increases in reported COVID-19 cases in NYC, New York state, and New England, Dr.Brooks cautioned that these upticks reflect very small increases from an already very low level of infections, and making it difficult to interpret without sustained levels of data.
Wastewater surveillance for Covid 19 RNA
Aside from hospitalizations and reported test results, the CDC tracks infections by their presence in wastewater systems. The RNA that COVID-19 produces is shed in feces. So public health officials can detect the presence of RNA as it exits a person’s body, by testing wastewater in our neighborhoods,
“We hope that the system will pick up a signal even before we’re aware that something’s going on in the community; we’ll detect outbreaks and clusters of infection.”
Wastewater surveillance has been adopted in a large number of states said Dr.Brooks and the learnings from this pandemic will be truly informative for public health in the future.
Is there a new wave coming?
The CDC is watching signals from Western Europe, UK and parts of Asia. However Dr.Brooks points out that more than 95% of Americans have some evidence of either being vaccinated or previously infected with Covid, creating high levels of immunity in this country.
He explained that the immunity developed in response to infection from the latest Omicron variant is relatively fresh. Immune systems are most highly revved up the closer they are to the immunizing event. Also, the pandemic sparked a bump in people seeking out booster doses and completing their vaccination series..
Dr.Brooks was cautiously optimistic that these high rates of immunity and access to increasing number of therapeutics would lead to better outcomes for the US.
Is COVID-19 endemic yet?
It’s common theory in infectious diseases that when the severity of symptoms lowers, the virus becomes endemic – meaning that we will learn to live with it and that it has a constant, predictable or expected presence.
But are we there yet?
But a pathogen has other plans when infecting us explained Dr.Brooks, “ It’s using us to replicate and survive and if it kills its host, that doesn’t do any good to the organism. It’s not to its advantage to be very severe. So over time, pathogens often adapt to live with us rather than kill us, he added, referring to the chickenpox virus as a good example.
But, the virus is deadly cautioned Dr.Brooks. “Not only did it kill a lot of the vulnerable (people), but it made a lot of other people very sick. The difficulty in knowing whether the virus is becoming less severe, is compounded by the fact that many of us are immune.”
It is not yet a benign disease, he warned.
Vaccines and children under 5
Many parents with children under 5 who have not been immunized, are still deeply concerned. Currently multiple manufacturers are conducting clinical trials and once the FDA reviews the data for strong evidence of safety and effectiveness, they will authorize emergency use of the vaccine for children in this age group.
Experts asserted that vaccination remains the most effective and safest way to prevent this disease.
“We’ve given more than 559 million doses of COVID-19 vaccines, and that’s three times the amount of vaccine that’s usually given in a flu season. A majority of them have been with new vaccine technology – the mRNA vaccine, ” said Dr.Shannon Stokley, Co-Lead of the Vaccine Task Force, CDC Emergency COVID-19 Response.And these vaccines have been proven safe and effective at preventing complications of covid 19 including severe disease, hospitilizations and death.”
“Our goal is to get to a point where COVID-19 is no longer disrupting our daily lives.”
Vaccine hesitancy and breakthrough cases
If you are boosted, you are 21 times less likely to die from COVID-19.
And yet, vaccine hesitancy exists – not just from an ideological point of view but also from skeptical folks who know of breakthrough cases of getting COVID-19 even after a vaccine?
“We do know that over time with vaccines, you have waning immunity and that is why we are recommend boosters, ” said Dr.Stokely. “Vaccines are very good at preventing severe outcomes like hospitalization or death.” It is possible to get an infection even after vaccination but usually the symptoms are mild and not as severe as those who have never been vaccinated.
Getting a COVID-19 vaccine after you recover from COVID-19 infection provides added protection to the immune system. People who already had COVID-19 and do not get vaccinated after their recovery are more likely to get COVID-19 again than those who get vaccinated after their recovery.
Vaccine and testing inequities in the US and around the world
Testing in the US is free and widely available but in some parts of the country, people don’t have access to it. The good news is that the US government today provides home testing to all with a mailing address.
The Senate halted $10 billion in funding for COVID-19 vaccines, therapeutics and research. It cut $5 billion in funding for global aid, which many experts say is crucial to block development of new variants that could impact U.S. citizens. The deal also eliminated support for tests, vaccination and treatment of uninsured people.
“We live in one world and we are only as safe as a plane ride away,” reflected Dr.Brooks. Untreated COVID-19 infections are the source of new variants. Preventing infection can stop the emergence of new variants and reduce the threat of Covid worldwide. “These are good reasons to want to provide vaccines to everyone possible.”
Two Years In
“It is very hard sometimes during a pandemic, when we are forced to think about ourselves, to recognize the difference between those things that are a matter of personal choice and those things in the realm of community responsibility,” observed Dr.Brooks. “With each pandemic, I hope we learn how to manage those boundaries better and we don’t let our personal fear override our ability to respond confidently to what is ahead of us.”
We are in it together – all across the world. Let’s not forget that.
Anjana Nagarajan-Butaney is a producer at DesiCollective and a 2021 and 2022 grantee from the USC Center for Health Journalism, reporting on domestic violence in the South Asian community. She is interested in strengthening communities by exploring the intersection of politics, science & technology, gender equality, social justice and health.
Photo by Alin Luna on Unsplash