As COVID-19 Cases Surge Again, Public Health Leaders See A Turning Point
MARY LOUISE KELLY, HOST:
For a few months, it looked like COVID-19 was retreating in the U.S. Then...
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UNIDENTIFIED REPORTER #1: Infection rates in the Northeast approaching the highest levels now in nearly three months.
KELLY: Yeah. COVID cases are rising across the country again.
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UNIDENTIFIED REPORTER #2: ...Pushing New York City to raise its alert level from low to medium risk.
KELLY: The increase was concentrated in the Northeast at first.
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UNIDENTIFIED REPORTER #3: California is once again seeing a jump in COVID-19 cases.
UNIDENTIFIED REPORTER #4: Last week, Illinois reported nearly 4,000 new...
UNIDENTIFIED REPORTER #5: COVID infections are rising in Hawaii. And there's...
KELLY: Still last week, Dr. Anthony Fauci, President Biden's chief medical adviser, told PBS's NewsHour's Judy Woodruff...
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ANTHONY FAUCI: What we hope to do - I don't believe, and I've spoken about this widely - we're not going to eradicate this virus. If we can keep that level very low and intermittently vaccinate people - and I don't know how often that would have to be, Judy. That might be every year. That might be longer in order to keep that level low. But right now, we are not in the pandemic phase in this country.
KELLY: Now, as you might have heard earlier this week on this podcast, Fauci later clarified to NPR the pandemic is not over. But with severe hospitalizations and deaths down from previous phases, Dr. Fauci suggested the U.S. is in transition into an endemic phase. CONSIDER THIS - public health leaders are signaling that the U.S. is turning another corner in this pandemic. And a new COVID surge may just be part of the new normal.
ANDY SLAVITT: It just means it's following a predictable pattern.
KELLY: We'll explore what the latest variant could have in store for the U.S. and what the endemic phase could look like.
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KELLY: From NPR, I'm Mary Louise Kelly. It's Friday, May 6.
It's CONSIDER THIS FROM NPR. Cases are still low across the U.S. overall, but scientists are concerned about a new variant.
MICHAELEEN DOUCLEFF, BYLINE: It has a complex name. It's called BA2.12.1. It's a mouthful.
KELLY: A mouthful, indeed. That is NPR's Michaeleen Doucleff, who's been reporting on this new version of omicron.
DOUCLEFF: Basically, the omicron variant picked up several mutations that give it an advantage and help it spread faster than the previous version, about 50% faster.
KELLY: Doucleff told my co-host Ari Shapiro that while the latest variant is most common in New York, New Jersey and the mid-Atlantic, it's present throughout the whole country. We pick up their conversation there.
DOUCLEFF: Given its current trajectory, it will likely dominate the outbreak here in the U.S. within a month or so. In terms of whether it will cause another wave, I was talking to Shishi Luo about that. She's a bioinformatician at the company Helix, which tracks variants across the country. She says there's little doubt that this new variant will cause a surge in cases.
SHISHI LUO: Because the current trajectory is that it's growing, and we're seeing rises in new cases. And we're seeing wastewater levels go up. So I think the question is how high will it go before it peaks? I don't know the answer to that. It really just depends on people's behavior and the weather how big of a bump it is.
DOUCLEFF: So this bump or surge she's talking about will likely occur in about a month or two, she says.
ARI SHAPIRO, BYLINE: So you're telling me that if last summer vacation was all about the delta variant, vacation this summer is going to be BA2.12.1.?
DOUCLEFF: Yes. It might get another name by then, but yeah. And, you know, this prediction is supported by what's happening in South Africa right now. That country has a new variant - or two variants that are very similar to the one here in the U.S. And it's already causing a surge there. And the U.S. tends to be about six weeks behind that country. Fortunately, though, scientists don't think this next wave will be as big as the surge we had last summer - or sorry - last winter, which perhaps, you know, half of Americans caught omicron back then.
SHAPIRO: But if half of Americans caught omicron last winter and so many Americans have been vaccinated, how could a version of omicron cause a surge when so many Americans are protected?
DOUCLEFF: You know, that is a really great question. And two preliminary studies that came out this week start to answer it. And what these studies found is these new versions of omicron, both here in the U.S. and in South Africa, picked up just a few mutations that allow them to overcome or evade immune protection generated by a prior infection with omicron. So these new variants likely can reinfect people who have already had omicron. I was talking to Pei-Yong Shi about this. He's a virologist at the University of Texas Medical Branch in Galveston. He says omicron is really unique because it has an incredible ability to change or evolve in a way that allows it to just zoom past the immune system, and it does this very quickly.
PEI-YONG SHI: In terms of the ability to evade antibodies, omicron is a master player. It's way more efficient than all the previous variants. Like, in this case, sometimes you just need one key mutation there that can totally flip things around.
DOUCLEFF: But Shi emphasized that there's no sign this new variant causes more severe disease compared to the previous omicron.
SHAPIRO: Well, that's good news. How about the effectiveness of the vaccine against this new variant?
DOUCLEFF: You know, generally, the vaccine probably won't offer much protection against infection, especially over the long term. But scientists do think it will still offer excellent protection against severe disease and hospitalization. But you do need the booster - so three doses of the mRNA vaccine. And if you're over age 50, health officials recommend you get a fourth dose or a second booster about four months after the first one. That will give you a little more protection against severe disease, especially if you're at high risk. So, Ari, really, you know, the hope here is that although cases will probably surge again at some point, maybe this summer, hospitalizations won't because, as you said, the majority of Americans now have some protection.
KELLY: That was NPR's Michaeleen Doucleff speaking with my co-host, Ari Shapiro.
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KELLY: So what else are experts saying about the next phase of the pandemic? Well, let's go back to that term endemic and what it means. Here's Andy Slavitt, former senior adviser to President Biden on COVID and former head of Medicare and Medicaid in the Obama administration.
SLAVITT: The best definition of endemic that I've heard is just when the surprises are gone, and it becomes predictable.
KELLY: Which does not mean we'll be totally in the clear.
SLAVITT: Endemic doesn't necessarily mean everybody's safe. Endemic doesn't necessarily mean people are no longer losing their lives. It just means it's following a predictable pattern.
KELLY: The challenge - how will we know when we've crossed over into the endemic phase?
SLAVITT: What we don't know but we may be witnessing are some clues as to what a predictable pattern will look like when we settle into one.
KELLY: Slavitt spoke with my co-host, Adrian Florido.
ADRIAN FLORIDO, BYLINE: Why is it so important for us to know that we're in an endemic phase, assuming we get there at some point?
SLAVITT: I think the real question is, what are the tools that we need to have as a country in order to live as normal life as possible? The best news of all is that we have incredible scientific tools - vaccines, boosters, oral therapeutics. And while none of them are perfect on their own, when you combine them with what our own immune system does and the continued kind of improvement of these tools, the layered immunity we have, COVID should become less and less fatal. It will still be dangerous and is still dangerous for people who are frail, people who are immunocompromised. But even in those situations, the tools are better and better. So what we really want to know is, is it going to get any more severe, and is it going to get any more frequent, and are the vaccines and tools we have going to continue to work? And if we are in a situation where we need to update our vaccines once or twice a year, we need to be prepared to do that.
FLORIDO: What are the unknowns out there that could change your assessment about how close we're getting to an endemic phase of this disease?
SLAVITT: So scientists talk about this notion of drift versus shift. And what they mean by that is a drift virus would indicate that we will just continue to see more progressions almost laddering up of new omicron waves - 1.1, 1.2, 1.3, 1.4. And a drift is a better scenario than a shift. A shift is where we would get an entirely new Greek letter, in this case, with completely different mutations and characteristics. What's better about a drift is that our body is, generally speaking, forming better immunity in prior versions that protect us against newer versions. And our vaccines will, generally speaking, be more aligned to what we see next than they would be if we were to see a shift. So the big question is, are we going to be in drift mode and for how long will we be in drift mode, or are we going to go back to shift mode, where we'll see a delta, an omicron, etc.? No one knows the answer, but there are a number of scientists who say that the number of times we'll see a major shift could be pretty rare, could be as infrequently as once a decade.
FLORIDO: And what are the factors that determine whether the virus progresses in the drift or shift direction?
SLAVITT: Well, unfortunately, this virus has shown itself to be wily and continued to surprise us more than many other types of viruses have. So if we were to see something that replaced omicron with something, you know, more significant, it would be much more contagious. And for that to have happened, it would mean that there's someplace in the world, likely in someone's body, where it's been replicating and replicating, and it breaks out. It could also happen in the animal kingdom because we know that the coronavirus travels between humans and animals and back. So you can't rule any of those things out. But what the question becomes is, how likely is it to happen? - not whether it will happen. And how likely it is to happen will determine how frequently it will happen.
FLORIDO: As you said, the predictability that comes from the endemic phase will help us figure out what kind of public health measures to use, but I wonder if it'll also discourage people from taking precautions like masks and vaccinations.
SLAVITT: Well, predictability will be a good thing. You know, if we knew that we were going to see COVID-19 every June and every December, we might not like that, but at least it would tell us that we can take the kinds of precautions that we need to take then, and we don't need to take them other parts of the year. What bothers people is feeling like they're taking precautions in periods of time when it doesn't matter. So we know we don't give people flu shots in April, May and June because the risk of the flu is quite low then. So if we understand this well enough and it becomes predictable enough, I think you can then create targeted campaigns to say, hey, every time that this happens, these are the precautions we ought to take. We ought to wear masks. We ought to stay away from these types of crowds and these types of situations if we're immunocompromised. But other times of the year, go on. Live your life. Things will be more or less safer.
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KELLY: That is NPR's Adrian Florido talking with Andy Slavitt. He's a former Biden and Obama administration official, author of "Preventable" and the host of the "In The Bubble" podcast.
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KELLY: It's CONSIDER THIS FROM NPR. I'm Mary Louise Kelly.
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