Five times in the last two years, coronavirus cases in Europe increased a few weeks before they increased in the United States.
Now the cases are rising again in at least a dozen European countries from Finland to Greece. And they’re shooting up in South Korea, Hong Kong and parts of mainland China.
Experts here are concerned that some of these countries may predict our future.
“We’re learning a lot about the next wave that’s going to happen in the United States,” said Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California. “It’s going to happen. It’s inevitable.”
Researchers say they are not yet sure if the United States is heading for another tsunami of cases or just a bit of a bump.
“It will be a wave of a kind whose size is unclear,” Topol said.
Predictive models may indicate that a wave of infections is on the way, but can not say exactly how large that wave will be, said Dr. Joshua Schiffer, an infectious disease expert at the Fred Hutchinson Cancer Research Center in Seattle, who specializes in developing mathematical disease models.
This is because so much of an outbreak is determined by how people react. “The answer to this question goes far beyond what we can explain with science,” he said.
The best way to describe the moment we are in now in the pandemic, Schiffer said, is “messy”.
“Everyone knew the ramp from the pandemic would be very bumpy and unpredictable,” Schiffer added. “I’m not even quite sure we’m on the off ramp yet.”
Around the world, infections are largely due to the BA.2 version of omicron, which arrived in the US at the end of last year and has grown slowly since then, and which now accounts for about a quarter of cases here, according to Centers for Disease Control and Prevention. As a percentage of cases, BA.2 has roughly doubled every week in the last month, suggesting it is poised to become dominant.
That was what happened in the UK, which had an equally bad omicron wave that the US had not long ago, and which is now enduring another hit from BA.2.
“It indicates that the virus may be gaining a foothold, but that’s a little hard to say right now,” said Jeffrey Shaman, director of the Climate and Health Program at Columbia University’s Mailman School of Public Health. “Because Britain is ahead of us in this area, it provides a kind of analogy that we can work from.”
In addition to data from other countries, another potential upside indicator also suggests that cases in U.S. cases may be on the rise again. Analysis of coronavirus particles in wastewater – which is rising even before people know they are infected – shows increases in 40% of communities after weeks of national decline. According to the CDC, more than a quarter of the 400 tracked sites have seen at least a doubling of viral particles in the last two weeks, and 53 have seen a 1,000% jump.
The wastewater data is not definitive, and some, including Rob Knight, a professor at the University of California, San Diego, who tracks wastewater on campus and in the surrounding communities, are not convinced that the data is even accurate.
But the Shaman said, “it’s another piece of information that points to being careful, being careful.”
William Hanage, an infectious disease epidemiologist at the Harvard TH Chan School of Public Health, said he can not guess how bad another wave will be, but he knows where it is likely to hit hardest.
“The only thing I’m very prepared to predict is that places with large amounts of unboosted, unvaccinated older people will have a more impact experience with BA.2,” he said.
What the worldwide trends suggest for the United States
COVID-19 increases in Asian countries such as South Korea and China also come after two years of very successful prevention efforts.
Although their populations are highly vaccinated, the shots most common in Hong Kong, for example, are not as effective as Pfizer-BioNTech and Moderna shots used in the United States, Hanage said. And very few people have protection against natural infection.
Omicron is so much more contagious, he said, that it has been impossible to curb infections using the strategies that worked in Asian countries earlier in the pandemic. With previous variants, 2 out of 3 infections had to be stopped to slow the spread. But with BA.2, 7 out of 8 must be stopped, he said, “which is a lot harder to do.”
Hong Kong is particularly “unique and terribly sad,” Schiffer said, because the elderly population remains under-vaccinated, so older people are dying at the same rate as seen in the early days of the pandemic in places like Wuhan, China, parts of Italy. and New York City.
The Chinese mainland is another wild card, Topol said. With infections rising there, it can spur the development of another variant or simply keep the current one in circulation long enough to re-infect people around the world as their immunity fades over time.
It remains to be seen, Topol said, how long the immunity Americans have built up over two years of vaccinations and infections will last compared to the highly contagious BA.2.
Compared to Asia, the current situation in Europe is more similar to ours – and therefore more predictable for our future, experts said. As here, most of Europe has recently lifted mask mandates and other demands for social distancing. BA.2 is gaining ground or is already dominant throughout Europe.
And as with Americans, many people have been vaccinated or have been infected over the past two years, Schiffer said.
But Europe is not the same as the United States.
“There are a number of things that are pulling the American experience away from the European,” Hanage said.
Vaccination and booster rates in many European countries are higher than in the US, so most of the infections in places like Denmark have been mild, Hanage said.
“It’s not entirely clear,” Hanage said why BA.2 has not made more inroads in the U.S. because it appears to be about 20% more contagious than BA.1.
Britain is really the country you have to keep an eye on to get a sense of how bad a new wave can be, Shaman said. It had a recent BA.1 outbreak like ours and is closest to the US physically
“What I think we need to keep an eye on is to really see what’s going on there – whether this is taking off or not, or it’s plateaus or just flames out,” he said. “Because it can give us some sense here in the United States of whether the boost and the latest wave of omicron BA.1 still provide protection against BA.2.”
What to do in case of another increase
There is no doubt that it is easier to stop a wave that has just begun than one that has taken hold, Shaman said.
“The earlier you intervene to short-circuit or disrupt exponential growth or at least slow it down, the better off you will be, the more you will flatten the curve,” he said.
But it can be politically and socially impossible to get ahead of this one, Shaman said, because Americans are so tired of restrictions and mandates.
Earlier this week, Congress declined to support additional funding for President Joe Biden’s COVID-19 preventative measures, which would include funding for tests, treatments, boosters and the development of next-generation vaccines.
The main way to stop coronavirus cases remains the same, Hanage said: get vaccinated, and especially if you are older, boosted. Boost will have the greatest effect on people over 65, he said, because they are most vulnerable to severe outcomes after capturing COVID-19.
Those who are healthy and fully vaccinated and boosted or newly infected are likely to be well protected at the moment, Hanage said. But omicron remains highly contagious, and “it does not disappear just yet – unless something else comes along and displaces it, which I would not rule out.”
Topol said he would like to see the federal government make a big booster push that allows fourth shots for people who want them and encourages vaccinations for those who rely on past infections to protect them.
And while every single decision to wear a mask may not do much to stop the pandemic, Schiffer said, the combination of many people wearing them – especially indoors at potentially super-spreader events – can make a dramatic difference, especially at a time like this, when things seem to be just starting to rise.
“It’s an incredibly effective tool if used on a large scale and most importantly, if people use the best possible mask,” Schiffer said, adding that he understands that asking people to take it is not a simple problem. stitches on again so fast.
America has previously paid the price for not paying attention to early warning signs, such as cases in Europe and rising wastewater levels. Topol said he sees no sign that we have learned from the past mistakes.
“Who is not tired of (the pandemic)? Who does not want this to be over once and for all?” he said. But “one can not ignore the signals. They are unambiguous.”
Cast: Adrianna Rodriguez
Contact Karen Weintraub at [email protected]
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
This article originally appeared on USA TODAY: COVID is rising in Europe and Asia. What does this mean for the United States?