Warning signs for the US as Covid cases rise in Europe

Cases and deaths from Covid-19 have dropped in the US, but warning signs and rises in other countries are prompting experts to take future and existing variants of the virus seriously – and they warn that America has not yet reached the endemic phase.

It is important to prepare now for the next climb or variant, whether it is BA.2 or another, experts say.

Related: Again, America denies signs of a fresh Covid wave | Erik Topol

Although it is not yet clear whether BA.2, a subgenus of Omicron, will cause another rise so rapidly in the heels of the first Omicron outbreak, it shows worrying signs of being able to re-infect those who came earlier himself from Covid, as his sibling BA.1.

“I would not be surprised if in the next few weeks we see something of either a flattening of our reduction or maybe even an increase,” Fauci told the ABC News podcast Start Here, ABC reported Friday.

Regarding the UK, which sees an upward trend in cases, Fauci said: “Their use of intensive care units is not increasing, which means they are not seeing an increase in serious illness.

“Whether it will lead to another increase [in the US]a mini-wave or maybe even a moderate increase is very unclear because there are a lot of other things going on right now, “Fauci said.

Several countries in Europe are experiencing another increase now, and early indicators, such as wastewater monitoring, show that cases may start to tick up again in the US. But it is not clear whether the reason for the increase is due to the variant’s increased transferability or its ability to evade immunity, or the countries’ relaxed precautions and declining immunity – or all of the above.

“It’s really, really hard to answer definitively because everything happens at the same time,” said Aris Katzourakis, a professor specializing in virus development at the University of Oxford. But he and other researchers warned Monday that other variants will emerge, and they may be more serious than variants we have seen before.

While Omicron is less severe than Delta, Delta was more severe than previous variants.

Researchers in particular are keeping an eye on BA.2 for evidence that it is capable of re-infection after previous battles with Covid.

“This is the most important and challenging scientific issue right now in the field of Sars-CoV-2 epidemiology,” said Samuel Scarpino, a mathematical epidemiologist and executive director of pathogen monitoring at the Rockefeller Foundation’s Pandemic Prevention Institute.

“It is very unusual to see an increase followed by another increase in rapid succession. When that happens, it is almost always a sign of some form of immune evasion.”

The U.S. is often three to four weeks behind increases in the UK, Scarpino said. “I think all the signs are pointing to an increase in BA.2 in the US, but what we’re seeing in Europe has just started to happen in the last week and a half – so it’s still early days , which means there is a lot of uncertainty. “

It is not yet clear how bad such a wave would be, especially given prior immunity from the recent rise and changes in behavior.

“There are more unanswered questions about this than any previous variant,” he said.

Understanding the nature of new variants is more complicated than it was when Covid first appeared, he added. Now huge sections of the population have very different levels of protection, whether from vaccination or from previous infection, which may have arisen a year or two ago and started to fade. Only 44% of the U.S. population has been boosted.

That makes vaccination and booster campaigns even more important in preparation for upcoming hikes, Scarpino said. “It takes weeks to build immunity; sometimes it takes weeks and weeks to get the campaigns rolled out. We really need to get on with this now. “

That’s because there will undoubtedly be another variant of concern, even though BA.2 is buzzing, he said.

There is “a real and credible risk that there may be another increase and we just have to make sure that people are aware of this and that we have plans to respond to ensure that we are not left in the middle in all this again in a month ”.

Still, the Biden administration has announced that it is running out of Covid funds, which could create huge gaps in its ability to respond to this and other variants.

Joe Biden gets his booster in the White House last September.

Joe Biden gets his booster in the White House last September. Photo: Kevin Lamarque / Reuters

Part of the problem is centered around a misunderstanding of what happens when a virus becomes endemic.

Endemicity has a very narrow definition in epidemiology. A pathogen is considered endemic when the number of people susceptible to the virus equalizes the reproductive rate, creating a constant number of cases each year.

In other words, it is regular and predictable enough because populations have a certain level of immunity that experts have a certain ability to predict what will happen.

Some commentators have suggested that the United States has already reached this state – and perhaps more worryingly, they have assumed that the virus will inevitably develop into milder.

“Both are problematic,” said Katzourakis, who has also written about the damage caused by endemic viruses. This virus is still out of control, and “we do not know what and when it will come next”.

“Endemic” also does not mean “safe”, Scarpino said – and that does not mean officials give up fighting the virus.

Endemic viruses, like the flu, also mutate regularly to create epidemics or even pandemics, he said. And “the more the virus circulates uncontrollably in the population, the greater the chance of another variant that will destroy our optimistic hopes”.

The biggest concern now is that officials seem to be giving up control of the virus. “It seems like a very, very risky situation to be in,” Katzourakis said. “That’s the real danger here – accepting that we do not have to do anything to control the virus. more problems.”

This is one of the reasons why close monitoring of viruses is still important, even after they have been embedded in human populations.

Scarpino compares this type of work to weather forecasting. “People complain a lot about the accuracy of weather reports, but weather reporting is actually pretty accurate,” he said. If schools close due to bad weather, they usually have an idea of ​​how long these closures will last – think of days, not months.

The United States needs a similar pathogen prediction system, he said. “If you have real-time information, we can keep schools open … We can save lives.”

A big part of that is having very up-to-date information that is clearly communicated. Right now, CDC data is lagging by about two weeks, making it hard to understand what is happening.

Understanding that viruses like Sars-CoV-2 will evolve to pose new threats, and monitoring them closely, gives managers time to prepare for major increases.

“Early action is always better,” Scarpino said. “If we’re starting to see cases rise, we may need to take more action.

“As much as I and everyone else want this to be over, it’s not over.”

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