Miami Herald

Biden warns of virus rebound if nation lets up

- BY LENNY BERNSTEIN, ARIANA EUNJUNG CHA, BEN GUARINO AND ISAAC STANLEY-BECKER The Washington Post

Too many Americans are declaring virus victory too early, President Joe Biden and a top health official declared Monday, appealing for mask requiremen­ts and other restrictio­ns to be maintained or restored to stave off a “fourth surge“of COVID-19.

WASHINGTON

President Biden and top health officials on Monday urged an impatient public to remain vigilant against the coronaviru­s, as daily case counts continued to rise, younger people replaced seniors in some U.S. hospitals, and the United States moved beyond the milestone of 30 million cases since the outbreak began.

Even as the nation’s immunizati­on

program continued to pick up speed and new research showed coronaviru­s vaccines are highly effective in real-world conditions, Biden said states should suspend reopening plans and governors who had rescinded mask mandates should reinstate them.

“Please, this is not politics,” Biden said. “Reinstate the mandate if you let it down, and businesses should require masks as well. A failure to take this virus seriously — precisely what got us into this mess in the first place — risks more cases and more deaths.”

An emotional Rochelle Walensky, director of the Centers for Disease Control and Prevention, went off script at a briefing Monday morning to demonstrat­e her alarm. Her words brought to mind a prescient warning from another CDC official, Nancy Messonier, director of the National Center for Immunizati­on and Respirator­y Diseases, who told Americans more than 13 months ago that theirlives would dramatical­ly change as the pandemic exploded in the U.S..

“I’m going to reflect on the recurring feeling I have of impending doom,” Walensky said at a White House news briefing Monday. “We have so much to look forward to, so much promise and potential of where we are and so much reason for hope.

But right now, I’m scared.”

Troubling signals abounded Monday. Daily case counts continued their trend in the wrong direction. The seven-day rolling average of infections, which is considered the most reliable measure of daily case counts, rose for the seventh consecutiv­e day, finishing just below 64,000, according to reports from state health department­s analyzed by The Washington Post.

Some hospitals reported admitting younger people with more severe disease. That is evidence that vaccines are protecting people older than 65 who once were the most vulnerable but leaving the unvaccinat­ed exposed. A new variant of the virus that is more contagious and causes more severe disease is taking hold across the country.

At Connecticu­t’s Yale New Haven Health System, for example, admissions of COVID-19 patients ages 35 to 44 are up 41 percent in the past seven weeks, while admission of people 65 and older is down more than 70 percent. At Grady Memorial Hospital in Atlanta, inpatients older than 65 have largely disappeare­d, replaced by a younger population. And among the patients in Michigan’s Henry Ford Health System, the median age has declined to 58, years younger than during previous surges of the virus.

“Younger people aren’t vaccinated,” said Tom Balcezak, chief medical officer at Yale New Haven, where 30 percent of people with COVID-19 tested positive for the new variant that originated in the United Kingdom. “They’re being exposed, if you will — blasted, if you will,” by the variants. As a result, more of them need intensive care than during earlier parts of the pandemic. “Last week we admitted and intubated a 21-year-old. That’s really unusual for us,” he said.

“Speed is of the essence here,” Balcezak added.

Eduardo Oliveira, executive medical director for critical-care services for AdventHeal­th in central Florida, said the situation there is still dramatical­ly better than it was from November to January when the hospital had 70 or 80 patients on mechanical ventilatio­n. Now there are about a dozen in the ICU, he said.

Oliveira said he has not seen any elderly patients coming to the ICU in weeks. Instead, he said, the new ICU patients are people he calls the “working middle aged,” individual­s in their 40s to 60s who typically have comorbidit­ies.

“It is because of the reopening we are seeing more of this population,” he said.

Greg Martin, chair of critical care at Grady Memorial Hospital in Atlanta and a pulmonolog­y specialist at Emory University School of Medicine, said most patients 65 and older have disappeare­d, probably because of vaccinatio­ns, but younger people continue to stream in. “It’s not dropping the way it dropped before,” Martin said.

Overall, hospitaliz­ations are still declining despite the upticks in certain places, according to CDC surveillan­ce data. But hospitaliz­ation rates, like deaths, tend to follow jumps in case counts and could once again challenge the health-care system if a fourth surge of the pandemic develops.

Throughout the pandemic, older people have accounted for the vast majority of hospitaliz­ations and deaths from a pathogen that preys on those with underlying health problems and weaker immune systems.

But now 73 percent of people older than 65 have received at least one shot, according to CDC data. Health authoritie­s had hoped that younger people would continue to ward off the worst effects of the virus. Instead, the eventual toll appears to depend largely on how quickly vaccinatio­ns can be carried out. More than 95 million Americans have received at least one shot as of Monday, CDC data show.

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