Another COVID-19 surge may be coming
Scarcely two months after the omicron variant drove coronavirus case numbers to frightening heights in the United States, scientists and health officials are bracing for another swell in the pandemic and with it the first major test of the country’s strategy of living with the virus while limiting its effects.
At local, state and federal levels, the nation has been relaxing restrictions and trying to restore a semblance of normalcy. Encouraging Americans to return to pre-pandemic routines, officials are lifting mask and vaccine mandates and showing no inclination of closing down offices, restaurants or theaters.
But scientists are warning that the U.S. isn’t doing enough to prevent a new surge from endangering vulnerable Americans and potentially upending life again.
New pills can treat infections, but federal efforts to buy more of them are in limbo. An aid package in Congress is stalled, even as agencies run out of money for tests and therapeutics. Though less than one-third of the population has the booster shots needed for high levels of protection, the daily vaccination rate has fallen to a low.
While some Americans may never be persuaded to roll up their sleeves, experts said health officials could be doing a lot more, for example, to get booster shots to the doorsteps of older people who have proved willing to take the initial doses.
“You use the quiet periods to do the hard work,” said Jennifer Nuzzo, a public health researcher at Johns Hopkins Bloomberg School of Public Health. “You don’t use the quiet to forget.”
The clearest warnings that the brief period of quiet may soon be over have come from Western Europe. In a number of countries, including Britain, France and Germany, case numbers are climbing as an even more contagious subvariant of omicron, known as BA.2, takes hold.
In interviews, 10 public health researchers and infectious disease experts said many of the ingredients were in place for the same to happen in the U.S.
Case numbers are still dropping nationally, but BA.2 accounts for a growing proportion of those infections, rising to almost onequarter of new cases last week. The subvariant is estimated to be 30 percent to 50 percent more contagious than the previous version of omicron, BA.1.
In New York City, average daily case numbers rose by roughly 40 percent over the past two weeks, though they remain extremely low when compared with recent months. In Connecticut, scientists estimate that the frequency of BA.2 infections is doubling every seven or eight days — half the rate of omicron’s growth this winter but considerably faster than the delta variant’s 11-day doubling time before that.
“I expect we’ll see a wave in the U.S. sooner than what most people expect,” said Kristian Andersen, a virus expert at the Scripps Research Institute in La Jolla, Calif. He said it could come as soon as April, or perhaps later in spring or early summer.
And given that some cases inevitably turn more serious, Andersen said, “yes, such a wave would be accompanied by rising hospitalizations and deaths.”
Some experts cautioned, however, that BA.2 had not driven up case numbers in every country where it emerged. In a best-case scenario, they said, even if U.S. case numbers started climbing, leftover immunity from the first omicron wave this winter could help protect against a heavy surge of hospital admissions. And a shift toward outdoor socializing could temper an increase in case numbers.
In trying to forecast what lies ahead, U.S. health officials and scientists have debated what mixture of factors has driven up case numbers in Europe and just how serious the wave there could get.
BA.2 began its march across Europe around the time that certain countries were lifting restrictions and mask mandates, potentially giving it extra kindling for its spread. Some scientists in Britain have also attributed that country’s surge in part to immunity tending to weaken over time after vaccinations or earlier infections.
In the U.S., scientists are concerned that many people have gone more than six months since their last doses of vaccine, reducing levels of immunity. Pfizer and BioNTech have asked U.S. regulators to authorize fourth doses in older people, and Moderna is seeking clearance for the additional shots for all adults.
It is less clear whether relaxing COVID-19 rules in the U.S. will help fuel transmission to the same degree that it may have in some European nations. Parts of the U.S. have effectively been without restrictions for months.
“There are lots of moving parts,” said David Dowdy, a public health researcher at Johns Hopkins University. “It’s really difficult to disentangle which of these is driving any given wave.”