USA TODAY International Edition

‘ I don’t think it’s done with us,’ experts caution

Summer forecast is for smaller wave of cases

- Adrianna Rodriguez

The past two pandemic summers saw a spike in COVID- 19 cases, hospitaliz­ations and death, but this season may be different.

Though health experts expect cases to rise, they said the wave won’t be as devastatin­g as the previous two summers or the surge of the omicron variant of the coronaviru­s.

Unlike the previous summers, most of the U. S. population has some immunity against the coronaviru­s from vaccines, boosters and previous infections. People have access to antivirals that can prevent hospitaliz­ations in the unvaccinat­ed.

However, immunity wanes and new variants could evade what protection remains.

“I know we all want to be done with COVID, but I don’t think it’s done with us,” said Dr. Jessica Justman, associate professor of medicine in epidemiolo­gy and senior technical director of ICAP at Columbia University’s Mailman School of Public Health.

Coronaviru­s trends in the spring give experts clues about what to expect this summer. Cases plummeted after the omicron surge in the winter, then plateaued and began to rise again in the spring.

A USA TODAY analysis of Johns Hopkins data shows the pace of cases doubled in April compared with the month prior to about 54,000 per day. The average pace of deaths fell to 327 per day, about half of where it was at the end of March.

The month ended with 17,288 COVID- 19 patients in the hospital, not far above March’s ending of 16,032.

Though the unpredicta­ble coronaviru­s makes it difficult to pinpoint what the summer will look like, experts have a few theories.

The worst- case scenario is the emergence of a potent variant that isn’t dulled by vaccines and previous infections, causing a large wave of cases, hospitaliz­ations and deaths.

“A full surge over the summer is going to be really dependent on a variant fully emerging. That tends to be the biggest trigger that will send us into a surge,” said Dr. Keri Althoff, professor of epidemiolo­gy at the Johns Hopkins Bloomberg School of Public Health. “Those transmissi­ble variants are good at finding pockets of unvaccinat­ed people, and those people are more at risk of hospitaliz­ation and death.”

The best- case scenario is a sustained level of low transmissi­on and no new variants.

Julie Swann, a professor and public health researcher at North Carolina State University, expects the situation this summer to land in the middle: a small wave throughout the country with a slight uptick in hospitaliz­ations and deaths.

Areas likely to be most affected by this swell are ones not heavily affected by the omicron variant where people haven’t mounted immunity protection.

“I expect this next wave to be much smaller than the one we had in January,” she said. “In the U. S., there are communitie­s that have had less exposure to this virus, and so ( they will) likely have a large impact from the virus in the next few weeks and months.”

Barring a devastatin­g variant, most health experts agree, the country may finally be out of the acute pandemic phase.

It’s still far from an endemic phase, when COVID- 19 would become like the seasonal flu, bringing a week or two of misery but low risk of severe disease or death.

“We’re in the middle,” Justman said. “I hope that we are moving towards endemic, but I can’t say that we’re endemic because I don’t feel like things are predictabl­e, yet.”

For COVID- 19 to be considered endemic, Althoff said, scientists must determine an acceptable level of transmissi­on. That hasn’t happened.

“We don’t have an agreed- upon baseline level of COVID that occurs in communitie­s for years and decades and lifelongs to come,” she said. “We have to figure out what that level is and agree ( on it) as a reasonable level of disease.”

A virus also can be considered endemic when it follows a predictabl­e pattern, Justman said.

For example, health officials can predict each year when the flu season will start and end, what strains may appear and how many cases may occur. SARSCoV- 2 hasn’t shown a discernibl­e seasonable pattern.

“We would all agree that we’re not in a place where we can predict how many cases there will be and what the locations of those case numbers will be,” Justman said. “We don’t know what’s coming.”

An endemic virus doesn’t disrupt people’s lives, Althoff said, and that’s not the case with COVID- 19.

When people test positive for the coronaviru­s, they have to isolate from family members, quarantine, wear a mask and avoid travel. Sometimes a person is pulled out of school or works from home and must notify close contacts.

“Is the virus still disrupting our lives? Absolutely it is,” Althoff said.

Although the virus hasn’t entered an endemic phase, health experts hope the country is on its way. The first step is to prevent severe illness, so a surge in cases doesn’t lead to more hospitaliz­ations and deaths, Justman said.

The best way to do this is for Americans to stay up to date with their vaccines and practice mitigation measures to keep vulnerable loved ones safe.

“I’m hopeful that we’re approachin­g the point where we can disconnect the surge in cases from a surge in hospitaliz­ations,” Justman said. “That’s where we want to go.”

Contributi­ng: Karen Weintraub and Mike Stucka 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.

 ?? MATT ROURKE/ AP ?? Customers visit the Reading Terminal Market in Philadelph­ia on April 22 after the city abandoned its indoor mask mandate.
MATT ROURKE/ AP Customers visit the Reading Terminal Market in Philadelph­ia on April 22 after the city abandoned its indoor mask mandate.

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