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WASHINGTON — States with low coronavirus vaccine booster rates could see COVID-19 deaths rise as strains of the Omicron variant spread across the U.S., White House pandemic response coordinator Dr. Ashish Jha warned on Sunday.
“There is an important pattern emerging in the Northeast that helps chart the path forward,” Jha wrote on Twitter. He and others have tried to tamp down concerns about the new surge in cases while pointing to readily available means for keeping people out of hospitals — and morgues.
Infection rates in New England and the mid-Atlantic have been rising for weeks, driven by BA.2, a subvariant of Omicron. Other subvariants, including BA.2.12.1, BA.2.13, BA.4 and BA.5, have also been detected, with BA.2.12.1 in particular gaining a foothold in the United States. These new subvariants “show potential higher transmissibility over BA.2,” according to one recent study.
Previous infection from the original Omicron variant seems to offer little protection against reinfection by the newest subvariants. And although these new strains also have the ability to break through the firewall of vaccines, booster shots seem to bolster protection — making booster rates an especially telling indication of how states might fare in the coming weeks.
“We have to accept that COVID-19 is here with us, and what needs to be done is to use the tools at our disposal to live with the disease while also protecting the vulnerable,” George Washington University public health professor Dr. Leana Wen told Yahoo News in a text message.
Not all states have embraced those tools — vaccines, boosters and treatments — with equal enthusiasm. Masking has become a matter of choice, and Democratic states are as open as those governed by Republicans. The nation marked its 1 millionth death from COVID-19 last week.
“It's extremely difficult to avoid getting infected with the coronavirus,” Wen said.
The White House is also warning that unless Congress provides $22.5 billion in funding, the nation will be unprepared for a fall wave, which the Biden administration predicts could infect 100 million Americans. “That is the key thing,” a White House official who works on pandemic response told Yahoo News about a new round of funding. Jha reiterated that message. “If Congress does not do that now, we will go into this fall and winter with none of the capabilities we have developed over the last two years,” he told ABC on Sunday.
With summer approaching and new coronavirus subvariants spreading, and with congressional funding and Americans’ patience both dwindling, the Biden administration has been faced with a dilemma about how to describe the present pandemic moment. There is unlikely to be the kind of declaration of victory President Biden offered from the White House on Independence Day last year.
But there also seems to be little appetite for the kinds of restrictions that followed the original Omicron wave earlier this year, when schools and businesses shut down again and some worried that 2022 would look all too much like 2020. The vast majority of Americans have some form of immunity from the coronavirus, either from previous infection or from vaccination. And though the new strains of Omicron are more transmissible, they do not cause more severe illness.
“I expect this next wave to be much smaller than the one we had in January,” North Carolina State public health professor Julie Swann told USA Today.
In other words, keep calm and carry on — as long as you’re vaccinated and boosted, properly assessing your risk, masking on public transit and isolating if you do get sick. Some may find such qualifications burdensome, but public health officials — and many Democratic elected leaders — insist that they are a prerequisite for a healthful return to normal living.
“We’ve entered the endemic phase where we (unfortunately) accept that COVID isn’t going away while surging resources to our highest-risk patients and populations,” Washington, D.C., physician Lucy McBride told Yahoo News. “We cannot eliminate risk; we can only mitigate it. And we know how to do that: with vaccines, ventilation and vigilance protecting the vulnerable.”
The Gridiron Club gala and the White House Correspondents’ Association dinner, both held in Washington, D.C., in April, saw attendees test positive for the virus. New York City Mayor Eric Adams tested positive for the coronavirus last month, as did Vice President Kamala Harris; New York Gov. Kathy Hochul announced her own asymptomatic coronavirus infection on Sunday.
But while some decried these as examples of society rushing prematurely to reopen, others argued that communities that had taken the right measures were justified in returning to normal.
Jha was among the attendees at the correspondents' association gala, as was the president. Neither wore a mask. The event reportedly angered Dr. Anthony Fauci, the president’s top medical adviser. He had been slated to attend, only to announce he would stay away from the festivities, which had been canceled for the past two years; Politico subsequently reported that Fauci saw the dinner as “a troubling sign that many Americans no longer view COVID as a serious threat.”
Jha’s thread on Twitter was a kind of rebuttal to Fauci, who had himself recently said that the “pandemic emergency” was over, only to revise that comment after criticism.
The U.S. as a whole is now seeing an average of about 70,000 new cases per day. By contrast, there were only 25,000 new cases per day across the country in March. But public health officials have said for months that infection rates themselves are a poor indicator of the state of the pandemic. Guidelines revised by the Centers for Disease Control and Prevention earlier this year stressed hospitalizations as a more accurate indicator of a community’s risk level.
As Jha noted, infection spikes in states like Connecticut, Massachusetts and Rhode Island are not as concerning as they would have been in 2020. “We're seeing a real split between cases and deaths,” he wrote. COVID-19 deaths tend to follow infection spikes by several weeks. They have remained exceptionally low across New England and the mid-Atlantic states, suggesting that the spike that began there in March has killed few people.
Jha pointed out that the case fatality rate (the number of deaths divided by the number of cases) had fallen to 0.3% in parts of the Northeast, about a fifth of what it had previously been. New York City, once the center of the coronavirus epidemic with thousands of deaths daily, is now recording about five COVID-19 deaths per day.
High booster rates help explain the differential. The original vaccine dose’s protection deteriorates over time but can be restored by a booster. Individuals older than 50 are now eligible for a second booster shot.
What was once deemed “the pandemic of the unvaccinated” has fractured yet again with differential booster rates. Only 30% of the U.S. population is boosted. Rates are highest in the Northeast, with 83% of people above the age of 65 — the population most likely to suffer from severe illness — boosted in Vermont. By contrast, only 36% of the elderly are boosted in North Carolina, and only 48% in Alabama.
Those areas could see hospitalizations and fatalities rise more steeply than they have in the Northeast, Jha warned on Sunday. “Unfortunately, other parts of our nation have lower booster rates and less testing, so the virus can spread more easily without detection. And the population is less well protected — which worries me for the weeks/months ahead as BA.2.12.1 spreads to other, less boosted places.”