Repeated waves of Covid-19 have left millions dead, with only vaccines helping to reduce the toll. Now the virus is spreading again – evolving, evading immunity and leading to an increase in cases and hospitalizations. The latest version of its shapeshifter, BA.5, is a clear sign that the pandemic is far from over.
The latest Omicron fork, along with a closely related variant, BA.4, fueled a global surge in cases – 30% in the past two weeks, according to the World Health Organization (WHO).
In Europe, the Omicron subvariants caused a jump in cases of about 25%, although Dr. Michael Ryan, executive director of the WHO’s Health Emergencies Programme, said the number may actually be higher as there given the “near collapse of testing”. The BA.5 is on the move in China, raising concerns that major cities there may soon reimpose strict lockdown measures that were only recently lifted. And the same variant has become the dominant strain in the United States, where it accounted for 65 percent of new infections last week, according to the Centers for Disease Control and Prevention (CDC).
“We have watched this virus evolve rapidly. We planned and prepared for this moment. And the message I want to convey to the American people is this: BA.5 is something we’re watching closely, and most importantly, we know how to manage it,” said Dr. Ashish Jha, co-ordinator of the Covid-19 response. at the White House, at a news briefing on Tuesday.
On the same day, the WHO’s Emergency Committee said that Covid-19 remains a public health emergency of international concern — the highest level of alert first declared on 20 January 2020 — amid rising cases, ongoing viral mutation and increasing pressure on already overstretched healthcare systems. In a statement, the commission, which is made up of independent experts, highlighted the challenges facing the ongoing global response to Covid-19, including a drop in testing and spotty genome sequencing, raising the question of how accurately any nation can reasonably be able to monitor BA.5. Official figures dramatically understate the true number of infections in the US, epidemiologists say, leaving the nation with a critical blind spot as the most transmissible variant of the coronavirus still takes hold. Some experts estimate there could be as many as 1 million new infections each day among the broader US population — 10 times the official number.
As for how to manage the new wave, Jha urged Americans age 50 and older to get a second booster shot. Adults who are up to date on vaccinations are less likely to be hospitalized than those who are not vaccinated. But only about one in four U.S. adults over age 50 received their recommended second boosters, data compiled by the CDC show.
US health officials are urgently working on a plan to authorize second Covid-19 boosters for all adults, a senior White House official confirmed to CNN on Monday, amid concerns that immunity in younger adults may be waning as cases of Covid-19 increase with the dominance of BA.5. What makes the BA.5 different? Eric Topol, a cardiologist and professor of molecular medicine at Scripps Research, called BA.5 “the worst version of the virus we’ve seen.” He explained in a recent newsletter, “It takes immune escape, already extensive, to the next level and, as a function of that, improved transmissibility,” far beyond earlier versions of Omicron.
In other words, BA.5 can easily evade immunity from previous infections and vaccines, increasing the risk of re-infection. While the variant doesn’t appear to lead to more severe disease, in an interview with CNN on Monday, Topol said that given BA.5’s level of immune system evasion, he expects to see hospitalizations escalate, as we’ve seen in Europe and elsewhere that the option has become necessary. “One good thing is that it doesn’t seem to be accompanied by ICU admissions and deaths like the previous options, but it’s definitely worrisome,” he added.
Public health experts in the US may take solace in the trajectory of the variant in Europe. The WHO’s Ryan said last week that while many European countries were experiencing a surge in hospitalizations, “what we are not seeing is an increase in intensive care unit admissions, so the vaccines are still working to a large extent and it is these gaps in immunity that are causing the problem.”
But still, the sharp decline in Covid-19 surveillance worldwide is hampering the efforts of epidemiologists as they race to track the evolution of the virus.
“Omicron sub-variants, such as BA.4 and BA.5, continue to result in waves of cases, hospitalizations and deaths around the world,” WHO Director-General Tedros Adhanom Ghebreyesus said at a media briefing on Tuesday. “Surveillance has declined significantly – including testing and sequencing – making it increasingly difficult to assess the impact of variants on transmission, disease characteristics and the effectiveness of countermeasures.”
“The new waves of the virus demonstrate again that Covid-19 [pandemic] it is far from over,” he added.
HE ASKED YOU. WE ANSWERED.
Q: How should I protect myself amid the new wave of Covid-19?
A: At this stage of the pandemic, many people may no longer want to plan their lives around Covid-19 — especially if they are generally healthy. On the other hand, those with underlying health conditions or who have concerns about long-term symptoms are still trying to play it safe. Given how contagious the new Omicron sub-variants are, avoiding infection requires some planning and forethought, explains CNN medical analyst Dr. Leanna Wen.
“I don’t think most people should change their daily activities, but I think people should be aware of the risk of contracting Covid-19 if they don’t take extra precautions,” Wen said. The question you have to ask yourself, she added, is this: How much do I want to continue to avoid infection?
For people looking to reduce their risk, Wen advises keeping up with their boosters (in the U.S., anyone age 5 and older can get a first booster, and those 50 and older can get a second booster for a total of four shot). She also recommends wearing a high-quality N95 mask or equivalent in an indoor, crowded area and staying outside for large gatherings as much as possible—something easier to do in the summer.
“For those who find masks uncomfortable, I would encourage wearing masks in the most risky settings — for example, a mask while in a crowded airport security line and during boarding and disembarking,” she said.
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READING OF THE WEEK
First Covid vaccine mandate imposed in mainland China
Last week, Beijing announced a Covid-19 vaccine mandate for residents who want to enter public facilities, becoming the first city in mainland China to do so as it tries to curb the spread of BA.5, Nectar Gan reports. Those who are “ineligible” for vaccination will be exempt from the requirement, a city official said, without clarifying how they can provide the proof needed for an exemption. The vaccine mandate comes after Beijing reported three cases of the highly contagious Omicron subvariant. Several Chinese cities have imposed new curbs since the opening of BA.5. Shanghai, which only recently emerged from a two-month lockdown, identified its first case on Friday and will carry out two rounds of Covid testing this week. A BA.5 outbreak has already shut down the northwestern city of Xi’an, home to 13 million people, where entertainment, sports and religious venues are closed and restaurants are limited to takeout and delivery services. Casinos in gambling hub Macau were ordered to close for the first time since February 2020 due to the Covid outbreak, sending shares of their operating companies tumbling, and fears of further lockdowns in Shanghai undermined the wider Chinese market. Chinese stocks remained under pressure after Monday’s sell-off, fueled by the threat of new Covid restrictions, particularly in the technology sector, Laura He reports.
Drug-resistant infections and deaths have increased among hospital patients
In recent years, the United States has made significant progress in combating drug-resistant infections. But those gains were largely wiped out during the Covid-19 pandemic, with hospital-acquired infections and resulting deaths increasing by 15% in 2020, according to new data, Deidre McPhillips reports.
A special report released Tuesday by the CDC found that more than 29,400 people died from antimicrobial-resistant infections in the first year of the pandemic — nearly 40 percent of those deaths were among people who contracted the infection while in the hospital. The full number is likely even higher, given that data on half of the 18 pathogens identified as threats is unavailable or delayed.
The WHO has called antimicrobial resistance a “silent pandemic,” and drug-resistant infections were linked to nearly 5 million deaths worldwide in 2019. The Covid-19 pandemic likely contributed to the increased risk in the US, especially because many people delayed care or have left untreated infections — either due to closed clinics or fear of exposure to Covid-19 — which could increase the risk of developing drug resistance.
Pulse oximeters do not work well in people of color
Often, when Dr. Thomas Valli sees a new patient in the intensive care unit at Michigan Medicine in Ann Arbor, he clips a pulse oximeter to their finger, one of many devices he uses to assess their health and what course of treatment they are taking. need, whether they are a child with seizures, a teenage victim of a car accident or an elderly person with Covid-19.
But recently, Valley, an assistant professor in the University of Michigan’s Division of Pulmonary and Critical Care Medicine, realized that the small device could give less accurate oxygen readings in dark-skinned patients. If the device is not calibrated…
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