CHICAGO — Covid-19 is on the rise again in the United States in what experts believe is the most transmissible variant of the pandemic to date.
But this time something is different: public health authorities are holding back.
In Chicago, where the county’s Covid alert level was raised to “high” last week, the city’s chief medical officer said there was no reason for residents to let the virus control their lives. Louisiana’s state health director likened the new spike in Covid cases there to heavy rain — “a bump within a bump” — but characterized the situation as troubling but not alarming.
And King County, Wash., Public Health Officer Dr. Jeffrey Duchin said Thursday that officials are discussing reissuing a mask mandate, but would prefer the public wear masks voluntarily. “We’re not going to be able to have an endless series of mandates forcing people to do this, that and the other,” he said.
The latest surge, driven by a surge in BA.5 subvariant cases in this country since May, has seen infections rise in at least 40 states, particularly in the Great Plains, West and South. Hospitalizations have climbed 20 percent in the past two weeks, leaving more than 40,000 people in US hospitals with the coronavirus on average per day.
More than two years after the pandemic began, however, public health officials are issuing only quiet warnings amid a picture they hope has been changed by vaccines, treatments and rising immunity. Deaths are rising, but so far only modestly in this new wave. And state and local public health officials say they must now consider the reality that is evident on the streets from Seattle to New York: Most Americans are meeting a new Covid wave with a collective shrug, shrugging off masks, joining crowds indoors and movement from the never-ending batch of virus warnings from the past months.
“I feel strongly that you can’t just cry wolf all the time,” said Dr. Alison Arwadi, the commissioner of the Chicago Health Department, who said she would wait to see if hospitals pick up before considering another term for masks throughout the city. “I want to keep the requirements around masks or updating vaccine requirements when there is a significant change.”
Complicating the country’s understanding of this BA.5 wave is the scarcity of data. Since the earliest months of the pandemic, there has been so little accurate information about the number of actual infections in the United States. As public testing sites were shut down and home testing — if people tested at all — became commonplace, publicly reported data became sparse and spotty.
Still, experts say the outlines of a new wave are indisputable.
“You don’t have to count every raindrop to know it’s raining,” said Dr. Joseph Kanter, Louisiana’s health officer and medical director. “And it’s raining right now.”
In that state, the health department is analyzing a wide range of data to track the spread of the virus, including case counts, samples from a growing network of sewage testing sites, positive test rates and hospitalization rates.
The BA.5 subvariant, which was first detected in South Africa in January and has spread to a number of European countries, was responsible for 1% of cases in the United States in mid-May, but now accounts for at least two-thirds of new cases in the country.
Anita Kurian, assistant director of the San Antonio Health Department, said cases have increased in the area for six weeks in a row. But some measures, such as the low number of deaths so far, suggest the nation is entering a newer and less deadly stage of the pandemic, where vaccines and treatments have greatly improved the chances of survival, she said.
“We’re nowhere near where we were with the previous spikes,” she said.
So far, the number of hospitalizations and deaths in the current wave pales in comparison to previous peaks. During Omicron’s peak in early 2022, nearly 159,000 people were hospitalized each day.
Experts warn that forecasting the coming months is difficult, especially given the high transmission rate of BA.5. Words of caution from national health leaders have slowly increased in intensity in recent weeks.
Still, even as federal health officials have repeated calls for people to get tested for Covid before attending large indoor gatherings or visiting particularly vulnerable, immunocompromised people, they are striking a delicate balance, telling Americans that while they shouldn’t to change their lives, you must pay attention to the threat of Covid.
“We must not let this disrupt our lives,” Dr. Anthony S. Fauci, President Biden’s chief medical adviser on the virus, said at a White House briefing, adding that new options could continue to emerge. appear. “But we can’t deny that it’s a reality we have to deal with.”
As health officials in many places avoided issuing new virus restrictions during the latest surge, California stood out as an exception. There, public health authorities issued stark warnings and moved to reimpose restrictions.
The warnings were prompted by worrying data, experts said. Walgreens said more than half of the Covid tests administered at its California stores have come back positive. Studies of wastewater in the Bay Area indicate that this spike may be the largest on record.
And the number of weekly deaths in Los Angeles County from the coronavirus has doubled from about 50 a month ago to 100 last week. Deaths are still below levels from Omicron’s winter spike, when more than 400 died each week in the county.
Los Angeles officials say they plan to reinstate the countywide indoor mask mandate as early as the end of this month. Barbara Ferrer, the county’s director of public health, said even a slight increase in masking would help slow the transmission of the virus.
“I’m like everyone else: I hate wearing this mask. But more than that, I hate the idea that I could accidentally pass it on to someone else,” Ms Ferrer said. “That’s my biggest fear — that we’re so eager to get this virus over with that we’re getting complacent.”
Charles Chiu, an infectious disease specialist and virologist at the University of California, San Francisco, says data from patients suggests that BA.5 does not cause more severe disease in patients than other variants of Omicron. But he says he’s concerned that the variant is so contagious and so able to evade the protections of vaccination and previous infection that it could be unstoppable.
“We can’t seem to control it,” he said.
Dr Chiu said he sympathized with the plight of government officials trying to mitigate the spread of the virus. They face a public that resents the renewed directives, even in parts of the country where people were previously most receptive to them. In places where Covid mitigation measures are mandatory, such as in the New York subway, compliance with masking rules is increasingly patchy.
“Public health officials have an impossible task here,” said Dr. Chiu.
In New York, the rate of positive tests, cases and hospitalizations is increasing. But health officials opposed reissuing the mask-wearing mandates, and many residents said they were not worried, relying on vaccines, immunity from previous infections and antivirals to protect against severe illness. The city no longer has a contact tracing system in place or requires proof of vaccination to enter restaurants.
In Louisiana, officials have seen an increase in hospitalizations of people with Covid in the state, but they say those numbers are still far below previous spikes, when more than 2,000 residents were hospitalized at times.
“I feel much stronger that we have the ability to protect ourselves,” Dr. Kanter said.
During the peak of the Delta wave in Louisiana in 2021, about 20 percent of hospitalized Covid patients were on ventilators, according to Dr. Kanter, state health officer and medical director. That figure fell to 10 percent during Omicron’s initial surge in the state and is now below 5 percent.
For people most at risk of severe illness from Covid, the sense that public health warnings have eased was not much comfort and actually made them more worried than ever about contagion.
Neida Bonilla, 48, of Mission, Texas, was diagnosed in April with breast cancer. As the number of cases in South Texas increases, she now fears that an infection while undergoing chemotherapy could prove catastrophic for her health.
She has received all available vaccines and boosters, she said, and now wears a surgical mask in public and rarely leaves the house except to work as an administrator at an ambulance company.
“I hope people open their eyes,” she said. “We never had to take off our masks. This is not over.”
Yet even in some cities whose residents have taken precautions against Covid during the pandemic, the latest spike has not sparked widespread alarm.
In Berkeley, Calif., Jeff Shepler, general manager of Spanish Table, a specialty store selling Iberian wine and food, said he goes to Giants games across the San Francisco Bay Area, recently attended a Pearl Jam concert at the Oakland Coliseum, and has no hesitation to shake hands.
“It became exhausting for me to wear a mask all day, every day,” he said. “I’m at a point in my life where I have the vaccine and I’ve had Covid. I think I’m pretty safe.
Julie Bosman reported from Chicago, Thomas Fuller from San Francisco and Edgar Sandoval from San Antonio. This report was contributed by Soumia Karlamangla, Eliza Fawcett, Sarah Cahalan and Holly Seccon.
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