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A new variant of the coronavirus, even more virulent than previous strains, is now dominant in the United States. But rising cases shouldn’t prompt calls for most Americans to buckle down or politicians to reimpose restrictions. Instead, the rapid spread of the omicron BA.5 subvariant is a window into what the future looks like with this coronavirus.
We’ve seen this pattern before. The original omicron variant was more infectious than the delta variant before it and quickly became dominant last winter. There was a brief lull, after which this strain was replaced by a more virulent subvariant, BA.2. The infections caused by BA.2 began to decline just in time for the BA.4 and BA.5 subvariants to take over.
BA.5 now accounts for 65 percent of all infections in the United States. This should not be surprising. New variants are constantly emerging, with more virulent strains displacing previous ones.
Lulls followed by spikes are the new normal. Instead of reacting with alarm, health officials should expect that while hospitals are not overwhelmed and vaccines are still working to prevent severe disease, policies should focus on minimizing disruption to daily life.
Reader Q&A: How bad is BA.5? Dr. Liana Wen answers your questions.
Virologist and pediatrician Paul Offit agrees. Offitt is director of the Center for Vaccine Education at the Children’s Hospital of Philadelphia and a member of the Food and Drug Administration’s influential Vaccine Advisory Committee. He told me in an interview that this coronavirus “will be here for my lifetime, for the lifetime of my children and for the lifetime of their children.” He added: “We cannot maintain perpetual masking and quarantine to prevent asymptomatic infection; we have to accept mild illness as part of life with covid-19.”
Its purpose, which I share, is to protect people from serious diseases. For most people, vaccines work well, including against BA.5. Hospitalizations are increasing, but are about a fifth of the peak of the first omicron wave. Since the true number of infections can be up to 10 times higher than the reported number, this means that the vaccines are doing their job and separating the infection from severe disease.
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counterpoint The worst version of the virus has just arrived. The pandemic is not over.
It is unreasonable to ask Americans to give up travel, restaurants or weddings to prevent what for most people will likely be a mild illness. As I’ve argued before, government-imposed restrictions — including mask mandates — should be reserved for dire emergencies, which we’re not in now. Instead, officials should increase interventions that have broad support, such as testing, treatment and improved ventilation.
Resources should be targeted specifically at helping those most vulnerable to severe covid-19 outcomes. Among those 65 and older who received the initial two doses, about 30 percent have not yet received their first booster. And of those, only 34 percent received a second booster. We also fail to use other tools to their full extent, such as the preventive antibody Evusheld and antiviral treatments including Paxlovid — all of which are effective against BA.5. This needs to change.
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In the meantime, we need urgent investment in better vaccines, specifically a pan-coronavirus vaccine that will work against all strains, and nasal vaccines that reduce transmission of the virus. We need “Operation Warp Speed Part 2” to accelerate the development of vaccines and additional therapeutics to treat covid and long-distance symptoms.
This does not mean that those at low risk of severe disease should forgo precautions. Even if they are vaccinated and boosted or have previously had covid, there is a high chance they will contract BA.5. Without precautions, the incredible transmissibility of emerging variants means that people could contract covid-19 several times a year going forward.
Whenever people are infected with the virus, they can end up with a long covid. Some will say that’s exactly why they want to continue to avoid this coronavirus. They can continue to follow strict precautions, including asking others to test before congregating and wearing a high-quality mask indoors. Others will say they are ready; they don’t want to pay the ever higher price to avoid covid. Many will choose something in between; they won’t restrict their activities, but will keep up with boosters, mask in crowded places and test before visiting vulnerable relatives.
Offit explains that the definition of a pandemic includes changing the way we live, work and play. “We determine when the pandemic is over,” he said. “Based on people’s behavior, it seems like most of the country has decided that this has already happened.”
I don’t think the pandemic is over. This coronavirus may have many more surprises in the coming years. A new variant may emerge this fall or next that is much more deadly and that does not respond to existing vaccines and treatments. Health officials must maintain their credibility to call for an emergency response when it is truly necessary. That time is not now with the BA.5 variant.
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