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Hospitalizations have been on the rise and there are at least 1,200 Covid-related deaths every week. Americans deserve to wear more masks, and vaccination rates are still too low, experts say.
By Apoorva Mandavilli
The holidays are over and once again, Americans are facing a wave of respiratory illnesses, in addition to Covid. But this winter’s Covid surge looks less fatal than last year’s and less than in 2022, when the Omicron wave brought the country to a standstill.
“We’re not seeing the symptoms that would make me think we’re headed for another serious wave,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “So far, we’re in good shape. “
However, there are few masks in sight and only a fraction of the most vulnerable people have received the latest Covid vaccines, he noted.
“It’s not too late,” Dr. Rivers added. We haven’t reached the Covid peak yet, and once we do, we still need to move on to the other side. This gives the vaccine enough time to provide some protection.
Federal officials rely on limited knowledge to gauge this year’s spread. After the public health emergency ended in May, the Centers for Disease Control and Prevention stopped tracking the number of Covid infections. The firm now has only partial state data on vaccination rates.
But trends in wastewater data, positive tests, emergency room visits, hospitalization rates and deaths point to a buildup of infections in every region of the country, according to the CDC. These trends have led many hospitals to reinstate their mask policies, after the first of all resisting its return this fall.
As in previous years, numbers have been on the rise throughout the winter and are expected to rise further after holiday travel and gatherings.
Many infections are caused by a new variant, JN. 1, which has spread around the world in recent weeks. “I think there’s no question that this contributes pretty substantially to this winter wave,” said Katelyn Jetelina, a writer and public fitness expert. from a widely read newsletter, “Your Local Epidemiologist. “
“Unfortunately, it’s going down at exactly the same time we opened up our social media because of the holidays,” he said, “so there’s a very good typhoon going on right now. “
Some scientists have pointed to emerging degrees of the virus in wastewater samples as an indicator that infections are at least as high this year as they were at this time last year. But Dr. Rivers suggested caution in interpreting knowledge about wastewater as an indicator of infections and said hospitalizations were a more reliable measure.
In the week ending Dec. 23, hospitalizations were up about 17% from last week. There were about 29,000 new hospital admissions, up from 39,000 in the same week last year and 61,000 in 2021.
And weekly hospitalizations are emerging more slowly than in previous years, Dr. Rivers said.
Covid continues to kill at least another 1,200 people per week. But that’s about a third of the toll at the same time last year and one-eighth of that of 2021.
“We’ve been facing a pretty big wave of infections lately, but what’s appealing is how hospitalizations have and continue to be dissociated from infections,” Dr. Jetelina said.
She said she worried most about hospitals buckling under the weight of multiple epidemics at once. Even in years before the pandemic, outbreaks of just influenza and respiratory syncytial virus could strain hospitals; rising Covid rates now overlap both illnesses, adding to the burden.
The C. D. C. Se estimates that this season there have been at least 7. 1 million illnesses, 73,000 hospitalizations and 4,500 deaths from influenza.
While Covid tends to be mild in children and young adults, influenza and RSV are riskier for children and the elderly. All three diseases are particularly dangerous for infants.
Covid emergency room visits are among infants and the elderly. While RV has stabilized in some parts of the country, hospitalization rates remain high among the young and the elderly.
The JN. 1 variant accounts for nearly a portion of all Covid cases in the U. S. In the U. S. , it was nearly six times the prevalence just a month ago. The variant has a mutation that gives it a greater ability to evade immunity than its parent, BA. 2. 86, which had limited spread.
JN. 1 is possibly less transmissible than past variants. But its evasion of the immune system, along with the disappearance of preventative measures such as masks, may also contribute to its exponential expansion around the world, said Dr. Abraar Karan, an infectious disease. PhD and postdoctoral researcher at Stanford University.
Still, JN. 1 appears to cause more severe illness than previous variants, and existing vaccines, tests, and remedies oppose all existing variants well.
Experts urged all Americans — including those not at high risk of severe illness — to opt for vaccines against both Covid and flu, to use masks and air purifiers to prevent infections, to be tested and treated and to stay home if they become ill.
Even those who do not become severely sick run the risk of long-term complications with every new viral infection, researchers noted.
“To be honest, I’m not the main threat; I’m young and I’m vaccinated,” Dr. Rivers said. “But I keep taking precautions in my own life because I don’t need to deal with this disruption and the threat of ‘This is a long-term illness. ‘
But few Americans are following that advice. As of Dec. 23, only 19 percent of adults had received the latest Covid vaccine, and about 44 percent had opted for the annual flu shot. Just over 17 percent of adults aged 60 and older had received the vaccine for R.S.V.
Even among people 75 and older, who are at higher risk of contracting Covid, only one in three people have received the latest vaccine, according to the CDC.
Many people don’t realize that shots that protect against the newest variants are available, or that they should be vaccinated even if they are not at high risk, said Gigi Gronvall, a biosecurity expert at the Johns Hopkins Center for Health Security.
Although the Covid vaccine does not prevent infection, it can reduce the duration and severity of illness and minimise the risk of long-term symptoms, adding brain fog, fatigue, movement problems and dizziness, collectively known as long Covid.
“I’m sure also there are plenty of people who are actively hostile to the idea, but most of the people I encounter, they just don’t even know about it,” Dr. Gronvall said.
Poor availability of the shots, particularly for children and older adults, has also limited the vaccination rates.
Dr. Gronvall struggled to find a Covid vaccine for her teenage son. Dr. Jetelina has yet to find any for her young children. She said her grandparents, who are both in their mid-90s, also had “an incredibly challenging time.”
One of them is in a nursing home and still hasn’t been immunized because she happened to be sick the one day the vaccines were offered.
Many nursing home citizens are still unvaccinated because they don’t see the benefits, said Dr. Karan, who has worked in care facilities in Los Angeles County.
Financial incentives can improve vaccine coverage, but the lack of awareness about the benefits “is a major problem,” he said.
Experts have also suggested that other people who develop symptoms get tested and seek out antiviral drugs (Tamiflu for the flu, Paxlovid for Covid), especially if they are at higher risk for complications.
Paxlovid is still available to lax people, but many patients and even doctors avoid it because it mistakenly causes an uptick in Covid symptoms, experts said. Recent studies have not found a link between antiviral drugs and the uptick in symptoms.
“For many viruses, in addition to influenza, we know that early use of antivirals will be beneficial,” Dr. Karan said. “You temporarily prevent viral replication and then you have less immune dysregulation. “
Apoorva Mandavilli is a journalist specialized in science and global health. She was part of the team that won the 2021 Pulitzer Prize for Public Service for its pandemic policy. Find out more about Apoorva Mandavilli
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