After two years, 90 million cases and over one million deaths, COVID-19 continues to evolve, reinfect and spread across the country. As the latest COVID wave has made it clear,
BA.5, a COVID subvariant of Omicron, is now responsible for nearly 80% of cases in the U.S., according to the CDC, which predicts that the daily case count will rise from 3,200 to 13,800 by August. And while hospitalizations have not reached last winter’s numbers, the U.S. is seeing hospitalization rates increase by 11% within just a single week of July.
“The likelihood of getting Covid has increased,” says Dr. Stanley Schwartz, president and CEO of WellOK, the Oklahoma Business Coalition on Health. “Immunity as the result of infection with the original strain or with older variants is less effective now. The vaccines we have don't match the current subvariants, and vaccine effectiveness wanes more quickly.”
Read more:
Dr. Schwartz notes that the effectiveness of the vaccines seems to decline around 150 days after receiving the shot — meaning those who were last boosted before January are already at a disadvantage. On top of that, there is a possibility that this subvariant, along with BA 2.75, makes it harder for antibodies to prevent the virus from infecting the cells, explains Dr. Schwartz. But the subvariants are too new to be sure.
“It's important to know vaccines may not protect against getting an infection,” he says. “But being fully up-to-date on vaccines and boosters is still good against reducing the chance of severe illness, hospitalization and death.”
The CDC estimates that more than 97% of patients who have gone to the hospital due to COVID are unvaccinated. However, that does not mean vaccinated individuals are invincible. Research led by Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis, found that the vaccines only lower the risk of long COVID by 15%, and the more someone is reinfected, the higher their chances are of developing serious health issues. For example, even if someone had half the chance of developing long COVID after contracting the virus a second time, they still have a 50% higher chance than someone who did not get reinfected with COVID.
And according to Dr. Schwartz, reinfection is going to be hard to avoid as these new subvariants elude any immunity built over the past two years of vaccines and infections.
Read more:
“We recognize this virus to be more capable of mutations than originally thought,” he says. “The continuous level of infection across the country and across the globe means that uncountable numbers of viral multiplications in infected persons will inevitably produce a mutation with greater competence for ‘immune avoidance.’”
This means the U.S. healthcare system will continue to be strained by ongoing waves (or any other new public health risk entering the picture, like monkeypox), while the economy suffers from a loss of able workers. That’s a fact airlines already know too well, as the industry has canceled 30,000 flights since Memorial Day Weekend.
But Dr. Schwartz emphasizes that Americans can still take precautions to lower their risk of infection, as well as lower the risk of spreading COVID to their family and community. And employers would be smart to encourage these actions too, he says.
Aside from being up-to-date on vaccines, he encourages the use of N95 of KN95 masks indoors or in any crowded venue. If someone believes they may have been exposed to COVID, they should test after five days of the potential exposure or as soon as symptoms develop. The latest subvariants still produce cold-like symptoms, from a sore throat, cough and runny nose to headache and fatigue. Dr. Schwartz also warns that rapid tests are less reliable with the newest subvariants — it’s best to get a “molecular” test, like a PCR.
Read more:
For those who do become infected with COVID, Dr. Schwartz recommends taking Paxlovid or molnupiravir to help reduce the chances of developing a serious illness, especially if they are over the age of 65, or anyone who already lives with health risks. Although, these medications are hardly accessible. A treatment course of Merck and Ridgeback's molnupiravir costs $707 and one Paxlovid course costs $529. However, Dr. Schwartz notes that both medications can be provided for free at participating pharmacies.
Regardless, due to societal COVID fatigue and diminished government regulations surrounding masking, Dr. Schwartz knows many Americans will not heed his advice.
“The American public is kind of moving away from being engaged on COVID due to so many people having gotten COVID and done okay,” says Dr. Schwartz. “And when personal risk is perceived as low, people are unwilling to sacrifice. In other words, 3,000 people a day dying from COVID [at the peak in December 2020] is not that important of a statistic. If airliners went down in a single day and there were 3,000 deaths, that would be an unspeakable catastrophe. It’s the way the American people interpret disaster that really makes a difference.”
In the meantime, Dr. Schwartz hopes nationwide apathy can be beaten on some level and asks employers to show that they care and are aware of the risks COVID poses with every new mutation and wave. This starts with having a physician executive on the team who has an understanding of epidemiology and the social determinants of health, explains Dr. Schwartz. From there, leaders can build a flexible COVID policy that takes into account if anyone in the company is immunocompromised, changes the virus’ behavior or the number of cases in their area. This means also keeping a remote option for workers.
Read more:
“Policies will need to be dynamic; it will need to be vetted and changed as the epidemiology of this virus changes, which it will,” says Dr. Schwartz. “I am not going to tell my employees to come into the office where there’s a health risk along with an ongoing gasoline crisis.”
Dr. Schwartz can only recall going into the office two or three times in the last two years and would expect nothing more of his employees. He predicts that COVID will eventually become endemic, like Influenza, but worries about the damage the virus will do as testing and treatment can still come at a financial burden to Americans, and COVID fatigue permeates the nation.
“We'll continue to see new mutations that escape the protection from available vaccines, just as we've seen so often with Influenza,” says Dr. Schwartz. We'll eventually have better testing, more effective vaccines and more effective anti-viral medications available at pharmacies, but COVID will be a public health problem for a significant time.”
