POST 249. May 6, 2022. CORONAVIRUS. “The United States is “certainly, right now, in this country, out of the pandemic phase..” (Dr. Anthony Fauci). “The US should prepare for a possible summer surge of Covid-19 cases across Southern states..” (Dr. Deborah Birx)

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“The United States is “certainly, right now, in this country, out of the pandemic phase,” Dr. Anthony Fauci, President Joe Biden’s chief medical adviser and the director of the National Institute of Allergy and Infectious Diseases, said on PBS’s “NewsHour” on Tuesday.

“Namely, we don’t have 900,000 new infections a day and tens and tens and tens of thousands of hospitalizations and thousands of deaths. We are at a low level right now. So if you’re saying, are we out of the pandemic phase in this country? We are,” he said.

On Wednesday, Fauci told CNN that his comments had been mischaracterized by some to mean that the pandemic is over, “which is not what I said.”

“We’re not over the pandemic. Don’t let anybody get the misinterpretation that the pandemic is over, but what we are in is a different phase of the pandemic,” he said. “A phase that’s a transition phase, hopefully headed toward more of a control where you can actually get back to some form of normality without total disruption of society, economically, socially, school-wise, etc.”

Fauci noted that, in fact, Covid-19 cases are trending up again, though it’s not anywhere near the rise we saw over the winter with the Omicron wave.

“So what we need to do is continue to be vigilant, to follow the CDC guidelines, to do the kinds of things that protect you: Get vaccinated, if you’re not vaccinated; get boosted if you’re eligible for a boost. If you do get infected, be aware that there is availability of antivirals.”

Fauci’s comments on PBS drew attention on the same day the Biden administration announced that he would not be attending the annual White House Correspondents Dinner after considering his individual risk.” (A)

“Though it would be next to impossible to eradicate SARS-CoV-2, it is fully feasible to control it, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), during a virtual event held Friday morning by the National Press Club.

A variety of factors make COVID-19 different from polio and measles, viruses that were previously eliminated in the U.S., including the number of genotypically and phenotypically diverse variants of SARS-CoV-2, and that SARS-CoV-2 has animal reservoirs for the virus, Fauci noted.

There has also been a lack of widespread acceptance when it comes to COVID vaccines, and immunity through vaccination or infection wanes over several months.

“We’re hoping for control,” Fauci said, which would involve a combination of common-sense hygiene and mitigation measures, intermittent vaccination, and treatment with effective antivirals and monoclonal antibodies.

As for the next generation of COVID shots, and how regularly they would be needed, Fauci was both optimistic and realistic.

“I would hope that we get to the point where immunity lasts long enough where we only intermittently need to be boosted,” he said, adding that he doesn’t think a schedule of receiving shots as often as once every 4 months is feasible.

However, waning immunity is not surprising, he noted.

“The protection that follows infection is not particularly durable, and you would expect, that being the case, that the protection following [vaccination is] not going to be durable,” Fauci said. “We are trying very hard to develop vaccines that give a greater degree of durability of immunity.”..

Fauci stressed that it will be essential to continue to monitor for variants. There are currently subvariants of Omicron that are 25% to 30% more transmissible, though they are not necessarily more severe…

Ultimately, to attain control, case counts need to be low enough that they are not disrupting society, overwhelming hospitals, or creating fear, Fauci said, putting SARS-CoV-2 in a similar place as other respiratory viruses like RSV and influenza.” (B)

“They were the words everyone has been waiting to hear—that the COVID-19 pandemic is dialing down from the five-alarm fire that flared up in 2020 to a somewhat lesser conflagration. On April 27, the U.S.’s chief medical advisor, Dr. Anthony Fauci, described the country as in a “transitional phase, from a deceleration of the numbers into hopefully a more controlled phase and endemicity” in an interview with the Washington Post…

Although we may be out of the urgent pandemic phase, we’re not quite ready to call COVID-19 endemic, which would mean the virus is still among us but relatively under control, similar to influenza.

And it’s not clear when that will happen. Even if it does, health experts may not all agree about the transition. There are no hard and fast definitions for “pandemic” and “endemic,” and no thresholds for case numbers or deaths that mark a shift from one to the other. The World Health Organization considers a pandemic to be an “epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people.” Experts have noted that these parameters say nothing about how quickly the outbreak is spreading, how much disease it’s causing, or what role immunity in the population plays.

But those are the factors that are critical for public health experts and political leaders as they manage a pandemic. There are no metrics for determining when to dial down an initial urgent response, or to pull back on drastic measures such as lockdowns and mask mandates.

That’s what the world is grappling with now—figuring out whether the risk of SARS-CoV-2 is now at a point where we can treat it more like influenza, by protecting ourselves as much as we can with immunization and basic hygiene such as washing our hands and covering our coughs, or whether we still need to manage SARS-CoV-2 as a serious enough threat for most people that we should maintain public health measures such as mask-wearing and social distancing…

Those trends suggest that it may be too early to relax our vigilance over COVID-19, which remains a potent threat for a number of reasons. First, no vaccine is 100% effective in protecting against infection or disease, and the COVID-19 shots are no exception. While highly effective in warding off the worst COVID-19 symptoms from the original virus strain emerging from China, the shots are less effective in protecting against newer variants of SARS-CoV-2. And the virus continues to mutate, with each version appearing to improve on the last strain’s ability to infect quickly and efficiently. Fortunately these changes haven’t led to a more virulent strain so far, but they could veer in that direction, and cause more serious disease on top of being more transmissible. If that happens, the vaccines and drug treatments currently available might provide little, if any, protection at all.

That leads to the second reason that COVID-19 isn’t fading into the background any time soon. Despite the effectiveness of the vaccines, scientists still don’t know exactly what it takes to fully protect someone from COVID-19. That question actually breaks down into two related queries: What does it take to prevent infection in the first place, and what level of immunity is needed to protect against serious illness? Even into the third year of the COVID-19 pandemic, scientists still don’t have solid answers for either.” (C)

“The US should prepare for a possible summer surge of Covid-19 cases across Southern states, former White House Coronavirus Response Task Force coordinator Dr. Deborah Birx told CBS on Sunday morning.

It’s now predictable that the South will see surges in the summer and Northern states will see surges in the winter — especially around the holidays, Birx said.

Birx said she closely follows data out of South Africa, which has recently seen a rise in new Covid-19 cases.

“Each of these surges are about four to six months apart. That tells me that natural immunity wanes enough in the general population after four to six months — that a significant surge is going to occur again,” Birx told “Face the Nation.”

“This is what we have to be prepared for in this country. We should be preparing right now for a potential surge in the summer across the Southern United States because we saw it in 2020 and we saw it in 2021.”..

Birx’s warning comes as US cases are again rising with the spread of another Omicron strain, the BA.2 subvariant. The seven-day average of US cases was almost 54,000 Saturday, up from about 49,000 a week earlier and almost 31,000 a month ago.

Nearly 60% of adults and 75% of children have antibodies indicating that they’ve been infected with Covid-19, according to new data from the US Centers for Disease Control and Prevention.

It is unclear what that means for protection against future infections, health experts say, and for that reason, the CDC says it is still important to stay up to date on Covid-19 vaccinations and boosters.”  (D)

“After more than two years of Covid-19, plenty of people are lowering their guards. But the pandemic isn’t over yet — and, Bill Gates warns, the worst might still be ahead.

“We’re still at risk of this pandemic generating a variant that would be even more transmissive and even more fatal,” the billionaire Microsoft co-founder and public health advocate told the Financial Times on Sunday. “It’s not likely, I don’t want to be a voice of doom and gloom, but it’s way above a 5% risk that this pandemic, we haven’t even seen the worst of it.”

New Covid cases, powered by the BA.2 subvariant of Covid’s omicron strain, are currently growing across the U.S.: The country’s seven-day average of daily new U.S. cases is up to 54,429 as of Sunday, according to Johns Hopkins University data. That’s a 9% increase over the week prior, with cases growing in 39 states over that time frame.

But Covid-related deaths are declining, leading White House Covid czar Dr. Ashish Jha to say last month that he’s “not overly concerned right now” about BA.2. Rather, its spread is more a reminder that Covid is still lurking — and as Gates notes, the virus could potentially mutate again, resulting in a strain of greater concern.

For Gates, one lesson from the Covid pandemic so far is that preemptive planning and protective measures could help the world better manage future pandemics. It’s the core concept of his upcoming book, “How to Prevent the Next Pandemic,” set to publish later this year.

One proposal, he says, is for the World Health Organization to launch a global surveillance team, consisting of experts who can quickly spot new health threats around the world and rapidly coordinate with global governments to prevent future illnesses from growing into pandemics.

Gates, who has labeled his proposed task force the “Global Epidemic Response and Mobilization” (GERM) initiative, told the Financial Times that the idea would require significant financial investment from WHO and its member countries in order to create a global team of experts, including epidemiologists and virologists, and give them the tools they need to proactively identify and contain future outbreaks…

And, while he cautions against becoming complacent against Covid’s ongoing risks, the billionaire has also expressed optimism that the coronavirus will be more manageable by this summer — saying in January that, ideally, most Americans will eventually be able to treat Covid like the “seasonal flu.”” (E)

“Countries are beginning to offer a fourth dose of the Covid-19 vaccine to vulnerable groups, but medical professionals are undecided on whether it would benefit the wider population.

The U.S. Food and Drug Administration has so far authorized a fourth shot only for those aged 50 and above, as well as those who are immunocompromised. And the U.S. Centers for Disease Control and Prevention was skeptical of the need for a fourth dose for healthy adults in the absence of a clearer public health strategy.

Those decisions came as a study from Israel found that although a fourth dose of the Pfizer-BioNTech vaccine offers protection against serious illness for at least six weeks after the shot, it provides only short-lived protection against infection, which wanes after just four weeks.

The medical consensus so far is that there hasn’t been enough research on how much protection a fourth dose can offer.

The World Health Organization hasn’t given an official recommendation on a fourth dose, and “there isn’t any good evidence at this point of time” that it will be beneficial, said WHO chief scientist Soumya Swaminathan.

“What we know from immunology is that if you give another booster, you will see a temporary increase in the neutralizing antibodies. But what we’ve also seen is that these neutralizing antibodies will wane quite rapidly,” Swaminathan told CNBC in an interview.

A fourth dose doesn’t really do much of anything … I’m not sure we need to get out and just jump up and down screaming that everybody needs to get aboard.

“This happened after the third dose. And it’s happened again after the fourth dose,” she added.

Paul Goepfert, professor of medicine at the University of Alabama, shared that view, saying that “a fourth dose doesn’t really do much of anything … I’m not sure we need to get out and just jump up and down screaming that everybody needs to get aboard.”

Since the study from Israel shows the fourth dose can provide protection against serious disease, countries such as Israel, Denmark and Singapore have made a second booster shot available to high-risk groups.

“Rather than saying that the protection wanes, I would say that this boost effect is strongest shortly after the vaccine was administered, but that it remains protective overall,” said Ashley St. John, an associate professor at Duke-NUS Medical School.

“Importantly there was no waning of protection against severe disease, which is the most key effect of vaccination we aim to achieve,” she added.” (F)

“Reports of new coronavirus cases have doubled in the past month as Omicron subvariants have spread across the country.

Cases are increasing in all but four states and territories, and in more than a dozen, the daily case average is twice as high today as it was two weeks ago. Despite this rapid growth, the virus’s true spread is believed to be even greater, since many infections go uncounted in official case reports.

Hospitalizations have also risen in recent weeks, though more modestly than cases. Just over 17,000 people are in American hospitals with the coronavirus each day, an increase of 16 percent since mid-April.

Still, the surge so far appears milder than the waves that preceded it. Cases remain well below the levels seen during the Delta and Omicron surges late last year, and fewer coronavirus patients are in intensive care today than at any point since the pandemic’s earliest days.

Coronavirus deaths in the United States are expected to reach 1 million in the coming weeks, but for now, daily death reports continue to decline. Fewer than 350 deaths are currently being announced each day, a decrease of more than 20 percent in the past two weeks.” (G)

• A.The US is in ‘transition phase’ of pandemic, Fauci says, By Naomi Thomas and Brenda Goodman, https://www.cnn.com/2022/04/27/health/fauci-covid-pandemic-phase/index.html
• B.Fauci: COVID-19 Is Here to Stay, but We Can Control It, by Jennifer Henderson, https://www.medpagetoday.com/infectiousdisease/covid19/98486
• C.The U.S. Is in a ‘Controlled Pandemic’ Phase of COVID-19. But What Does That Mean?, by Alice Park, https://ca.finance.yahoo.com/news/u-controlled-pandemic-phase-covid-171226759.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAEGr9D4Iwaipdt_hJN4AsUCUJJyzgdHdgCUMg-qHVjM42rgox4SzF_RxJAR8kkHo-flJpAmop4Uep3yQgukRDiPkKMcCSYUqyF6KNMQGSADBNs069wrNOe5Es9QuqahH3zbeJO5U3VWcm6_n0o5Slw7OLiPgbAAffyIMsmQhwzc9
• D.The US should prepare for a predictable Southern summer surge of Covid-19, Birx says, By Hannah Sarisohn, https://www.cnn.com/2022/05/01/health/covid-southern-summer-surge-prediction/index.html
• E.Bill Gates on Covid: ‘I don’t want to be a voice of doom and gloom,’ but ‘the worst’ could still be ahead, by Tom Huddleston Jr., https://www.cnbc.com/2022/05/02/why-bill-gates-says-the-worst-of-covid-could-still-be-ahead.html
• F.Time for a fourth Covid vaccine dose? Here’s why medical professionals are skeptical, by Charmaine Jacob, https://www.cnbc.com/2022/05/02/medical-professionals-are-skeptical-on-a-fourth-covid-vaccine-dose.html
• G.Coronavirus in the U.S.: Latest Map and Case Count, https://www.nytimes.com/interactive/2021/us/covid-cases.html
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