Wednesday, February 8, 2023

One year later, Omicron continues to create Covid waves

A year after the Omicron variant began its assault on humanity, the ever-changing mutation of the coronavirus caused COVID-19 cases to spike in many places as Americans gathered for Thanksgiving. It was a foreshadowing of a wave that experts predict will soon sweep the United States.

Phoenix-area emergency physician Dr. Nicolas Vasquez, the hospital where he works, has seen a significant number of people with serious illnesses and nursing home residents with severe cases of COVID-19 this month.

“It’s been a long time since we’ve needed COVID wards,” he said. “It’s clearly coming back.”

Nationwide, new COVID cases averaged about 39,300, much lower than last winter, but well below the true level due to declines in testing and reporting. About 28,000 people with COVID are hospitalized daily and about 340 die.

The cases and deaths are from two weeks ago. Yet a fifth of the US population has not been vaccinated, most have not received their most recent booster dose, and many have stopped wearing masks.

Meanwhile, the virus continues to find ways to avoid defeat.

The Omicron variant arrived in the United States just after Thanksgiving last year, causing the largest wave of cases in the pandemic. It has since given rise to a large expanding family of subvariants, such as those currently most common in the United States: BQ.1, BQ.1.1, and BA.5. They displaced their competitors by reformulating to avoid the immunity provided by vaccination and previous infections, and sickened millions of people.

Carrie Johnson’s family was infected twice. In January she was infected with COVID-19 during Omicron’s first wave, with flu-like symptoms and excruciating pain that kept her in bed for a week. His son Fabian Swain, 16, had very mild symptoms in September, when the BA.5 variant was dominant.

Fabian recovered rapidly, but Johnson suffered from headaches for weeks. Other problems persisted for longer.

“It was something like: ‘I can’t feel well.’ I couldn’t concentrate. I had no energy,” recalls Johnson, 42, who lives in Germantown, Maryland. “And I was like that for months.”

highly affected sites arise

Some communities are being hit especially hard right now. A Mayo Clinic follow-up shows cases are on the rise in states including Florida, Arizona, Colorado and New Mexico.

In Arizona’s Navajo County, the average daily case rate is more than double the state average. Dr. James Macauley said that in the Indian Health Service Center where he works, 25 to 50 people are getting infected with the corona virus in a day. Earlier only a few cases used to come daily.

Macaulay, the clinical director of Whiteriver Indian Hospital, which cares for the White Mountain Apache tribe, said they are “essentially back to where we were at our last tipping point” in February.

COVID-19 is part of a triple threat that also includes influenza and respiratory syncytial virus (RSV).

Dr. Vincent Hsu, who oversees infection control for AdventHealth, said his Orlando Children’s Hospital is nearly overcrowded with children sickened by these viruses. Dr. Greg Martin, past president of the Society for Critical Medicine, sees similar trends elsewhere.

Children’s hospital emergency rooms and urgent care clinics are more crowded than ever, said Martin, who works primarily at Grady Memorial Hospital in Atlanta. “This is a record compared to any month, week or day in the past,” he said.

In the future, experts identify the beginning of a generalized wave in the United States. They give as an example what is happening internationally: an increase in BA.5 in Japan, a combination of the variant that is causing a surge in cases in South Korea and the start of a new wave in Norway .

Some experts predict that the wave may start during the Christmas holidays in the United States as people gather indoors. Trevor Bedford, a biologist and geneticist at the Fred Hutchinson Cancer Research Center, said about 150,000 cases a day could be about the same as what the country saw in July.

A new wave would be drastic, said Dr. Mark Griffiths, medical director of the emergency department at the Atlanta-Spalding Hospital Children’s Center. “There are so many systems that are going to be completely overloaded, and if on top of that we have another outbreak of COVID, it’s going to break some systems,” he said.

One positive aspect? There are likely to be very few deaths as compared to the previous phases of the pandemic. Bedford said the death rate at present is 1 in 2,000 infections, up from 1 in 200 in the first half of 2020.

Omicron’s One Year Reign

The same widespread immunity that reduced deaths also caused the coronavirus to mutate. By the end of last year, many people had become infected, vaccinated or not. That created the initial space for Omicron to spread,” Bedford said, “as the virus evolved significantly in its ability to evade existing immunity.”

Omicron is done. By mid-December, the first Omicron strain accounted for 7.5% of the variants circulating in the environment, and two weeks later, 80%, said Mara Aspinall, a professor of biomedical diagnostics at Arizona State University. At one point, cases in the United States reached one million a day. Overall, Omicron caused less severe disease than previous variants, but increased hospitalizations and deaths due to the larger number of infections.

The tidal wave subsided in mid-April. The virus mutates rapidly to form a series of subvariants that are better at evading immunity. According to a recent study published in the journal Science Immunology, this ability to evade antibodies is due to more than 30 changes in the spike protein that covers the surface of the virus.

Bedford said that Omicron had evolved so much in a year that today “it’s a meaningless word.”

Accelerated mutation is likely to continue.

“Viruses are facing a lot of pressure to diversify,” said Shashi Luo, director of infectious diseases at Helix, the company that provided viral sequencing information to the US Centers for Disease Control and Prevention.

Doctors say that still the best defense against subvariant warming porridge is vaccination. And officials say Americans who were vaccinated with the new combination booster for Omicron and the original coronavirus are currently better protected than others against symptomatic infection.

Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, said that if you’re eligible, getting a booster is “the most cost-effective thing you can do.”

Similarly, doctors also urge people to maintain preventive measures like getting tested, using face masks in crowds and staying home if sick.

“Covid remains a significant threat, especially for the most vulnerable,” said Dr. Lalu Fyanju of Oak Street Health in Cleveland, who specializes in the care of older adults. “People should continue to think of others. We’re not completely out of the woods on this yet.”

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Associated Press writer Heather Hollingsworth contributed from Mission, Kansas.

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The Associated Health and Science Department is supported by the Howard Hughes Medical Institute Department of Science Education. Associated Press is solely responsible for all content.

Nation World News Desk
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