We’re in a contagion-filled holiday season: Will the leaders step up?

By all accounts, the risk of another COVID-19 winter wave in the United States is high. And this time, the coronavirus is walking around alongside two friends — influenza and respiratory syncytial virus (RSV). in some areas, Hospitals are already overwhelmed.

It is not clear how serious this “triple epidemic” will be. What is very clear, however, is that the pandemic-weary public is not taking the threat seriously enough. Shockingly, neither was the government. Biden administration officials have voiced their concerns for months, but so far there have been no loud alarm bells. That includes a White House briefing on Tuesday where officials barely mentioned the triple threat as they sought to spur efforts to boost more people with the new bivalent COVID-19 vaccine. Even today, about 12 percent Those who qualify get the new booster.

Meanwhile, the The Senate voted on November 15 To end the Federal Government’s COVID-19 Pandemic Emergency Declaration, which has been in place for the past three years. This gave the Biden administration the money and policy tools to fight the virus.

Not taking decisive action yet is unwise, especially with Thanksgiving and holidays coming up when indoor gatherings increase infection risks. Continued inaction through 2023 will result in unnecessary illness, absenteeism, economic losses – and thousands of preventable deaths.

Let’s remember the events of the pre-COVID-19 winter. Last year’s surge began just after Thanksgiving and by March included 75 million to 100 million infected people, some infected for the second or third time. Of the 1.1 million officially recorded deaths from COVID-19 so far, half have occurred during the last two winter waves. Brought Raise 2020-21 (November to March) 328,805 deaths, even as the first vaccines roll in but it’s too late to make much of a difference. Last winter’s wave killed another 227,352 people.

Deaths decreased last winter compared to the previous year despite the high infection rate because many people got vaccinated, have some immunity from previous infections and took preventative steps such as masking and strict quarantine. Unfortunately, the omicron variant, which peaked this past January and February, has chipped away at enough of that existing immunity to wreak havoc. Re-infections are becoming common.

COVID-19 experts are now worried this pattern will be repeated. This month, two new omicron variants — BQ.1 and BQ.1.1 — officially outperformed BA.5, the dominant variant for the past few months. These new variants now represent Almost half of COVID-19 cases nationwide.

The very bad news: Lab studies show that mutations in these two variants can make them up to seven times more “immuno-evasive” than BA.5.

The good news: The new variants don’t appear to cause more serious disease. However, the expected increase in the absolute number of new infections (in people who have not had COVID-19 before), superinfections (between vaccinations) and re-infections will lead to more hospitalizations and deaths.

As Dr. Jeremy Luban of the University of Massachusetts, a leading tracker, he told NPR on Nov. 11: “It’s rather familiar. … There’s this kind of deja vu feeling from yesteryear.”

The big unknown is the degree to which previous infections with Omicron or its variants will protect people from the new variants. An estimated 150 million to 170 million Americans – about half He was infected with some type of omicron. Many of these people have also been vaccinated. Having both is good: the immune system builds a layered response to infection as well as to the vaccination that researchers are still trying to figure out for COVID-19.

The bottom line is: (a) it is unlikely that previously infected people would be strongly protected against recurrence of infection and disease with the new variants and (b) it is likely that some protection It will be awarded against a bad outcome such as prolonged COVID, hospitalization and death.

Partly based on these calculations, and partly on sheer hope, the Biden administration has pegged its estimate of additional deaths from the fourth spike in the winter at between 30,000 and 70,000. This is on top of the COVID-19 underlying death rate of around 300 per day, prevalent in recent months. Thus, November to March could result in as many as 115,000 deaths from COVID-19 alone.

These numbers assume a continued low level of vaccination with the new bivalent booster. If everyone eligible for this drug — all people 5 years of age and older — had access to it, up to half of these deaths could be prevented.

Widespread use of masks would also prevent infections and deaths. Researchers at the Institute for Health Metrics and Evaluation at the University of Washington Project 46100 additional deaths from COVID-19 by February 1, 2023. They calculated that adhering to an 80 percent recommended masking could save about 30,000 of those lives.

As for the flu, if the numbers track experience since October 1st, as many as 33 million Americans (one in 10) will have it by the end of March 2023 and up to 18,000 will die, according to CDC projections. But it’s early. The flu usually doesn’t peak until January or February. Countries in the southern hemisphere have had a bad summer. Thus, if the number of cases per month doubles or triples – as is likely – the number of deaths could exceed 35,000 to 40,000. The very mild flu season 2021-2022 led to an estimate 9 million cases and 5,000 deaths.

Meanwhile, the incidence of RSV is now trending at three to six times Average of the past three winters. It affects children and people over the age of 65.

Preventing death is the first job. But it is not trivial — for families or for the economy — that COVID-19, influenza, and RSV could infect 100 million Americans or more in the next five months. For COVID-19, in particular, there are two other troubling risks. The first is long-term COVID and the second is the potential increased risk of health problems and death associated with being infected multiple times with different variants.

Several studies now show that between 10 and 20 percent of people who catch COVID-19 go on to develop symptoms or problems after they recover from the initial severe illness — and not all of them are older. as I did I wrote about it beforeThis level of risk hits me and is worth avoiding. While some studies suggest that Omicron (and possibly its variants) appear to present a lower risk of contracting COVID for a prolonged period, the risk is still very high. Studies have found that vaccination reduces this risk, although how much to vaccinate remains uncertain.

The potential cumulative health risks associated with contracting COVID-19 multiple times are also of concern. The science is less settled on this one, however one study This month it published 41,000 Veterans and received wide media attention. It found that those who had COVID-19 two or more times had, after six months, nearly double the risk of both prolonged COVID and/or death (not necessarily together) than those who had COVID-19 once.

Infectious disease specialists She was quick to notice The study did not actually track people in person over time. Instead, the study extracted the electronic medical records of nearly 6 million people to find 443,588 people had a single episode of COVID-19, and among that group, 40,947 had two or more episodes of COVID-19. The caveat is that such studies do not prove cause and effect; Factors other than multiple bouts of COVID-19 may increase risk.

The COVID-19, influenza, and RSV alarm bells I mentioned above may come in the coming weeks. The question is whether government and public health officials have the courage to challenge public apathy, inertia, and resistance to implementing a return to public health measures — such as mandatory masking in public, restricted access to public places and events unless vaccinated, and travel warnings.

I think the mandatory masking on public transport should have already been brought back nationwide. Of course, every American can and should adopt a DIY COVID-19, flu, and RSV protocol this winter. Designed for you and your family. As uncomfortable and depressing as it might be to – again – risk the coronavirus for so long, hospitalization and death seems foolish. With luck, there will only be another winter.

Stephen FindlayMPH, independent health policy analyst and journalist. He previously served as a senior health policy analyst at Consumers Union, as well as director of research and policy at the National Institute of Health Care Management.

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